Vachette Pathology

A technical problem affecting 20 Physician Quality Reporting Initiative quality-data codes, including the breast and colon cancer code, has caused some carriers to reject submissions for the first three months of 2009. The Centers for Medicare and Medicaid Services has issued instructions on how physicians may address the problem.

In most cases the status error caused line items containing the breast and colon cancer code to be rejected as unprocessable. CMS anticipates all carriers will be able to accept the affected codes within the next three weeks.

CMS announced it will exclude from the reporting denominator all cases for dates when the carriers could not accept the affected CPT II codes, unless inclusion of cases is more favorable to the physician.

In its notice, CMS provided two approaches to addressing the errors based on whether or not it is beneficial for the physician to seek correction of the affected codes.

The College will continue to monitor this problem, and will publish updates in upcoming issues of Statline.