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CMS 68 Medication Review

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Last Post by kmarsh 10 years ago

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kmarsh

(@kmarsh)

Posts: 85

Estimable Member

Topic starter

Since we started running the CQR reports for Meaningful Use in the 3Q, all of our providers have 0% for CMS 68. Medication review is something that is done at every visit by the Medical Assistant (certified) and the meds reviewed boxes and the PQRI 130 box by the MA. We are using the correct obsterms that were mapped to the SNOMED code for "Documentation of current medications" by GE. The GE user guide does state that "Eligible Professional attests to documenting a list of current medications..." but I haven't found anything that states that the boxes have to be checked by the EP him/herself. This is our workflow: the MA does a clinical list update which includes the med update, and signs it. The MA then opens an OV encounter, which displays the current medications list, and checks the review boxes. The update is put on hold for the EP to complete and sign. Are we getting 0% because the EP isn't the one checking the box? I haven't been able to get an answer from either GE or our VAR. This should be such an easy measure to meet. Any help with this would be appreciated.

Posted : December 16, 2014 7:37 am

lkeith

(@lkeith)

Posts: 457

Honorable Member

Someone correct me if I am wrong, but I believe the Meds Reviewed would need to be checked in the document for the office visit, not in a separate clinical list update.

We also have our nurses/MA go through the patient's current meds/allergies and update as needed. If no updates are necessary, then they check the 'Meds Reviewed' and/or 'Allergies Reviewed' checkboxes. The provider will then open this same document to complete the visit. We haven't had any issues with this measure.

Posted : December 16, 2014 7:59 am

DVI1501

(@dvi1501)

Posts: 80

Trusted Member

I opened a ticket with GE on this issue last week. We have everything "mapped" as well, but GE told me that CMS68 is SNOMED code driven, not obs term driven. The only way that you will see numerator data in this measure is to put an order in the system for it. GE built me a Service code for "Documentation of Current Medications in Medical Record", Code: SCT-4281910001241. (make sure you do not transfer the code to billing)

You either have to order this code every time, or use CCC 9.0 Conditional Action Metrics to trigger this when you click the Meds Reviewed box.

We are on CCC 8.3.8, so GE basically said without the CAM's, you are out of luck unless you can go in on every patient and order this service.

Posted : December 16, 2014 8:41 am

kmarsh

(@kmarsh)

Posts: 85

Estimable Member

Topic starter

Just to clarify - our MAs do check the review boxes in the Office Visit. But they do the actually med changes if there are any, in a separate update when they first bring the patient back to the exam room.. Do your MAs also have the 'Sign clinical list changes' box checked (on the End Update form)? It sounds like your workflow is a lot like ours.

Posted : December 16, 2014 9:00 am

DVI1501

(@dvi1501)

Posts: 80

Trusted Member

Our MA's are doing what yours are and it sounds like we have the same workflow. Without CAM to convert the obs term to a snomed service order, we're out of luck. Unless I teach 53 providers to put in a service order for the snomed code.......in addition to clicking the meds reviewed box. That will fly over like a lead balloon.

Posted : December 19, 2014 2:56 am

kmarsh

(@kmarsh)

Posts: 85

Estimable Member

Topic starter

I added a button that pushes an order for meds reviewed to the orders module and tried it out yesterday and we are finally seeing some results. Instead of resurrecting the misery of showing the providers how to do a referral and then create a TOC document, we decided to try to make it as easy as possible. We still use our own forms so I added the button on the first page of the first form of office visit encounter that only the providers can see it. They can't leave the page until they've click the button which pushes a visit code and now the meds reviewed code to orders. Billing is done in separate software and there is no connection to our EMR so the visit code is 99212 for every visit.

Posted : December 19, 2014 7:00 am

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