What does it mean when PQRI talks about the numerator and the denominator for measures?
I avoided PQRI, because I hate that math talk! However, after I got over my math fear, I found it was fairly simple. If you think about a fraction, the numerator is the number on top, and denominator is on the bottom. (I apologize to you math-types, for whom this is like saying, we breathe air.)
As far as PQRI is concerned, the numerator is the number of times for an individual measure that you correctly reported a Quality Data Code (QDC.) Let’s say, for simplicity, you reported 82 times on measure number one.
The denominator is the number of claims you submitted that met the criteria of an individual code. For measure number one, the number of times you provided an office visit (other codes are eligible in measure 1) for a patient on whom you reported on of the diabetes codes (there are a number of eligible diagnosis codes.)
For this example, let’s say you submitted claims for an office visit with a diabetes codes 150 times. If you reported a quality data code on 82 of these, (82/150) you would have not been successful in reporting this measure. You would have reported only 54.6%.
If, however, you had submitted claims for office visits on patients with a diagnosis code of diabetes 100 times, and you reported a QDC code 82 times, (82/100) or 82% of the time. Success!!