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  1. eCQM Issue Tracker
  2. CQM-6111

CMS 347 Initial population Determination

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      ​​Thank you for your inquiry on CMS347, Statin Therapy for the Prevention and Treatment of Cardiovascular Disease. Population 2 is defined by the following criteria: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia.

      During the most recent annual update process to finalize the CMS347 measure specifications for performance year (PY) 2024, SNOMED code 13644009 was removed from the familial hypercholesterolemia value set (2.16.840.1.113762.1.4.1047.100) used for Population 2. Similarly, during the update for the PY2021 measure specifications, ICD-10 code E78.00 was removed from the familial hypercholesterolemia value set. These changes should address the concern regarding mapping of the SNOMED code (13644009) to ICD diagnosis codes.
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      ​ ​​Thank you for your inquiry on CMS347, Statin Therapy for the Prevention and Treatment of Cardiovascular Disease. Population 2 is defined by the following criteria: Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >= 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia. During the most recent annual update process to finalize the CMS347 measure specifications for performance year (PY) 2024, SNOMED code 13644009 was removed from the familial hypercholesterolemia value set (2.16.840.1.113762.1.4.1047.100) used for Population 2. Similarly, during the update for the PY2021 measure specifications, ICD-10 code E78.00 was removed from the familial hypercholesterolemia value set. These changes should address the concern regarding mapping of the SNOMED code (13644009) to ICD diagnosis codes.
    • CMS0347v7
    • CMS0347v6
    • Accurate CQM reporting

      We need clarification on how to accurately identify 
      Population 2: 
      "Patients aged >= 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C >=190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia."

      E78.01 was a new diagnosis code introduced in 2017.

      The 2017 version of ICD-10 replaced E78.0 with two new options:

      • E78.00 (Pure hypercholesterolemia, unspecified)
      • E78.01 (Familial hypercholesterolemia

      Any familial hypercholesterolemia diagnosed before 2017 would be under E78.0

      ICD10 was implemented 10/1/2015. Before 10/1/15, ICD9 would be in use.

      In our EHR  the E78.00 code is mapped to the  SNOMED code (13644009). This SNOMED code is also mapped to other diagnoses, including E78.01. Therefore, a patient with dx  E78.00, gets identified as population 2 due to the SNOMED mapping of these diagnoses.

      Would CMS consider this result appropriate?

            edave Mathematica EC eCQM Team
            hensonsw@bcm.edu Gail Henson-Swaney
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