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  1. eCQM Issue Tracker
  2. CQM-7101

CMS-117 childhood Immunization Status (CMS-240): CVX code= 216 not included in the value-set. CDC recommends the following Codes: Pneumococcal Conjugate vaccines: PCV13: CVX code = 133 PCV15 CVX code = 215 PCV 20 CVX Code =216

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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    • Lorri Pilkington
    • 808-346-4334
    • Hawaii Pacific Health
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      Thank you for your inquiry regarding CMS117v12 (Childhood Immunization Status).

      Due to publication timeline, CMS117v12 does not include the recently updated Advisory Committee on Immunization Practices guidelines to include code for specific formulation, PCV20 pneumococcal vaccine formulation, to meet numerator requirements. The eCQM team since has created a known issue linked here: https://oncprojectracking.healthit.gov/support/browse/EKI-27. As indicated in known issue EKI-27, specific to 2024 reporting of the PCV20 pneumococcal vaccine formulation, the ‘Pneumococcal Conjugate Vaccine’ value set (OID: 2.16.840.1.113883.3.464.1003.196.12.1221) does not include CVX code 216. To meet numerator requirements, implementers can either map PCV20 to the ‘pneumococcal vaccine, unspecified formulation’ (CVX code 109) or the ‘Pneumococcal Conjugate, unspecified formulation’ (CVX code 152), as a workaround. If mapping is conducted, you should maintain documentation in case of a CMS audit. We are unable to update the published value set for 2024 reporting; however, please note that CVX code 216 is included in the published value set for 2025 reporting.
      Show
      Thank you for your inquiry regarding CMS117v12 (Childhood Immunization Status). Due to publication timeline, CMS117v12 does not include the recently updated Advisory Committee on Immunization Practices guidelines to include code for specific formulation, PCV20 pneumococcal vaccine formulation, to meet numerator requirements. The eCQM team since has created a known issue linked here: https://oncprojectracking.healthit.gov/support/browse/EKI-27 . As indicated in known issue EKI-27 , specific to 2024 reporting of the PCV20 pneumococcal vaccine formulation, the ‘Pneumococcal Conjugate Vaccine’ value set (OID: 2.16.840.1.113883.3.464.1003.196.12.1221) does not include CVX code 216. To meet numerator requirements, implementers can either map PCV20 to the ‘pneumococcal vaccine, unspecified formulation’ (CVX code 109) or the ‘Pneumococcal Conjugate, unspecified formulation’ (CVX code 152), as a workaround. If mapping is conducted, you should maintain documentation in case of a CMS audit. We are unable to update the published value set for 2024 reporting; however, please note that CVX code 216 is included in the published value set for 2025 reporting.
    • CMS0117v12
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       CVX code= 216 not included in the value-set. CDC recommends the following Codes: Pneumococcal Conjugate vaccines: PCV13: CVX code = 133 PCV15 CVX code = 215 PCV 20 CVX Code =216Our organization follows the current CDC recommendations.
      We are providing the correct care but are not getting credit for the great care given.
      Show
       CVX code= 216 not included in the value-set. CDC recommends the following Codes: Pneumococcal Conjugate vaccines: PCV13: CVX code = 133 PCV15 CVX code = 215 PCV 20 CVX Code =216Our organization follows the current CDC recommendations. We are providing the correct care but are not getting credit for the great care given.

      According to the current CDC guidelines, PCV 20 code 216 is a recommended Pneumococcal vaccine. This is the vaccine given to our patients. We are providing the correct care according to the CDC, but are not getting credit for the great care given.

      Please add this code to the acceptable/allowable PN vaccines

            edave Mathematica EC eCQM Team
            Lpilkington Lorri pilkington
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