Use of unique codes to identify an episode is inpatient or outpatient in eCQMs

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    • Type: Question/Guidance
    • Resolution: Resolved
    • Priority: Moderate
    • Component/s: None
    • None
    • Not measure related
    • Not measure related
    • Not measure related
    • Not measure related
    • Not measure related

      In chart based measures, EM Codes (from billing/CPT codes) where used to identify if a given encounter was an outpatient encounter, and regardless of measure being reported this code must be present to indicate an Outpatient Episode.

      With new measures being developed in eCQMs for outpatient visits, an episode is not as simple as inpatient episode of care (with Inpatient Encounter/admit date and discharge date). For example in EX-RAD Outpatient, Diagnostic code/CT Scan indicates an 'episode'. Or in STEMI measure, an ED encounter indicates an episode. It seems each measure is defining its own 'episode', which adds complexity to the case and measure reporting and therefore, outcome calculation becomes error-prone,  Are there any codes available in eCQM world similar to EM Codes, that can uniquely identify if an encounter submitted in the QRDA I file is an outpatient episode regardless of the measure they present? This will help the implementation teams clearly recognize the submitted data element and evaluate the measures submitted accordingly regardless of what measure, and how many measure are being reported in the QRDA File

            Assignee:
            Yan Heras
            Reporter:
            Hafsa Subhan (Inactive)
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            1 Vote for this issue
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              Created:
              Updated:
              Resolved: