General eCQM Information
| CMS Measure ID | CMS50v7 |
|---|---|
| NQF Number | None |
| Measure Description |
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred |
| Initial Population | Number of patients, regardless of age, who were referred by one provider to another provider, and who had a visit during the measurement period |
| Denominator Statement |
Equals Initial Population |
| Denominator Exclusions |
None |
| Numerator Statement |
Number of patients with a referral, for which the referring provider received a report from the provider to whom the patient was referred |
| Numerator Exclusions |
Not Applicable |
| Denominator Exceptions |
None |
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) |
| Domain | Communication and Care Coordination |
| Measure Scoring | Proportion measure |
| Measure Type | Process measure |
| Improvement Notation |
A higher score indicates better quality |
| Guidance |
The provider who refers the patient to another provider is the provider who should be held accountable for the performance of this measure. The provider to whom the patient was referred should be the same provider that sends the report. If there are multiple referrals for a patient during the measurement period, use the first referral. The consultant report that will fulfill the referral should be completed after the referral, and should be related to the referral for which it is attributed. If there are multiple consultant reports received by the referring provider which pertain to a particular referral, use the first consultant report to satisfy the measure. Eligible professionals or eligible clinicians reporting on this measure should note that all data for the reporting year is to be submitted by the deadline established by CMS. Therefore, eligible professionals or eligible clinicians who see patients towards the end of the reporting period (ie, December in particular), should communicate the consultant report as soon as possible in order for those patients to be counted in the measure numerator. Communicating the report as soon as possible will ensure the data is included in the submission to CMS. |
| Quality ID | 374 |
| Meaningful Measure | Transfer of Health Information and Interoperability |
| Next Version |
Data Element Repository
Header
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Updated Version Number.
Measure Section: eMeasure Version number
Source of Change: Measure Lead
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Updated Copyright.
Measure Section: Copyright
Source of Change: Annual Update
Logic
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Added supplemental timing attributes to most datatypes in QDM 5.3 to facilitate accurate retrieval of time related information within CQL logic. Timing attributes now include a time interval, such as prevalence period or relevant period, and/or actual time of documentation with Author Datetime. Relevant period is the general method to describe start and stop times for datatypes. Prevalence period is used for some datatypes to more accurately define onset and abatement times.
Measure Section: Multiple Sections
Source of Change: Standards Update
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Assigned cardinality to each attribute to be more explicit in guiding specification and implementation of QDM data elements. Cardinality refers to the number of instances of the attribute that can be included in the measure description. Cardinality for most attributes is 0.. 1 (i.e., can occur up to 1 time), but some attributes have a cardinality of 0.. * (i.e., can occur multiple times).
Measure Section: Multiple Sections
Source of Change: Standards Update
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CQL libraries contain sets of CQL definitions, or CQL expression statements. A context statement, patient or population, can now be used in a CQL library to clearly establish how the subsequent list of CQL expressions will be interpreted. A 'Population' context will interpret the CQL expression with reference to the entire population of the item being counted, patients or encounters. A 'Patient' context will interpret the CQL expression with reference to a single patient. Context statements are not required, but one or more context statements may be used within a library to help clarify how the CQL expressions will be interpreted. Patient context is the default if none is specified.
Measure Section: Multiple Sections
Source of Change: Standards Update
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Removed the 'Face-To-Face Interaction' data element and added relevant SNOMED codes to the Encounter Grouping value sets to better align between the SNOMED and CPT encounter codes.
Measure Section: Multiple Sections
Source of Change: Measure Lead
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Updated measure logic from Quality Data Model (QDM)-based logic to Clinical Quality Language (CQL)-based logic. Information on CQL can be found at the eCQI Resource center (https://ecqi.healthit.gov/cql). Information about specific versions of the new standards in use for CMS reporting periods can be found at the eCQI Resource Center (https://ecqi.healthit.gov/ecqm-tools-key-resources). Switching from QDM to CQL brings with it many changes, as well as enhanced expression capability, but only those changes with significant impact will be outlined in technical release notes. For example, in the case of timing operators, changes may only be summarized if those changes impact the measure calculation.
Measure Section: Multiple Sections
Source of Change: Standards Update
Value Set
The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.
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Value set Referral (2.16.840.1.113883.3.464.1003.101.12.1046): Added 3 SNOMEDCT codes (103698003, 183583007, 390866009).
Measure Section: QDM Data Elements
Source of Change: Annual Update
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Value set Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1264) including 7 codes.
Measure Section: QDM Data Elements
Source of Change: Annual Update
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Value set Payer (2.16.840.1.114222.4.11.3591): Added 11 SOP codes (299, 32127, 32128, 391, 517, 524, 614, 621, 622, 623, 629) and deleted 3 SOP codes (63, 64, 69).
Measure Section: QDM Data Elements
Source of Change: Annual Update
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Value set Face-to-Face Interaction (2.16.840.1.113883.3.464.1003.101.12.1048): Removed Face-to-Face Interaction.
Measure Section: QDM Data Elements
Source of Change: Annual Update
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Value set Payer (2.16.840.1.114222.4.11.3591): Deleted 1 SOP code (24).
Measure Section: QDM Data Elements
Source of Change: 2019 Addendum