[CQM-1065] CMS 52 numerator 1 criteria Created: 03/11/14  Updated: 05/23/16  Resolved: 10/20/14

Status: Closed
Project: eCQM Issue Tracker
Component/s: Measure

Type: EC eCQMs - Eligible Clinicians Priority: Minor
Reporter: Elissa Chandler (Inactive) Assignee: Ramya Tallapragada (Inactive)
Resolution: Answered Votes: 0
Labels: None

Attachments: Microsoft Word NextGen Question CMS 52_031114.docx    
Issue Links:
Relates
Contact Name: Elissa Chandler
Contact Email: echandler@nextgen.com
Contact Phone: 2677255354
Institution/Name: NextGen Healthcare Information Systems
Guidance required: numerator 1 criteria
Solution: The RxNorm value sets for the 2014 measure republication were updated for the EP measures on May 30, 2014 and will reflect the current RxNorm code system version as of January 2014. In general, CMS and ONC accept remapping of clinically similar or identical codes to the codes present in the Meaningful Use EHR Incentive Program eCQMs. If an audit were performed, system or EHR data should demonstrate that codes remapped to published value set content are clinically appropriate. It is acceptable to use terminology services or clinical expertise to provide that mapping provided it would be considered clinically appropriate. Over time, CMS and ONC, in concert with NLM, hope to provide more frequently updated content and additional guidance in remapping value sets, but for Stage 2 of the Meaningful Use program, the statute allows value set updates no more frequently than on an annual basis.

The only change to value sets for this measure since the June 2013 update was the removal of one code from the "Face-to-Face Interaction" value set which applies to several measures. We did not remove the "Dapsone and pyrithimine" value set from the list as the code is still active within RxNorm and in alignment with the latest guidance, even if not prescribed.

When the issue first arose, we agreed to investigate so we could update as appropriate in the June 2014 update. However, our assessment is as described above, ie, this value set is still included.
 
2015 Performance Period EP eCQMs :
CMS52v3/NQF0405
Impact: critical as impacts certification

 Description   

QUESTION: CMS 52: SEE ATTACHMENT W SCREEN SHOT AS WELL

Numerator 1: The only rxnorm provided for ‘Dapsone and pyrimethamine’ for this measure is ‘105337’. However, with the medication updates we recently received it looks like this drug has been retired. Thus, this will result in difficulty for providers to meet the NUM 1 for this measure as this drug is required. Are there any other drugs we can add to this list in replacement of this medication? If so what are the valid rxnorm for those medication?



 Comments   
Comment by Jeff McCartney (Inactive) [ 08/18/14 ]

The only change to value sets for this measure since the June 2013 update was the removal of one code from the "Face-to-Face Interaction" value set which applies to several measures. We did not remove the "Dapsone and pyrithimine" value set from the list as the code is still active within RxNorm and in alignment with the latest guidance, even if not prescribed.

When the issue first arose, we agreed to investigate so we could update as appropriate in the June 2014 update. However, our assessment is as described above, ie, this value set is still included.

Comment by Elissa Chandler (Inactive) [ 03/13/14 ]

ok to close per measures team.

Comment by Jeff McCartney (Inactive) [ 03/12/14 ]

Note that this issue is identical to CQM-796 that is assigned to me. It was reported by Judi Stephens on August 5th. Dan Roman recently provided me a response that I entered as a "Solution" in JIRA:

The drug Dapsone 100 MG / Pyrimethamine 12.5 MG Oral Tablet (105337) is listed as precribable in RxNORM but further investigation does call into question if this drug combination is available in the US. The use of this drug combination in the test patients should be reviewed

At this time we are only able to update value sets annually. CMS/ONC/NLM are looking into the impact of more frequent updates to value sets but do not anticipate review of this code until the next annual update.

Gina: I'm not certain of the JIRA process, ie, should we "link" this to CQM-796, or, instead, since it is exactly the same issue, notify Elissa and delete it? We purposely set the status of CQM-796 to "Resolved" rather than "Closed" to make sure the drug is included in the January 2014 RxNorm release. There is also a Cypress issue for this same issue, CYPRESS-181.

The response proposed below for CQM-1065 is more eloquent than ours, so I like it. I don't have access to the Medi-Span Master Drug Data Base so can't weigh in on whether the drug is included there or not. I'm cc:'ing both Dan and Aldo (Aldo, because Dan is on PTO) to weigh in if they like.

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