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  1. eCQM Issue Tracker
  2. CQM-7250

Need to know if we are able to use compatible LOINC codes instead of ones listed for CMS 153

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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    • Kristin Silva
    • 3058775005
    • Femwell Group Health
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      Thank you for your inquiry regarding CMS153v13. We noticed that the specific value set or codes you mentioned were not attached to your message, which limits our ability to provide precise guidance.

      According the the measure steward, the National Committee for Quality Assurance, regarding the LOINC code 72828-7, please note that this is a panel code used to order a set of lab tests rather than a result code. While panels help with ordering multiple tests at once, they do not provide the individual test results needed to meet criteria for CMS153. The approved LOINC codes in the measure's value set are specifically selected because they represent individual tests that demonstrate the performance of the measure.

      Clinically equivalent services may be mapped to the codes used in a measure's value sets to satisfy a value set requirement. If mapping is conducted, you should maintain documentation in case of a CMS audit.
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      Thank you for your inquiry regarding CMS153v13. We noticed that the specific value set or codes you mentioned were not attached to your message, which limits our ability to provide precise guidance. According the the measure steward, the National Committee for Quality Assurance, regarding the LOINC code 72828-7, please note that this is a panel code used to order a set of lab tests rather than a result code. While panels help with ordering multiple tests at once, they do not provide the individual test results needed to meet criteria for CMS153. The approved LOINC codes in the measure's value set are specifically selected because they represent individual tests that demonstrate the performance of the measure. Clinically equivalent services may be mapped to the codes used in a measure's value sets to satisfy a value set requirement. If mapping is conducted, you should maintain documentation in case of a CMS audit.
    • CMS0153v13
    • CMS0153v12
    • Our Lab company Medipath does not use any of the approved LOINC codes for CMS measure 153. Therefore, we cannot get credit for this measure unless we can use a replacement compatible LOINC code instead.

      I am seeking clarification on the potential for mapping equivalent LOINC codes for CMS Measure 153 in our EMR system. We use eClinicalWorks for attestation for both MIPS and PCMH. Our lab partner does not use any of the LOINC codes listed on the attached document; instead, they use LOINC code 72828-7.

      Could you please explain the fundamental differences between using this code versus the approved codes on the attached document? Specifically, what makes those particular LOINC codes eligible for credit for this measure, while others that test for the same condition are not? Is there a way to receive credit for this measure using the alternative LOINC code provided? If so, I would appreciate any proof or guidance to share with our EMR vendor, as they have not been helpful in resolving this issue.

            AIR EC eCQM Team AIR EC eCQM Team
            ksilva Kristin Silva
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