[CQM-3870] CMS2v8 and CMS124v8 should include additional OB codes 0500F, 0502F, 0503F Created: 12/12/19 Updated: 01/17/20 Resolved: 01/17/20 |
|
| Status: | Closed |
| Project: | eCQM Issue Tracker |
| Component/s: | None |
| Type: | Other | Priority: | Moderate |
| Reporter: | Rachel Cheung (Inactive) | Assignee: | Mathematica EC eCQM Team (Inactive) |
| Resolution: | Answered | Votes: | 0 |
| Labels: | None | ||
| Contact Name: | Rachel C |
| Contact Email: | rcheung@esperanzachicago.org |
| Solution: | Thank you for your question. CPT Category II codes are not recommended terminologies for eCQM reporting and are typically included in claims/CQM reporting. With respect to the OB related E+M HCPCS codes included in the comment, CPT codes 59400, 59510, and 59618, are included in theCMS2 denominator value set. Therefore, we recommend mapping any equivalent institutional-specific codes for the purposes of reporting. Similarly, for CMS124, equivalent services can be mapped to the measure's value sets. For both CMS2 and CMS124, if mapping is done, you should maintain documentation in the case of a CMS audit. |
| Solution Posted On: | |
| Impact: | IL Medicaid only accepts 0500F, 0502F, and 0503F as billing codes for prenatal and postnatal patients. However, as a result, our EHR vendor does not recognize these obstetric patients or any data from their OB encounters as part of many quality measures that are included in UDS, including CMS2v8 and CMS124v8. We would like to request that these codes be added to the visit value sets for these measures. |
| Comments |
| Comment by Mathematica EC eCQM Team (Inactive) [ 01/14/20 ] | |||||||||||||||||||
|
We continue to investigate the issue noted in your ticket and will provide a response as soon as we are able. Thank you for your patience. | |||||||||||||||||||
| Comment by Mathematica EC eCQM Team (Inactive) [ 01/07/20 ] | |||||||||||||||||||
|
Thank you for submitting your question. We will review your ticket and provide a response as soon as possible. | |||||||||||||||||||
| Comment by Albert W. Taylor (Inactive) [ 01/07/20 ] | |||||||||||||||||||
|
forwarding to measure development team for measure update consideration. If it's not possible to map these encounters to existing OB related E+M codes, these HCPCS codes would have to be added to the encounter value set
|