As soon as you have installed certified ChiroSuiteEHR version 17.0 or certified ChiroPadEMR version 17.0, start using the PQRS codes on the claims you submit to Medicare. You will eventually find that some specific codes are used frequently while some may never be used. Note that Medicare revises the PQRS codes annually, so be vigilant to use the correct code.
•Pain Assessment Prior to Initiation of Treatment – use only 1 of the following on each visit
o G8730 – You assessed the patient for pain AND documented a follow up plan that specifies when you will reassess the patient for pain
o G8731 – You assessed the patient for pain
§ but did NOT write out a follow up plan
§ but DID document a valid reason why no follow up plan was developed
•valid reasons for no follow up plan for pain are
o patient had no pain
o patient’s condition was NOT related to his/her pain
o G8509 – You assessed the patient for pain
§ But did NOT document a follow up plan
§ And did NOT give a valid reason for not creating a plan
o G8442 – You did NOT assess for pain but DID document why in the patient record
§ Valid reasons for NOT assessing pain
•Patient refusal
•Mental or physical incapacity
•Need for urgent care
•The pain was assessed during a recent visit and it is not yet time for the scheduled reassessment
o G8732 – You did NOT assess for pain AND you did NOT document why
•Functional Outcome Assessment in Chiropractic Care – as the name states, it is specific to Chiropractic
o You must have the patient complete a functional outcome assessment form at least once every 30 days while the patient is under Active Treatment, such as
§ Oswestry Disability Index
§ Roland Morris Disability/Activity Questionnaire
§ Neck Disability Index
§ Pain Disability Questionnaire
§ Any other standardized functional outcome assessment form that you prefer
o You must be able to prove that the patient completed the form, that is, it MUST be signed by the patient
o You must report both
§ when the functional outcome assessment was performed (every initial exam and re-exam) and
§ when it was NOT done (every regular office visit between exams)
o G8539 – on each visit when
§ the patient completed a functional outcome assessment form
§ you documented a care plan
o G8542 – on each visit when
§ A functional outcome assessment form was completed by the patient
§ But you did NOT document a care plan for a valid reason, such as
•Patient had NO functional deficiency
o G8543 – on each visit when
§ A functional outcome assessment form was completed by the patient
§ But you did NOT document a care plan AND
§ You did NOT explain why it was not documented
o G8942 – on each visit when
§ A functional outcome assessment was completed within the previous 30 days
o G8540 – on each visit when
§ A functional outcome assessment form was NOT completed by the patient
§ But you did document a valid reason why it was not done, such as
•Having a current functional assessment in the patient file that was performed within the past 30 days
•The patient refused to complete the form
o G8541 – on each visit when
§ A functional outcome assessment form was NOT completed by the patient
§ And you did NOT document a reason explaining why it was not done
In the ChiroPadEMR section of ChiroSuiteEHR, enter the PQRS items on the Plan window of ChiroPadEMR. The PQRS codes should be listed in the Modality column. Depending on the item, the region to select may be ‘patient’, or a specific body part.
In this example the mandatory PQRS codes are shown, as well as some optional PQRS codes