Dr. Stu:
Sam, can I interject on that, if you don't have electronic records set up yet for your practice that means that if you're seeing a Medicare patient, each year that you're seeing them Medicare is going to continue to pay you less and less until you get on electronic records …
Dr. Sam:
Right, they do [inaudible 00:11:31].
Dr. Stu:
Up to 5% of their approved rate, not your billing, but the Medicare approved rate.
Dr. Sam:
Exactly, the approval rate, so this year it's 2, then it goes 3, 4 and then in 2020, it caps at 5, so they’ll never go higher than 5, but 5% is pretty good chunk. PQRS does not increase after this year, it stays at 2%, but I think most doctors can comply because it's quite easy. Here's my statement of it, 99% of offices, now this is my opinion, have been performing these measures, you simply must report they're done. The good news is there's no registration, there's nothing you have to do in order to start doing it. You just simply start reporting on the 1500, so no registration, just start reporting the codes. What are the measures that chiropractors have to do? There’re only two, there're 190 measures that are out there for providers to do, but chiropractic only has two. We have Measure 131, which is the pain assessment and then Measure 182, a functional assessment. In simple terms, 131 is what's your pain today, the functional assessment is doing an Oswestry or a functional assessment form. Let’s get into it, how do we report these? These measures must be reported not on every patient thankfully, but 50% of your Medicare visits. If you see a 100 patients and you communicate this on 50 of them, you will still be okay. They do not have to be on every visit, but at least 50% of visits. How we do them is there's going to be extra codes, so you see here that second bullet says, these measures are communicated by Medicare by adding what's called a G code. I'm going to go through each of those codes, but they're just additional billing codes that go on the claim form that have no value, but communicate to Medicare that the reporting or PQRS was done. What I say is don't be intimidated by it or frustrated. A lot of people thing, “Oh my gosh, it's more work.” Not really, you're going to put two extra codes on the claim form. It's simply informing Medicare you did a pain scale and as you can see in the third bullet, it says, a verbal pain scale by the patient satisfies it. It need not be a form. The functional scale does require a form filled out by the patient, but only once every 30 days. That could be your simple neck disability, Oswestry but many others. Let's do the pain assessment. What you're doing with pain assessment is simply informing Medicare that the patient has pain and there’s a follow-up for care. It can also be reported when there's no pain, so obviously there can be pain that's positive and we continue, but there's also pain when the patient says, “Hey, I have no pain today,” which means we're going to release them. There is reporting situations also that what if you have a patient comes in and they refuse to tell you their pain. There's lots of ways of recording this. It's not just a simple yes or no, they have pain, there could be other issues. Let's do the more common ones.
The common codes are common things you can use, you can use almost anything. I think the verbal is simple, but you notice here on list, brief pain inventory, faces pain
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