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We are having issues with our CQM's populating data. I have been told this is because we don't use Super Bill CPT codes as orders to document the level of service. That the CPT codes are what CPS looks for to place it in the denominator or numerator. Any help would be appreciated.
Posted : July 15, 2015 5:34 am
We have the same issue with one of our offices. We added a snomed order that is supposed to attach in the background and send data to CQR but it doesn't appear to be working.
Jill
Posted : July 15, 2015 6:39 am
If you don't use E&M CPT codes for your office visits you will need to at a minimum push the SNOMED code: SCT-308335008 for patient encounter. That is how CQR measures everything based off office visit and then it wants additional data. We had keycodes set up so our providers didn't have to enter the 25 modifier and because they weren't E&M codes they weren't picked up. We created a text component to push the snomed code order. Like this: IF match(ORDERS_NEW("list"),"Ofc Vst Est Level II w/25 mod")>0 AND match(ORDERS_NEW("list"),"MU Tracking - Patient Encounter")==0 THEN MEL_ADD_ORDER("S","MU SNOMED Codes","MU Tracking - Patient Encounter", "", "ICD-V68.89", "Administrative NOS", "", "", "", "", "")
ELSE ""
ENDIF
Posted : July 15, 2015 6:40 am
I think it's important to note that GE's mapping tool accepts a specific list of CPT Codes per CQM that may not match your business workflows (ex. CQM 131 Diabetic Eye Exam doesn't count CPT Codes 92002, 92004, 92012, 92014 which are for ophthalmological eye exam). GE states that they built the mapping based upon the guidelines; however, the NIH official list includes those 4 ophthalmological CPT Codes.
I feel like GE throws these resource consuming "fixes" at us to buy themselves time to figure out the d*mn CQR...
Posted : July 15, 2015 9:48 am
