CMS Announces Updates to eCQM Value Sets for Q4 2017 Reporting, and 2018 Reporting and Performance Periods

September 5, 2017 - 10:16am

The Centers for Medicare & Medicaid Services (CMS) and the National Library of Medicine (NLM) will publish updates to the electronic clinical quality measure (eCQM) value sets to align with the most recent releases to terminologies, including, but not limited to, International Classification of Diseases (ICD)-10 Clinical Modification (CM) and Procedure Coding System (PCS), SNOMEDCT, LOINC, RxNorm, and Current Procedural Terminology (CPT). CMS will publish two addenda containing updates to these terminologies for the 4th Quarter (Q4) 2017 reporting period, and 2018 reporting and performance periods.

When will the addenda be published and what programs are affected by the addenda? 

2017 Q4 Reporting Period eCQM Value Set Addendum: In September, CMS will publish an addendum to the eCQM specifications (published in April 2016) to update relevant eCQM value sets for Q4 2017 reporting. This addendum will affect the electronic reporting of eCQMs for the following hospital programs:

  • ·       Hospital Inpatient Quality Reporting (IQR) Program; and
  • ·       Medicare and Medicaid Electronic Health Record (EHR) Incentive Program for eligible hospitals and critical access hospitals (CAHs).

 

The 2017 Q4 Reporting Period eCQM Value Set Addendum does not impact eCQM reporting for eligible professionals (EPs) in the Medicaid EHR Incentive Program or eligible clinicians in the Quality Payment Program.

2018 Reporting/Performance Period eCQM Value Set Addendum: By October, CMS will publish an addendum to the eCQM specifications (published in May 2017) to update relevant eCQM value sets for the 2018 reporting year. This addendum will affect the electronic reporting of eCQMs for the following programs:

  • ·       Hospital IQR Program;
  • ·       Medicare and Medicaid EHR Incentive Program for eligible hospitals, CAHs, and EPs; and
  • ·       Quality Payment Program: Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

 What changes are included in the addenda?

Changes will only affect the value sets for eCQMs. The Health Quality Measure Format (HQMF) specifications, the value set object identifiers (OIDs), and the measure version numbers for Q4 2017 eCQM reporting and 2018 eCQM reporting (Jan 1-Dec 31) will not change.

The changes to the value sets consist of (1) deletion of expired codes, (2) addition of relevant replacement codes, and (3) addition of newly available codes that represent concepts consistent with the intent of the value set and corresponding measure(s).

Where will CMS and the NLM post the addenda?

All changes to the eCQM value sets will be available through the NLM’s Value Set Authority Center download tab. The value sets will be available as a complete set, as well as value sets per measure. 

Updated measure information, including revised technical release notes, will be available on the eCQI Resource Center website.

What do I need to do?

Measure implementers should review these changes to ensure their submissions comply with the updated requirements.

Where do I go for assistance?

Measure implementers can report questions regarding the addenda, eCQM value sets, and appropriateness of mapping to the ONC CQM Issue Tracker.