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  1. eCQM Issue Tracker
  2. CQM-5755

CMS 69 eCQM BMI - Acute vs. Ambulatory

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      Thank you for clarifying your follow-up inquiry regarding CMS69v10: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. For v10, the BMI that is evaluated for the measure is the most recent BMI that is documented during a qualifying encounter or in the previous 12 months of a qualifying encounter. In the scenario you provide, if the ED visit and inpatient stay do not contain a qualifying encounter that is part of the "Encounter to Evaluate BMI” (2.16.840.1.113883.3.600.1.1751) value set, then the documented BMI in the acute setting would not be the BMI that is used to satisfy numerator criteria. You may review the codes contained within value sets on the Value Set Authority Center (VSAC) website at https://vsac.nlm.nih.gov/.

      For CMS69v11, with implementation in 2023, the measure will assess any BMI documented during the measurement period that is outside of normal parameters. For v11, in the scenario provided, the BMI documented in the acute setting will likely be evaluated as a BMI that will require follow-up to satisfy numerator criteria.
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      ​ Thank you for clarifying your follow-up inquiry regarding CMS69v10: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. For v10, the BMI that is evaluated for the measure is the most recent BMI that is documented during a qualifying encounter or in the previous 12 months of a qualifying encounter. In the scenario you provide, if the ED visit and inpatient stay do not contain a qualifying encounter that is part of the "Encounter to Evaluate BMI” (2.16.840.1.113883.3.600.1.1751) value set, then the documented BMI in the acute setting would not be the BMI that is used to satisfy numerator criteria. You may review the codes contained within value sets on the Value Set Authority Center (VSAC) website at https://vsac.nlm.nih.gov/ . For CMS69v11, with implementation in 2023, the measure will assess any BMI documented during the measurement period that is outside of normal parameters. For v11, in the scenario provided, the BMI documented in the acute setting will likely be evaluated as a BMI that will require follow-up to satisfy numerator criteria.
    • CMS0069v11
    • CMS0069v10

      Hi, I work for a health system with an EHR that includes both acute and ambulatory. For CMS 69, should an inpatient visit (not a provider in the TIN and wasn't billed under the TIN) be included in the ambulatory quality reporting? I am being told that no matter the provider or billed TIN that it will count. This doesn't make sense to me. Please advise. 

            edave Mathematica EC eCQM Team
            tmccaulla24 Tiffany McCaulla (Inactive)
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