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  1. eCQM Issue Tracker
  2. CQM-6179

2024 CMS 56 Partial hip arthroplasty only has ICD10PCS codes

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      Thank you for your inquiry for CMS56v12, Functional Status Assessment for Total Hip Replacement . Qualifying partial hip arthroplasties are defined by the codes listed in the value set "Partial Arthroplasty of Hip". Equivalent services can be mapped to the measure's value set. If mapping is done, you should maintain documentation in case of a CMS audit. We will consider updates to the value set in a future annual update cycle.
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      Thank you for your inquiry for CMS56v12, Functional Status Assessment for Total Hip Replacement . Qualifying partial hip arthroplasties are defined by the codes listed in the value set "Partial Arthroplasty of Hip". Equivalent services can be mapped to the measure's value set. If mapping is done, you should maintain documentation in case of a CMS audit. We will consider updates to the value set in a future annual update cycle.
    • CMS0056v12

      The value set "Partial Arthroplasty of Hip" includes only ICD10PCS codes. This is in contrast to the value set "Primary THA Procedure" which includes only SNOMEDCT, CPT, and HCPCS LEVEL II codes.

      "Partial Arthroplasty of Hip" should also include SNOMEDCT, CPT, and HCPCS LEVEL II codes since historical procedures performed outside of the system will not be mapped to ICD10PCS codes. Additionally, external systems will likely not send ICD10PCS codes.

       

      Value set "Removal, Revision and Supplement Procedures of the Lower Body and Spine" has the same issue.

            edave Mathematica EC eCQM Team
            GeorgeWu George Wu (Inactive)
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