For measures that use the generic medical reason, patient reason, or system reason, it is appropriate to map more granular concepts to the general concepts. This type of coding might actually make compliance with an audit more feasible. However, if the guidance in the measure specifies the types of reasons allowed for exceptions, it is expected the granular concepts would be aligned with those reasons. For example, if the medical reason states something like, "limited to patients with bleeding conditions or other medical contraindications" in the guidance, it would not be appropriate to remap a concept like "provider preference". One would anticipate if the reason would be found clinically consistent with the measure intent in an audit, there is not a contraindication to that type of remapping.

Trying to resolve collecting Joint Commission Core measure vs. eCQM measure data. Providers resist this general response and would prefer more granular responses. Our question is whether it is appropriate to collect more granular answers but map them (many to one relationship) to the applicable “surgical” or “medical” contraindication response. That would mean that our EHR would reflect the more specific response but the clinical quality reporting data would indicate the more general response. A similar question refers to examples when the responses are very close to their core measure cousins. I don’t have an example, but is it appropriate to collect data more in line with the Core Measure response and map it to the proper CQM response?