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  2. CQM-7210

CMS68 Clarification on encounter

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
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      Thank you for your question regarding CMS68v13: Documentation of Current Medications in the Medical Record.

       

      CMS68 is an episode-based measure that is attributed to all encounters for eligible clinicians during the measurement period. In the example you provided, each qualifying encounter (e.g., a daily visit where a CPT for a qualifying encounter is used) during the inpatient stay that the hospitalists have with the patient is considered a separate encounter (i.e., a separate CPT code being billed for a different eligible clinician), and documentation of medications is required by this measure for all eligible encounters. In other words, each eligible clinician would have to review/document meds at each encounter to satisfy measure requirements.​

       
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      Thank you for your question regarding CMS68v13: Documentation of Current Medications in the Medical Record.   CMS68 is an episode-based measure that is attributed to all encounters for eligible clinicians during the measurement period. In the example you provided, each qualifying encounter (e.g., a daily visit where a CPT for a qualifying encounter is used) during the inpatient stay that the hospitalists have with the patient is considered a separate encounter (i.e., a separate CPT code being billed for a different eligible clinician), and documentation of medications is required by this measure for all eligible encounters. In other words, each eligible clinician would have to review/document meds at each encounter to satisfy measure requirements.​  
    • CMS0068v13

      When a patient qualifies for the measure during an inpatient stay, it raises the question of whether each billed CPT code that qualifies should be counted as a separate encounter, necessitating medication reconciliation for each, or if the entire stay from admission to discharge should be considered a single encounter.

      For instance, if a patient is admitted on January 9th and discharged on January 13th, and each day a hospitalist sees the patient and drops a qualifying encounter code, should this be treated as five separate encounters or just one single encounter?

            AIR EC eCQM Team AIR EC eCQM Team
            jcooper Jessica Cooper (Inactive)
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