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  2. CQM-6634

CMS69v11 Value Set Interpretation for Follow Up

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
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    • Christal Mandella
    • 6672392902
    • LifeBridge Health Value Based Care
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      Thank you for your question regarding CMS69 v11: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The numerator logic for follow-up specifies that a follow-up plan included in the “Follow Up for Below Normal BMI" (2.16.840.1.113883.3.600.1.1528), "Follow Up for Above Normal BMI" (2.16.840.1.113883.3.600.1.1525), or “Referrals Where Weight Assessment May Occur” (2.16.840.1.113883.3.600.1.1527) must be ordered or performed during the measurement period and the reason for the follow-up intervention must be specified as ‘overweight’ or ‘underweight’ OR the patient must have a diagnosis of overweight or underweight that starts before or on the day of the intervention and does not end before the day of the intervention. This numerator criteria is in place to indicate that the follow-up is specifically related to the patient’s BMI.

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      Thank you for your question regarding CMS69 v11: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The numerator logic for follow-up specifies that a follow-up plan included in the “Follow Up for Below Normal BMI" (2.16.840.1.113883.3.600.1.1528), "Follow Up for Above Normal BMI" (2.16.840.1.113883.3.600.1.1525), or “Referrals Where Weight Assessment May Occur” (2.16.840.1.113883.3.600.1.1527) must be ordered or performed during the measurement period and the reason for the follow-up intervention must be specified as ‘overweight’ or ‘underweight’ OR the patient must have a diagnosis of overweight or underweight that starts before or on the day of the intervention and does not end before the day of the intervention. This numerator criteria is in place to indicate that the follow-up is specifically related to the patient’s BMI.
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    • CMS0069v11
    • Not measure related
    • We have several tools available to track this eCQM, and all seem to interpret differently and give different performance rates. We want to make sure we are interpreting appropriately and not falsely elevating or depreciating values.

      Our organization is having some challenges interpreting the value set for this measure. If a patient is under/overweight, is the diagnosis a required element for follow up in order to be captured in the numerator? I know there is no benchmark, but we utilize this measure as part of the CMMI MDPCP Program.

            edave Mathematica EC eCQM Team
            cmandella Christal Mandella
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