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  2. CQM-5352

Why is the logic updated to exclude telehealth (or virtual) encounters using the representation (class !~virtual) for measures that do not contain telehealth encounter codes?

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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    • Nancy Smith
    • 7176808500
    • CureMD
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      ​​Thank you for your inquiry regarding the telehealth eligibility of measures, such as CMS646v3: Intravesical Bacillus-Calmette-Guerin for non-muscle invasive bladder cancer. Per Table 3 of the 2023 EC Telehealth Guidance document (https://ecqi.healthit.gov/sites/default/files/2023-EC-Telehealth-Guidance.pdf), there are several eCQMs that are not eligible for telehealth encounters. These measures, including CMS646v3, may contain value sets that include codes for encounters that are considered telehealth-eligible. However, based upon the measures' required clinical action(s), telehealth encounters are not considered appropriate (more details are found within Table 3 of the document). Recent changes to the standards used to develop the eCQM technical specifications now allow for the application of the encounter.class attribute as a way to explicitly exclude telehealth-eligible encounters from meeting the measure's requirements. The use of ' .class !~ "virtual" ' within the logic indicates encounters that use the 'Virtual' code along with the .class attribute will be excluded from the measure criteria.
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      ​​Thank you for your inquiry regarding the telehealth eligibility of measures, such as CMS646v3: Intravesical Bacillus-Calmette-Guerin for non-muscle invasive bladder cancer. Per Table 3 of the 2023 EC Telehealth Guidance document ( https://ecqi.healthit.gov/sites/default/files/2023-EC-Telehealth-Guidance.pdf), there are several eCQMs that are not eligible for telehealth encounters. These measures, including CMS646v3, may contain value sets that include codes for encounters that are considered telehealth-eligible. However, based upon the measures' required clinical action(s), telehealth encounters are not considered appropriate (more details are found within Table 3 of the document). Recent changes to the standards used to develop the eCQM technical specifications now allow for the application of the encounter.class attribute as a way to explicitly exclude telehealth-eligible encounters from meeting the measure's requirements. The use of ' .class !~ "virtual" ' within the logic indicates encounters that use the 'Virtual' code along with the .class attribute will be excluded from the measure criteria.
    • CMS0646v3

      Why is the logic updated to exclude telehealth (or virtual) encounters using the representation (class !~virtual) for measures that do not contain telehealth encounter codes? 

      For example, in CMS 646v3, class !~virtual is mentioned in the qualifying encounter definition even when no virtual visit encounter is listed: 

      Has Qualifying Encounter 

      exists ["Encounter, Performed": "Office Visit"] ValidEncounter 

        where ValidEncounter.relevantPeriod during "Measurement Period" 

          and ValidEncounter.class !~ "virtual"

       

       

      Additionally,  we have referred to the telehealth guidance document and we're not understanding what you mean by 'eCQMs not eligible for telehealth encounter - may contain telehealth eligible encounter'. As stated before, CMS 646 does not contain any telehealth encounters so why is it listed that the eCQMs that may contain telehealth encounters. Which telehealth encounters are you referring to?

      https://ecqi.healthit.gov/sites/default/files/2023-EC-Telehealth-Guidance.pdf 

        1. Table 3.jpg
          Table 3.jpg
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            edave Mathematica EC eCQM Team
            Nsmith Nancy
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