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  2. CQM-7666

CMS50v13 Multiple Referrals Sent on Same Date and Time

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
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    • Ashish Trivedy
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      Thank you for your question related to CMS50 v13. If two or more referrals have the same time stamp and are being captured in the denominator as first referral, the referral that meets the numerator criteria may be used for the measure. If none of the referrals meet the numerator criteria, then any of the referrals may be used in the measure. We are working to evaluate potential logic modifications to the measure that may resolve these issues in the future.
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      Thank you for your question related to CMS50 v13. If two or more referrals have the same time stamp and are being captured in the denominator as first referral, the referral that meets the numerator criteria may be used for the measure. If none of the referrals meet the numerator criteria, then any of the referrals may be used in the measure. We are working to evaluate potential logic modifications to the measure that may resolve these issues in the future.
    • CMS0050v13

      We are seeking clarification on eCQM measure CMS50. When importing data from a QRDA 1 file, if a provider sends multiple referrals on the same day, the timestamps are often identical. In such cases, it is difficult to determine which referral is considered the FIRST referral for numerator purposes. If two referrals are sent, both having identical timestamps per the QRDA 1 file, and only 1 consult report is received, which referral should be considered the first?
       
      Example: 
      Provider sends 2 referrals for the same patient:
      Referral 1/1/2025 12:00:00  Orderid: ABC
      Referral 1/1/2025 12:00:00 Orderid: XYZ
       
      Consult Report 2/1/2025 12:00:00 - with related to: orderid XYZ

      Given that the referral timestamps are identical for both referrals and the orderid does not indicate the sequence in which the referrals are ordered, should both referrals be assessed as the FIRST referral and count for numerator purposes? If yes, what should be the outcome of the above scenario? If no, then please provide additional clarification on how these kind of cases should be handled.

            AIR EC eCQM Team AIR EC eCQM Team
            ashishtrivedy Ashish Trivedy
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