With the broadened definition for Eligible Clinicians, I am reviewing more closely how some providers will be captured appropriately for given measures. In my experience over the last few years, billing CPT codes has been a primary mechanism for attributing a patient to a provider to a measure.

There are some very generic SNOMED codes within the Encounter Performed value sets. For example 308335008 Patient encounter procedure (procedure) falls into most Encounter value sets and is found in 48 measures for 2017. SNOMED 308335008 by definition encompasses a significant number of patient/provider encounters including an ED visit 4525004 (child of 308335008).

With that said, an ED provider who bills a CPT 99283 (ED visit) might have a zero population for certain measures like CMS068, CMS155, and many others unless a mapping between CPT and SNOMED were to occur. Using only CPT 99283, limits the measure choices to just 6 - CMS022, CMS137, CMS146, CMS154, CMS161, CMS166.

If the EHR were to map various CPTs like 99283 to a generic SNOMED such as 308335008, nearly every measure would then become eligible to report for said provider.

Please allow me to state that I am not inquiring to the accuracy of the mapping example above, but to the intent of using very broad SNOMED codes such as 308335008. I have reviewed all the jira tickets on CPT to SNOMED mapping prior to opening this ticket. Regardless of how it is used in mapping or code assignment, it will make a patient widely eligible for most measures denominators.

Is the intent of the generic snomed codes listed across many value sets to allow for the majority of encounters to be considered for the measures?