eCQM Measure CMS 122

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Alexander South
    • Koan Health
    • Hide
      Thank you for your inquiry regarding CMS122v14 (2026 Performance Period). eCQM measures are designed to use clinical data from structured fields in the EHR, rather than billing or claims data. This measure's denominator looks for patients who have a qualifying encounter and an active diabetes diagnosis, using a code from the "Diabetes" value set (2.16.840.1.113883.3.464.1003.103.12.1001), during the measurement period. The data must be entered and documented into an EHR. An active diabetes diagnosis, with no end date, would meet the requirement for an active diabetes diagnosis.

      If you need assistance reading an eCQM, please refer to the resources available at eCQI Resource Center, such as "Guide for Reading eCQMs" or "Implementation Checklist eCQM Annual Update": https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs. For inquiries about CMS quality program reporting requirements or other quality measure collection types (e.g., MIPS CQM), please contact the QPP Helpdesk at QPP@cms.hhs.gov.
      Show
      Thank you for your inquiry regarding CMS122v14 (2026 Performance Period). eCQM measures are designed to use clinical data from structured fields in the EHR, rather than billing or claims data. This measure's denominator looks for patients who have a qualifying encounter and an active diabetes diagnosis, using a code from the "Diabetes" value set (2.16.840.1.113883.3.464.1003.103.12.1001), during the measurement period. The data must be entered and documented into an EHR. An active diabetes diagnosis, with no end date, would meet the requirement for an active diabetes diagnosis. If you need assistance reading an eCQM, please refer to the resources available at eCQI Resource Center, such as "Guide for Reading eCQMs" or "Implementation Checklist eCQM Annual Update": https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs . For inquiries about CMS quality program reporting requirements or other quality measure collection types (e.g., MIPS CQM), please contact the QPP Helpdesk at QPP@cms.hhs.gov .
    • CMS0122v14
    • CMS0122v13
    • CMS0122v12
    • Unclear specification rules

      For eCQM Measure CMS 122, the denominator qualification requires that the Diabetes Diagnosis overlap the measurement period. 1. Can historical diagnosis codes that still exist on the patient's EMR problem list be utilized for that determination, or must the diabetic diagnosis codes be billed within the measurement period? We are trying to determine if the DX code has to be captured/coded on a claim with a service date in the measurement period, or if historical DX from prior measurement periods can be utilized alone if they still exist on the patient's EMR current problem list. Screenshot of the specification data flow for reference is below, thank you

       

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Alexander South
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              Created:
              Updated:
              Resolved:
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