Use of RxNorm codes for CMS69v9, CMS2v10

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Megan Carlucci
    • 2020551727
    • National Committee for Quality Assurance (NCQA)
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      ​​Thank you for your inquiry regarding CMS2v10: Preventive Care and Screening: Screening for Depression and Follow-Up Plan and CMS69v9: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. Both of these are quality measures with several reporting modalities, including electronic clinical quality measures (eCQM), MIPS clinical quality measures (CQM), and Medicare Part B claims. For the eCQM modality, data from EHRs and/or health information technology systems are used to capture and report the clinical quality action of interest. For more information about each reporting modality and associated data sources, please visit the Quality Payment Program Resource Library at https://qpp.cms.gov/resources/resource-library. In order to satisfy reporting requirements for the eCQM modalities of these measures, medications prescribed as a follow-up plan for a positive depression screen or an out-of-range BMI must be identified using codes that are included in the value sets listed in the current measure specifications. For more details on the codes contained within the value sets, please visit the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/.

      CMS69v9 has been suppressed for the 2021 performance period, while guidance has been released for reporting CMS69v10 for the 2022 performance period.

      In December 2021 CMS announced suppression of CMS69v9.

      https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1732/2021%20MIPS%20Quality%20Measure%20Suppression.pdf

      The measure suppression is due to a misalignment between the numerator logic and the numerator as described in the measure header. A Known Issue, posted in November 2021 provides additional details related to this misalignment present in both CMS69v9 and CMS69v10. https://oncprojectracking.healthit.gov/support/browse/EKI-13

      For the CMS69v10 CMS published guidance, posted on the ECQI resource center, to support measure implementation for 2022.

      https://ecqi.healthit.gov/sites/default/files/CMS69v10_BMI_Measure_Guidance.pdf
      Show
      ​​Thank you for your inquiry regarding CMS2v10: Preventive Care and Screening: Screening for Depression and Follow-Up Plan and CMS69v9: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. Both of these are quality measures with several reporting modalities, including electronic clinical quality measures (eCQM), MIPS clinical quality measures (CQM), and Medicare Part B claims. For the eCQM modality, data from EHRs and/or health information technology systems are used to capture and report the clinical quality action of interest. For more information about each reporting modality and associated data sources, please visit the Quality Payment Program Resource Library at https://qpp.cms.gov/resources/resource-library . In order to satisfy reporting requirements for the eCQM modalities of these measures, medications prescribed as a follow-up plan for a positive depression screen or an out-of-range BMI must be identified using codes that are included in the value sets listed in the current measure specifications. For more details on the codes contained within the value sets, please visit the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/ . CMS69v9 has been suppressed for the 2021 performance period, while guidance has been released for reporting CMS69v10 for the 2022 performance period. In December 2021 CMS announced suppression of CMS69v9. https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1732/2021%20MIPS%20Quality%20Measure%20Suppression.pdf The measure suppression is due to a misalignment between the numerator logic and the numerator as described in the measure header. A Known Issue, posted in November 2021 provides additional details related to this misalignment present in both CMS69v9 and CMS69v10. https://oncprojectracking.healthit.gov/support/browse/EKI-13 For the CMS69v10 CMS published guidance, posted on the ECQI resource center, to support measure implementation for 2022. https://ecqi.healthit.gov/sites/default/files/CMS69v10_BMI_Measure_Guidance.pdf
    • CMS2v10/NQF0418e, CMS69v9/NQFna
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      Hello,

      Our project team received the inquiry and feedback below from an external partner regarding the following measures: CMS69v9 and CMS2v10. We would appreciate any insight your team is able to provide on this inquiry.

      Thank you!
      Megan
      Show
      Hello, Our project team received the inquiry and feedback below from an external partner regarding the following measures: CMS69v9 and CMS2v10. We would appreciate any insight your team is able to provide on this inquiry. Thank you! Megan

      Inquiry:

      We are reporting the CMS69v9 and CMS2v10 measures, which both use RxNorm codes in the value set to identify medications. If our organization does not use RxNorm codes for medications, can we adjust our query to find the corresponding medication name as free text? In general, for eCQMs, may we use data outside of claims data (e.g., medical record data) to report the measure?

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Megan Carlucci
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              Created:
              Updated:
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