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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Critical
    • Component/s: None
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      Thank you for your follow up question. The eCQMs identified in your inquiry are intended are intended to be reported by eligible clinicians, and therefore, CPT codes would be appropriate. There are other measures that are used for inpatient in the Eligible Hospital program, which can be found on the eCQI Resource Center (https://ecqi.healthit.gov/eh-cah?qt-tabs_eh=0&globalyearfilter=2022).
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      Thank you for your follow up question. The eCQMs identified in your inquiry are intended are intended to be reported by eligible clinicians, and therefore, CPT codes would be appropriate. There are other measures that are used for inpatient in the Eligible Hospital program, which can be found on the eCQI Resource Center ( https://ecqi.healthit.gov/eh-cah?qt-tabs_eh=0&globalyearfilter=2022 ).

      Hello we received a response from you for our questions regarding inpatient CPT mapping codes. (See below)

       

      We have follow up questions regarding this response.

      Good Morning,
      We are looking for clarification on "equivalent services". We are in an inpatient facility therefore those mapped codes are not used in the inpatient CPT codes. So, is it one to one CPT codes or is is equivalent services based on the encounter? 

      Previous response:
      Thank you for your inquiry regarding CMS127, 135, 138, 139, 144, 146, and 156. The value sets are "frozen" for the current performance period. Equivalent services can be mapped to the value sets, e.g., see example below for codes/value sets required for CMS127v10 denominator. If mapping is conducted, you should maintain documentation in the event of a CMS audit. The value sets that correspond to the inpatient population/denominator are located in the in the eCQM measure specifications. Please reference the Value Set Authority Center (https://vsac.nlm.nih.gov/) for to view the codes contained in the specified value sets. You can submit codes for measure developers to review for inclusion in future years.

      valueset "Office Visit" (2.16.840.1.113883.3.464.1003.101.12.1001)
      valueset "Annual Wellness Visit" (2.16.840.1.113883.3.526.3.1240)
      valueset "Preventive Care Services - Established Office Visit, 18 and Up" (2.16.840.1.113883.3.464.1003.101.12.1025)
      valueset "Preventive Care Services-Initial Office Visit, 18 and Up" (2.16.840.1.113883.3.464.1003.101.12.1023)
      valueset "Home Healthcare Services" (2.16.840.1.113883.3.464.1003.101.12.1016)
      valueset "Care Services in Long-Term Residential Facility" (2.16.840.1.113883.3.464.1003.101.12.1014)
      valueset "Nursing Facility Visit" (2.16.840.1.113883.3.464.1003.101.12.1012)
      valueset "Discharge Services - Nursing Facility" (2.16.840.1.113883.3.464.1003.101.11.1065)
      valueset "Online Assessments" (2.16.840.1.113883.3.464.1003.101.12.1089)
      valueset "Telephone Visits" (2.16.840.1.113883.3.464.1003.101.12.1080)
      code "Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal." ("CPT Code (99211)")

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Dallas Luciotti (Inactive)
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