If the Consensus Standards Approval Committee has made a positive

If the Consensus Standards Approval Committee has made a positive recommendation for a measure (full or time-limited endorsement), it is then sent to the Board of Directors for final approval. Once “board ratification,” step 7 selleck inhibitor of the process, has been achieved, the measures are published online and accessible

to the public. Should anyone dispute the final decision of the Board of Directors, a 30-day postendorsement window exists for formal appeal, the eighth and final step of the NQF measure development process. Once a measure has been developed and/or endorsed, it may be used by a variety of agencies, hospitals, physician groups, health insurance companies, and other health care entities. NQF endorsement may

or may not be a prerequisite to measure implementation. Measures used for pay-for-performance, pay-for-reporting, accreditation, or maintenance of certification purposes often have NQF endorsement. Measures used for internal quality improvement may or may not have NQF endorsement. In many quality reporting programs, data for quality measures are typically extracted from claims information or patient medical records. For the PQRS, the Inpatient Quality Reporting Program and the Hospital Outpatient Quality Reporting Program online manuals describe how to implement the available measures, including Ibrutinib in vitro the relevant patient demographics, International Classification of Diseases, ninth rev, Clinical Modification and CPT codes, and how to calculate the numerator and denominator 23, 27, 28 and 29. For example, relevant CPT codes for PQRS measure 195 (NQF 0507), “Stenosis Measurement in Carotid Imaging Reports,” include codes for neck MR angiography, neck CT angiography, neck duplex ultrasound, and carotid angiography. A CPT category II code exists for satisfactory reporting of the quality measure. Eligible CPT and Selleck Etoposide International Classification of Diseases, ninth rev, Clinical Modification codes are explicitly

listed for each measure, as are the inclusion and exclusion criteria. To tally groups in the numerator and denominator accurately, cases subject to inclusion and exclusion should be documented. Criteria for exclusion may include medical-related, patient-related, or systems-related reasons. Excluded cases should have an appropriate modifier to the CPT category II codes for the measure. Measure data that are gathered after measure development or endorsement are applied for the purposes of quality improvement and accountability. Every 3 years, an NQF fully endorsed measure undergoes periodic maintenance review and enhancement, an evaluation process to ensure that measures remain relevant and continue to reflect best practices.

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