SNOMEDCT codes missing from Value Sets

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Alicia Arace
    • 3135986312
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      Thank you for your inquiry. This response will be in reference to the measure versions from Performance Period 2024: CMS122v12, CMS124v12, CMS125v12, CMS128v12, CMS130v12, CMS131v12, CMS138v12, CMS139v12, CMS146v12, CMS153v12, CMS154v12, CMS156v12, CMS165v12, and CMS249v6. SNOMED CT codes are not included in the Preventive Care Services Established Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1025) and Preventive Care Services Initial Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1023) value sets because these value sets are specific to "preventive medicine," and currently, there are no SNOMED CT codes that fall under this category.

      However, SNOMED CT codes are available in other value sets included in the "Qualifying Encounters" definition used within these measures. Clinically equivalent services can be mapped to the measure's value set. If mapping is done, please maintain documentation in case of a CMS audit.
      Show
      Thank you for your inquiry. This response will be in reference to the measure versions from Performance Period 2024: CMS122v12, CMS124v12, CMS125v12, CMS128v12, CMS130v12, CMS131v12, CMS138v12, CMS139v12, CMS146v12, CMS153v12, CMS154v12, CMS156v12, CMS165v12, and CMS249v6. SNOMED CT codes are not included in the Preventive Care Services Established Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1025) and Preventive Care Services Initial Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1023) value sets because these value sets are specific to "preventive medicine," and currently, there are no SNOMED CT codes that fall under this category. However, SNOMED CT codes are available in other value sets included in the "Qualifying Encounters" definition used within these measures. Clinically equivalent services can be mapped to the measure's value set. If mapping is done, please maintain documentation in case of a CMS audit.
    • CMS0122v12
    • Clinicians cannot report quality measure data.

      We have Community Connect sites on our instance of Epic that do not do their billing through Epic. So, in order for them to report eCQMs, we map Encounter Types to valid SNOMEDCT codes. This allows the reporting logic to pick up encounters for measure evaluation. We noticed that some of the Value-sets for the 2025 reporting period have changed and now multiple measures are no longer available for these community connect sites since the logic cannot pick up the encounters.

      Do we know why SNOMEDCT codes have been left off of the following value sets:

      -Preventive Care Services Established Office Visit, 18 and up (Value Set OID: 2.16.840.1.113883.3.464.1003.101.12.1025)

      -Preventive Care Services Initial Office Visit, 18 and Up (Value Set OID: 2.16.840.1.113883.3.464.1003.101.12.1023)

      The value sets above are used in multiple measures and is having a major impact on reporting: Used by: CMS-50, CMS-122, CMS-124, CMS-125, CMS-128, CMS-130, CMS-131, CMS-138, CMS-139, CMS-146, CMS-153, CMS-154, CMS-156, CMS-165, CMS-249, CMS-347, CMS-349, CMS-951

      Thank you.

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Alicia Arace (Inactive)
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              Created:
              Updated:
              Resolved:
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