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  2. CQM-5461

CMS127v10 Pneumococcal Vaccination Status

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    • Resolution: Answered
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    • Rachael Grastorf
    • 410-227-1413
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      Thank you for your inquiry about CMS127v10, Pneumococcal Vaccination Status. In response to the first and third question, self-reported vaccinations are accepted if they are documented in a structured field in the EHR. There is a note in the guidance that indicates that patient self-report for procedures as well as immunizations should be recorded in 'Procedure, Performed' template or 'Immunization, Administered' template in QRDA-1.
      In response to the second question, the measure requires documentation via QDM v5.5 datatypes "Immunization, Administered" with any codes listed in the "Pneumococcal Polysaccharide 23 Vaccine" value set (2.16.840.1.113883.3.464.1003.110.12.1089), or "Procedure, Performed" with the CPT Code (90732) Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use. For the performance year 2022, implementers may map additional formulations of the pneumococcal conjugate vaccine, including pneumococcal conjugate vaccine 13 valent, pneumococcal conjugate vaccine 15 valent, and pneumococcal conjugate vaccine 20 valent, to the pneumococcal vaccine, unspecified formulation code (CVX code 109) in the Pneumococcal Polysaccharide 23 Vaccine (OID: 2.16.840.1.113883.3.464.1003.110.12.1089) value set.
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      Thank you for your inquiry about CMS127v10, Pneumococcal Vaccination Status. In response to the first and third question, self-reported vaccinations are accepted if they are documented in a structured field in the EHR. There is a note in the guidance that indicates that patient self-report for procedures as well as immunizations should be recorded in 'Procedure, Performed' template or 'Immunization, Administered' template in QRDA-1 . In response to the second question, the measure requires documentation via QDM v5.5 datatypes "Immunization, Administered" with any codes listed in the "Pneumococcal Polysaccharide 23 Vaccine" value set (2.16.840.1.113883.3.464.1003.110.12.1089), or "Procedure, Performed" with the CPT Code (90732) Pneumococcal polysaccharide vaccine, 23-valent (PPSV23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use. For the performance year 2022, implementers may map additional formulations of the pneumococcal conjugate vaccine, including pneumococcal conjugate vaccine 13 valent, pneumococcal conjugate vaccine 15 valent, and pneumococcal conjugate vaccine 20 valent, to the pneumococcal vaccine, unspecified formulation code (CVX code 109) in the Pneumococcal Polysaccharide 23 Vaccine (OID: 2.16.840.1.113883.3.464.1003.110.12.1089) value set.
    • CMS0127v11
    • CMS127v9/NQFna

      Our TIN is reporting on CMS127v10 Pneumococcal Vaccination Status for Older Adults in the 2022 MIPS reporting year.

      1. We are not a primary care TIN, so we do not administer this vaccine. If we simply document that the patient received the vaccine elsewhere, does that meet the intent of this measure?
      2. Is the patient required to have received the PPSV23 vaccine to be considered a "met" for this measure?
      3. Often, the patient is unsure of the kind of vaccine that they received elsewhere. Since we are not administering the vaccine, if we simply document that the patient received a pneumonia vaccine in the past, does that meet the intent of this measure?

            edave Mathematica EC eCQM Team
            Rgrastorf Rachael Grastorf (Inactive)
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