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  2. CQM-5883

MIPS Quality CQM vs eCQM

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Moderate Moderate
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    • Josean Cook
    • 9542577363
    • Pet Imaging- Tri County
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      ​eCQM measure logic includes references to valuesets, which contain a number of codes (SNOMED, CPT, ICD, etc.) that describe clinical and administrative concepts in quality measures. For CMS50V10, Closing the Referral Loop: Receipt of Specialist Report, 'Face to Face Encounter' is defined as follows:

      Has Face to Face Encounter during Measurement Period

      exists ( ( ["Encounter, Performed": "Office Visit"]
          union ["Encounter, Performed": "Ophthalmological Services"]
          union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"]
          union ["Encounter, Performed": "Preventive Care Services, Initial Office Visit, 0 to 17"]
          union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"]
          union ["Encounter, Performed": "Preventive Care, Established Office Visit, 0 to 17"] ) FaceToFaceEncounter
          where FaceToFaceEncounter.relevantPeriod during "Measurement Period
      With the "Data Criteria (QDM Data Elements)" section of the eCQM logic, you will find corresponding value sets that contains codes for types of visits included in the measure:
      "Encounter, Performed: Office Visit" using "Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001)"
      "Encounter, Performed: Ophthalmological Services" using "Ophthalmological Services (2.16.840.1.113883.3.526.3.1285)"
      "Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up" using "Preventive Care Services - Established Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1025)"
      "Encounter, Performed: Preventive Care Services, Initial Office Visit, 0 to 17" using "Preventive Care Services, Initial Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1022)"
      "Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up" using "Preventive Care Services-Initial Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1023)"
      "Encounter, Performed: Preventive Care, Established Office Visit, 0 to 17" using "Preventive Care, Established Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1024)"
      You can search for codes within valuesets at the Value Set Authority Center (VSAC) https://vsac.nlm.nih.gov/welcome. You will need to sign up for a free account (upper right hand corner of webpage). Enter the valueset number in the query box and then click the 'OID'. The codes within the value set will be displayed and are downloadable.
      Show
      ​eCQM measure logic includes references to valuesets, which contain a number of codes (SNOMED, CPT, ICD, etc.) that describe clinical and administrative concepts in quality measures. For CMS50V10, Closing the Referral Loop: Receipt of Specialist Report, 'Face to Face Encounter' is defined as follows: Has Face to Face Encounter during Measurement Period exists ( ( ["Encounter, Performed": "Office Visit"]     union ["Encounter, Performed": "Ophthalmological Services"]     union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"]     union ["Encounter, Performed": "Preventive Care Services, Initial Office Visit, 0 to 17"]     union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"]     union ["Encounter, Performed": "Preventive Care, Established Office Visit, 0 to 17"] ) FaceToFaceEncounter     where FaceToFaceEncounter.relevantPeriod during "Measurement Period With the "Data Criteria (QDM Data Elements)" section of the eCQM logic, you will find corresponding value sets that contains codes for types of visits included in the measure: "Encounter, Performed: Office Visit" using "Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001)" "Encounter, Performed: Ophthalmological Services" using "Ophthalmological Services (2.16.840.1.113883.3.526.3.1285)" "Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up" using "Preventive Care Services - Established Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1025)" "Encounter, Performed: Preventive Care Services, Initial Office Visit, 0 to 17" using "Preventive Care Services, Initial Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1022)" "Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up" using "Preventive Care Services-Initial Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1023)" "Encounter, Performed: Preventive Care, Established Office Visit, 0 to 17" using "Preventive Care, Established Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1024)" You can search for codes within valuesets at the Value Set Authority Center (VSAC) https://vsac.nlm.nih.gov/welcome . You will need to sign up for a free account (upper right hand corner of webpage). Enter the valueset number in the query box and then click the 'OID'. The codes within the value set will be displayed and are downloadable.
    • CMS0050v11
    • When submitting eCQMs are providers required to bill a required Patient encounter during (CPT or HCPCS) as with MIPS CQMs? .

      For example, please see Closing the Referral Loop: Receipt of Specialist Report  eCQM CMS50v10   no CPT codes reflected  as with to MIPS CMS 374

       MIPS CQM 374
      Patient encounter during the performance period (CPT or HCPCS): 92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99381*, 99382*, 99383*, 99384*, 99385*, 99386*, 99387*, 99391*, 99392*, 99393*, 99394*, 99395*, 99396*, 99397

            edave Mathematica EC eCQM Team
            JOSEANLOVE23 Josean Cook (Inactive)
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