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  2. CQM-1707

EP 0068 (and other measures) not including office consults in denominator criteria

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Minor Minor
    • ValueSet
    • None
    • Eric Gunther
    • Azara Healthcare
    • Thank you for your question. CPT codes 99241-99245 can be billed for one time consultations. As a result the patient will not have an established relationship with the provider. Therefore, we are excluding them from the measure.
    • CMS164v3/NQF0068
    • Not including some visits that may be clinically relevant

      I've chosen NQF 0068 for this issue, but this does seem to affect a number of measures that use similar value sets to define the encounter component of the denominator criteria.

      These value sets do not include office consults (CPT 99241-99245). Should these be included? If not, what is the clinical reason for not including them in the value set?

            edave Mathematica EC eCQM Team
            eric.gunther Eric Gunther (Inactive)
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