Independent Lab Claim

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for inquiring about the Preventive Care and Screening: Screening for Depression and Follow-Up Plan eCQM. This is an issue to bring to your coding department for a billing code correction, as the specified code requires a comprehensive medical evaluation in addition to lab orders. The measure specification, as written, appropriately includes CPT code 99396.
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      Thank you for inquiring about the Preventive Care and Screening: Screening for Depression and Follow-Up Plan eCQM. This is an issue to bring to your coding department for a billing code correction, as the specified code requires a comprehensive medical evaluation in addition to lab orders. The measure specification, as written, appropriately includes CPT code 99396.
    • CMS0002v15
    • CMS0002v14
    • Lab claim creating incorrect encounter when patient never had an office visit for CMS2.

      We have an instance where a patient hasn't had an office visit since 2023 but had a lab drawn in 2025 and because of the code that the lab claim produces, this created a visit that never happened but pulled the patient into the Initial Population. Should this still count towards the initial population or would it be appropriate to ignore these types of instances?

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Joseph Long
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              Created:
              Updated:
              Resolved:
              Solution Posted On: