From September, this will be an auto CQRS extraction.
To ensure practices qualify for payment in future automated extractions, it is essential that both the RSV vaccination and a pregnancy code are recorded on the same day in the patient record.
This is unusual as you will have already coded the patient’s pregnancy, however, the extraction is not looking back for previous pregnancy codes nor it is looking to see whether the patient is 28 weeks or more pregnant, this is something you will need to check.
Check 1 – September extraction – likely this will have been missed as the notification only came out in October. You may need to identify patients who should have been extracted and make a manual submission for any missed claims
Check 2 – Ensure everyone is aware they must add in a patient pregnant code the same day as they administer the RSV.
Check 3 – Validate your claims each month – the link below is the timetable for extractions, we recommend you validate your claims prior to the extraction date and add in the pregnancy code if any are missing from the extraction
