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  1. eCQM Issue Tracker
  2. CQM-1990

Can we capture CPT codes for satisfaction of CQM: CMS124v5.0.000

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    • Anna Dupuis
    • 617-402-6001
    • athenahealth
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      Thank you for your question. CPT & HCPCS codes are transition vocabularies for laboratory tests and are not recommended by the Health IT Standards Committee. Therefore, we did not include them in our Pap Test value set. However, they could be mapped if they technically and clinically correspond to the codes that are present in the measure. If audited, the system would be expected to show documentation supporting this correspondence.

      Our team will internally discuss adding these codes during the next round of annual updates. Any changes we make will not be reflected until the 2017 measure update cycle is completed.
       
      Show
      Thank you for your question. CPT & HCPCS codes are transition vocabularies for laboratory tests and are not recommended by the Health IT Standards Committee. Therefore, we did not include them in our Pap Test value set. However, they could be mapped if they technically and clinically correspond to the codes that are present in the measure. If audited, the system would be expected to show documentation supporting this correspondence. Our team will internally discuss adding these codes during the next round of annual updates. Any changes we make will not be reflected until the 2017 measure update cycle is completed.  
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      The CMS124v5.0.000 CQM does not currently list CPT codes for a Pap test for satisfaction of our eCQM. The HEDIS 2016 specifications list the following codes for satisfaction of this measure: 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88164, 88165, 88166, 88167, 88174, 88175, G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, P3000, P3001, Q0091. Without these codes included in the CQM, patients will be potentially satisfying the HEDIS measure by documenting this code, but not satisfying the CQM. Can these codes be included in the satisfaction criteria of this measure?
      Show
      The CMS124v5.0.000 CQM does not currently list CPT codes for a Pap test for satisfaction of our eCQM. The HEDIS 2016 specifications list the following codes for satisfaction of this measure: 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88164, 88165, 88166, 88167, 88174, 88175, G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, P3000, P3001, Q0091. Without these codes included in the CQM, patients will be potentially satisfying the HEDIS measure by documenting this code, but not satisfying the CQM. Can these codes be included in the satisfaction criteria of this measure?

          edave Mathematica EC eCQM Team
          adupuis Anna Dupuis (Inactive)
          Anna Dupuis (Inactive)
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