In the past, you have received feedback from organizations on CMS-347 (Statin Therapy) that the Hypercholesterolemia value set was too broad.  (CQM-4109 and CQM-4419)  The valueset was updated for 2022 and renamed to Familial Hypercholesterolemia, with ICD-10 78.00 (Pure hypercholesterolemia) and SNOMED codes 267432004 (Pure hypercholesterolemia) and 414416008 (History of hypercholesterolemia) removed. 

While these were definitely improvements, our clinicians are still finding that the diagnoses included are too broad, and patients are being pulled into the measure even if they don’t clinically require a statin.  After performing some analysis, the main issue appears to be with SNOMED 13644009 (Hypercholesterolemia).  Based on our diagnosis import from IMO, this SNOMED code includes diagnoses such as:
Borderline hypercholesterolemia
Mild hypercholesterolemia
High Cholesterol

The ICD-10 code associated with these diagnoses is 78.00, but they are still being included because of the SNOMED code.

To show the impact of this:  for our primary TIN, about 17,000 patients out of 24,000 that qualify for Population 2 have one of these “general hypercholesterolemia” diagnoses and do not have LDL > 190 or any of the familial diagnoses.

Our clinicians would recommend that SNOMED 13644009 is removed in future years.  Is this under discussion?