CMS 130 and 125 is an order or referral compliant for measure satisfaction

XMLWordPrintable

    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Hide
      Thank you for your question regarding CMS130v14 (2026 Performance Period). For the numerator criteria, applicable screenings to meet the numerator criteria may include fecal occult blood test, FIT-DNA test, flexible sigmoidoscopy, CT colonography, or a colonoscopy. Please note that the measure logic does not require screenings to be tied to a specific encounter. In your example, if the colonoscopy was performed within the required time frame and documented via QDM datatype "Procedure, Performed" using a code from the 'Colonoscopy' value set (2.16.840.1.113883.3.464.1003.108.12.1020), it may be used to meet numerator criteria. This information must be documented in a structured field in the EHR and approved for entry by the provider. We are unable to provide guidance on how these events should be documented in the EHR. We recommend you consult with your EHR vendor and clinical partners.

      If you have questions about reading the measure specification or understanding data requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. If you have questions regarding implementing the measure, you may refer to the "Implementation Checklist for eCQM Annual Update" for additional guidance. These resources can be found in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs. If you have questions regarding CMS quality program reporting requirements, please review the QPP website or contact the QPP Helpdesk at QPP@cms.hhs.gov.
      Show
      Thank you for your question regarding CMS130v14 (2026 Performance Period). For the numerator criteria, applicable screenings to meet the numerator criteria may include fecal occult blood test, FIT-DNA test, flexible sigmoidoscopy, CT colonography, or a colonoscopy. Please note that the measure logic does not require screenings to be tied to a specific encounter. In your example, if the colonoscopy was performed within the required time frame and documented via QDM datatype "Procedure, Performed" using a code from the 'Colonoscopy' value set (2.16.840.1.113883.3.464.1003.108.12.1020), it may be used to meet numerator criteria. This information must be documented in a structured field in the EHR and approved for entry by the provider. We are unable to provide guidance on how these events should be documented in the EHR. We recommend you consult with your EHR vendor and clinical partners. If you have questions about reading the measure specification or understanding data requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. If you have questions regarding implementing the measure, you may refer to the "Implementation Checklist for eCQM Annual Update" for additional guidance. These resources can be found in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs . If you have questions regarding CMS quality program reporting requirements, please review the QPP website or contact the QPP Helpdesk at QPP@cms.hhs.gov .
    • CMS0125v14, CMS0130v14

      If a patient had the office visit and "Screening colonoscopy" was documented in the assessment and plan section of the encounter and "Screening Diagnosis" is mapped to SNOMED code 444783004, which is valid according to the measure specifications. However that "Screening diagnosis and SNOMED" code were tied to the order and not the "actual screening colonoscopy"

      Is the patient satisfied with this date on the Assessment and plan where the "Screening colonoscopy diagnosis was entered for the order and not the actual screening?

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Erin Hall
            Votes:
            0 Vote for this issue
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved:
              Solution Posted On: