The IPP of CMS 113 has an AND statement that requires a diagnosis where the value set includes only ICD-9 codes. The deadline to transition away from ICD-9 has already passed. A number of vendors no longer use ICD-9 codes. This means they cannot meet this measure.

What is the guidance related to how vendors are expected to meet this measure?

Are providers without ICD-9 codes excused from this measure?

Would it be acceptable to add ICD-10 codes to the value sets used during calculation? This would cause the measure to calculate correctly but the QRDA Cat 1 files would have the ICD-10 code. This would be the preferred method because we would not need to alter the individual EHR software or the data stored in it, or make changes to the calculation engine. The codes recorded by the actual provider in the EHR would be preserved.

During a recent Cypress call it was suggested to map codes to ICD-9. If vendors are being asked to map codes for the purpose of CQM calculation is there any mapping provided? Most importantly, what are the codes that will survive an audit? Since ICD-9 does not have 1-to-1 mapping to ICD-10, is there any suggestion when there is no corresponding ICD-9 value for any ICD-10?