​Thank you for your inquiry for CMS165v10, Controlling High Blood Pressure and CMS122v10, Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%). These measures are specified using the Quality Data Model (QDM) version 5.5 Guidance for the 2022 performance period. Evidence of hypertension or diabetes is required, as documented via the "Diagnosis" QDM datatype, using any codes from the respective value sets, "Essential Hypertension" (2.16.840.1.113883.3.464.1003.104.12.1011) or "Diabetes" ((2.16.840.1.113883.3.464.1003.103.12.1001). As stated in the QDM v5.5 Guidance for this datatype ( https://ecqi.healthit.gov/sites/default/files/QDM-v5.5-Guidance-Update-May-2020-508.pdf), "the QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR."; therefore, hypertension or diabetes determined either via patient history or examination that were mapped to this QDM datatype are acceptable for evaluating denominator criteria.

If a specialist provider adds hypertension or diabetes to the Past Medical History section of the visit note, will that put the patient in the denominator for these two metrics? Their EMR is pulling these patients into the denominator in their MIPS dashboard; however, I thought these diagnoses would have to be in the Assessment section of the note rather than Past Medical History. Please clarify.