NextGen is our ONC certified EHR vendor for reporting PQRS via eCQMs extracted from our EHR for all payers. We recently learned NextGen is using both CPT code and Snomed Visit Type codes to identify qualifying encounters to be included in the denominator and the Snomed Visit Type codes are adding patient encounters to the denominator that should not be based on qualifying CPT code. Example is CMS 138v4 Tobacco Screen and Brief Counseling. We use Office Visit which has an assigned Snomed code for a variety of appointment types (X-Ray Only, Medical Office Assistant Only, Cast Room Only, injection Only, MRI only) and the CPT codes for these appointments are not qualifying codes per measure specification. NextGen data extraction has Snomed Visit Type code trump the CPT code thus adding non-qualifying patient encounters to the denominator and dropping our performance on the measure. This is effecting other measures as well. NextGen white papers recommended denominator workflow instruct adding Snomed Visit Type codes to the encounter is optional but their EHR forces the selection of Visit Type from a limited list. When we reached out to NextGen’s PQRS support team they confirmed we can edit the data extraction module to exclude Snomed Visit Type codes but cautioned this would affect all measures. They are not able to define what affect excluding Snomed Visit Type codes would have on reporting. We reviewed the CMS white papers for definition of qualifying denominator encounters and identified CPT codes. We request confirmation that our GPRO can exclude Snomed Visit Type codes and use CPT codes to identify qualifying encounters for eCQM measures and that Snomed Visit Type codes are an optional alternate method to identify qualifying encounters. Of note, we identified some measures require Snomed codes to report numerators.