Hybrid (CMS 844v5) Medicare Advantage Payer and Medicare FFS Payer ValueSet Overlap

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Referred to External Party for Resolution
    • Priority: Moderate
    • Component/s: Guidance
    • None
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      Hello and thank you for your inquiry. Unfortunately, this ticket is out of scope for the eCQM Issue Tracker. Your question has been redirected to the QualityNet Service Desk, and the following ticket has been opened for you:

      [CS2440949]

      You will be contacted by their team and assigned a customer service representative who will work to resolve your inquiry. We are closing this ticket now. Please let us know if you have any additional questions about eCQM logic or specifications.
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      Hello and thank you for your inquiry. Unfortunately, this ticket is out of scope for the eCQM Issue Tracker. Your question has been redirected to the QualityNet Service Desk, and the following ticket has been opened for you: [CS2440949] You will be contacted by their team and assigned a customer service representative who will work to resolve your inquiry. We are closing this ticket now. Please let us know if you have any additional questions about eCQM logic or specifications.
    • EH
    • CMS0844v4
    • CMS0871v2

      Hybrid (CMS 844v5) Medicare Advantage Payer and Medicare FFS Payer ValueSet Overlap

      • valueset "Medicare Advantage Payer" (2.16.840.1.113762.1.4.1104.12)
      • valueset "Medicare FFS Payer" (2.16.840.1.113762.1.4.1104.10)

      For example, currently 'Medicare Other' is within both valuesets. 

      How should this be evaluated? By code value alone or should we consider the value set OID as well?

      If patient has Medicare Advantage and Medicare FFS which do they classify as? What should display within the QRDA file?

       

       

            Assignee:
            Augustine Weber
            Reporter:
            Becky Crellin
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              Created:
              Updated:
              Resolved:
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