To report on and bill for PQRI measures, there must be procedures associated with the measures. Select Setup, Procedures/Diagnosis, Procedure Codes to display the Procedure Lookup screen. Use the Search function to find existing procedures, New to create a procedure, Edit to modify an existing procedure and Delete to remove a procedure from the system.
In the example, although 4048F can be added only once, and the system will apply the 1P and 8P modifiers when necessary, it is recommended that a procedure code be created for each one to allow reporting by procedure only as opposed to procedure and modifier. The Bill Zero $ Charge indicates if the procedure should be billed in the event the charge amount is zero. This overrides the option on the Practice Setup – Claims Tab to suppress zero dollar charges. It is a CMS requirement to bill a zero dollar charge.
Note - Some claims clearinghouses will reject zero dollar charges. In that case, CMS will permit billing of $0.01.
