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  1. eCQM Issue Tracker
  2. CQM-6235

CMS-529: Medicare Payer and Payer Value Sets included in Hybrid Measures

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    • Resolution: Answered
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      Hello and thank you for your inquiry. Unfortunately, this ticket is out of scope for the eCQM Issue Tracker. Your question has been redirected to the QualityNet Service Desk, and the following ticket has been opened for you:
      CS2004158
      You will be contacted by their team and assigned a customer service representative who will work to resolve your inquiry. We are closing this ticket now. Please let us know if you have any additional questions about eCQM logic or specifications.
      Show
      Hello and thank you for your inquiry. Unfortunately, this ticket is out of scope for the eCQM Issue Tracker. Your question has been redirected to the QualityNet Service Desk, and the following ticket has been opened for you: CS2004158 You will be contacted by their team and assigned a customer service representative who will work to resolve your inquiry. We are closing this ticket now. Please let us know if you have any additional questions about eCQM logic or specifications.
    • CMS0529v3
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      We submitted CMS-529 files last October and did not receive an HSR due to what we thought were missing MBI/HICN numbers. The SOP we submitted on most of the files was 1-Medicare. Our medical record vendor thinks this is why we didn't receive feedback due to our files not being identified as Medicare FFS patients. They advise that the SOP CMS is looking to link is 121-Medicare FFS. When we look at the specifications, it seems the value sets tied to Medicare Payer and Payer both include 1-Medicare.

      Our question is do we need to have an SOP of 121-Medicare FFS on these files to CMS to even recognize the files as a Medicare FFS patient to begin matching to our claims data or can it be any value included in the value sets provided in the specifications for Medicare Payer and Payer? Is that truly the only SOP CMS is looking for?
      Show
      We submitted CMS-529 files last October and did not receive an HSR due to what we thought were missing MBI/HICN numbers. The SOP we submitted on most of the files was 1-Medicare. Our medical record vendor thinks this is why we didn't receive feedback due to our files not being identified as Medicare FFS patients. They advise that the SOP CMS is looking to link is 121-Medicare FFS. When we look at the specifications, it seems the value sets tied to Medicare Payer and Payer both include 1-Medicare. Our question is do we need to have an SOP of 121-Medicare FFS on these files to CMS to even recognize the files as a Medicare FFS patient to begin matching to our claims data or can it be any value included in the value sets provided in the specifications for Medicare Payer and Payer? Is that truly the only SOP CMS is looking for?

          JLeflore Mathematica EH eCQM Team
          cherman Curin Herman
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