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CMS153v12 - Question on including HIV diagnosis but not HIV testing

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      Thank you for your question regarding CMS153v13 (2025 performance period). According to the measure steward, the National Committee for Quality Assurance, the HIV testing code (LOINC 7917-8) is not included in the value set for "Lab Tests for Sexually Transmitted Infections" (2.16.840.1.113883.3.464.1003.110.12.1051) because HIV can be transmitted through various means beyond sexual activity. When patients are being tested for STIs due to their sexual activity, it’s unlikely that they would be tested for HIV in isolation. Therefore, other STI tests would qualify the patient for the measure.
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      Thank you for your question regarding CMS153v13 (2025 performance period). According to the measure steward, the National Committee for Quality Assurance, the HIV testing code (LOINC 7917-8) is not included in the value set for "Lab Tests for Sexually Transmitted Infections" (2.16.840.1.113883.3.464.1003.110.12.1051) because HIV can be transmitted through various means beyond sexual activity. When patients are being tested for STIs due to their sexual activity, it’s unlikely that they would be tested for HIV in isolation. Therefore, other STI tests would qualify the patient for the measure.
    • CMS0153v13
    • Providers must document additional information about patient's sexual activity status when testing for HIV infection, yet other tests for sexually transmitted infection do not require additional documentation.

      Providers in our organization are questioning why the measure includes diagnosis codes for HIV as a a qualifier of "Has Diagnoses Identifying Sexual Activity" for the measure denominator, but the value set used by the condition "Has Laboratory Tests Identifying Sexual Activity But Not Pregnancy" specific to sexually transmitted infections does not include LOINC codes like 7917-8 for HIV testing.
      Value set name: Lab Tests for Sexually Transmitted Infections
      OID: 2.16.840.1.113883.3.464.1003.110.12.1051

            AIR EC eCQM Team AIR EC eCQM Team
            kevfairley Kevin Fairley
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