[CQM-7124] Coding for PCV20 in CMS117v12 Created: 07/17/24 Updated: 07/30/24 Resolved: 07/30/24 |
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| Status: | Closed |
| Project: | eCQM Issue Tracker |
| Component/s: | None |
| Type: | EC eCQMs - Eligible Clinicians | Priority: | Moderate |
| Reporter: | Miranda Schufman | Assignee: | Mathematica EC eCQM Team |
| Resolution: | Answered | Votes: | 0 |
| Labels: | None | ||
| Solution: | Thank you for your follow-up comment for CMS117v12, Childhood Immunization Status.
We apologize for the inconvenience this may have caused. Unfortunately, the value sets, once published, cannot be revised. The publication policies and timelines for the MIPS program are determined by the Centers for Medicare & Medicaid Services (CMS). The Advisory Committee on Immunization Practices (ACIP) approved recommendations for the use of 20-valent pneumococcal conjugate vaccine (PCV20) for children, and these recommendations were adopted by the CDC Director on June 27, 2023. This date falls after the value set publication dates for 2023 and 2024 performance periods, on May 5, 2022 and May 4, 2023 respectively. Upon this discovery, the eCQM team created a known issue for Performance Period 2023 (CMS117v11) and 2024 (CMS117v12) implementations EKI-27 acknowledges that the value set does not include CVX codes 216, for PCV20. A workaround, specifically mapping to existing codes in the value set (CVX code 152 or unspecified CVX code 216) is included. Specifically, the recommendation for the known issue states: “Implementers can map the use of 20-valent pneumococcal conjugate vaccine (PCV20) (CVX code 216) to the ‘pneumococcal vaccine, unspecified formulation’ code (CVX code 216) or the ‘Pneumococcal Conjugate, unspecified formulation’ code (CVX code 152) in the 'Pneumococcal Conjugate Vaccine' (OID: 2.16.840.1.113883.3.464.1003.196.12.1221) value set.” The value set used for the Performance Period 2025 implementation of CMS117v13 (published 2024.05.02) has since been updated to include PCV20 (CVX code 216) for use in PY2025 reporting. We regret any inconvenience this may have caused. |
| Solution Posted On: | |
| 2024 Performance Period EC eCQMs: |
CMS0117v12
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| Impact: | Inaccurate eCQM performance rate due to PCV20 coding missing from 2024 value set |
| Description |
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Regarding eCQM CMS117v12 for 2024 MIPS reporting, our organization has transitioned to the most recent Prevnar recommendations (link referenced below). Being the value set does not include the appropriate codes for PVC20, the eCQM performance rates will show as inaccurately low. The workaround suggested in known issue EKI-27 of mapping to a different CVX code is not recommended by EHR vendors as this would send unspecified and inaccurate data & codes to the immunization registries we are required to exchange this data with.
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| Comments |
| Comment by Mathematica EC eCQM Team [ 07/25/24 ] |
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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 [ 07/18/24 ] |
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Thank you for submitting your question. We will review your ticket and provide a response as soon as possible. |