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  1. eCQM Issue Tracker
  2. CQM-7166

eCQM 165 ICD-10 Diagnosis Codes

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      Thank you for your inquiry for CMS165v12 (2024 performance period). You are correct that those codes are not included in the measure as exclusions. We will review the codes for potential inclusion in future publication.

      Please review the measure specification for codes/data that do meet the advanced illness/frailty exclusion criteria, for example, it is the combination of age, frailty, and advanced illness that would qualify patients to be excluded, not just frailty. Please also note that the measure has other exclusions, such as evidence of ESRD, dialysis or renal transplant. If you need assistance reviewing data requirements from measure specifications, please refer to guidance available on eCQI Resource Center. Clinically equivalent services may be mapped to codes in the value sets. If mapping is done, documentation should be retained in case of a CMS audit.
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      Thank you for your inquiry for CMS165v12 (2024 performance period). You are correct that those codes are not included in the measure as exclusions. We will review the codes for potential inclusion in future publication. Please review the measure specification for codes/data that do meet the advanced illness/frailty exclusion criteria, for example, it is the combination of age, frailty, and advanced illness that would qualify patients to be excluded, not just frailty. Please also note that the measure has other exclusions, such as evidence of ESRD, dialysis or renal transplant. If you need assistance reviewing data requirements from measure specifications, please refer to guidance available on eCQI Resource Center. Clinically equivalent services may be mapped to codes in the value sets. If mapping is done, documentation should be retained in case of a CMS audit.
    • CMS0165v12
    • Codes are not included in value set to determine exclusion

      Please clarify why the following ICD-10 Codes are not in the value set for eCQM 165 as facts for Denominator Exclusion/Frailty.

       

      Z99.2 Dependence on renal dialysis

      R53.83 Other fatigue

      Thank you! 
      Jen 

            edave Mathematica EC eCQM Team
            jdchang Jennifer Chang
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