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  1. eCQM Issue Tracker
  2. CQM-5556

eCQM 130 Colorectal Cancer Claim data

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
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      Thank you for your inquiry about CMS130v11 (2023 Performance Period). The eCQMs are designed to use clinical data extracted from structured fields in EHRs. In order for the colonoscopy to be included in the numerator criteria, for example, the procedure must be documented using any codes from the "Colonoscopy" value set, with documented date/time indicating that it was performed within the measurement time frame. Result is not required for colonoscopy, but a "non-null" result is required for other screening options such as FOBT and FIT-DNA laboratory tests. A non-null result can be interpreted as a result that is present in the electronic record in which any entry is acceptable; no specific value or code is required. Equivalent services can be mapped to the measure's value sets. If mapping is done, you should maintain documentation in case of a CMS audit.
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      Thank you for your inquiry about CMS130v11 (2023 Performance Period). The eCQMs are designed to use clinical data extracted from structured fields in EHRs. In order for the colonoscopy to be included in the numerator criteria, for example, the procedure must be documented using any codes from the "Colonoscopy" value set, with documented date/time indicating that it was performed within the measurement time frame. Result is not required for colonoscopy, but a "non-null" result is required for other screening options such as FOBT and FIT-DNA laboratory tests. A non-null result can be interpreted as a result that is present in the electronic record in which any entry is acceptable; no specific value or code is required. Equivalent services can be mapped to the measure's value sets. If mapping is done, you should maintain documentation in case of a CMS audit.
    • CMS0130v11
    • Our organization plans to turn on care everywhere claim data to satisfy the measure criteria. We like to confirm the claim data only would satisfy the measure criteria.

      Hi! 

      Our organization plans to turn on care everywhere claim data to satisfy the measure criteria. We like to confirm the claim data only would satisfy the measure criteria.

      For example, measure criteria is met if  we receive the claim data for colonoscopy procedure performed without the results of the procedure.

      Thanks!

            edave Mathematica EC eCQM Team
            S0188724 Shuchuan Yang
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