The Centers for Medicare & Medicaid Services (CMS) and the National Library of Medicine (NLM) has published an addendum to the 2016 eCQM specifications (published in April 2016). This addendum updates relevant International Classification of Diseases (ICD)-10 Clinical Modification (CM) and Procedure Coding System (PCS) eCQM value sets for the 2017 performance year. These changes affect electronic reporting of eCQMs for the following programs:
- The Hospital Inpatient Quality Reporting Program;
- The Medicare Electronic Health Record (EHR) Incentive Program for eligible hospitals and critical access hospitals (CAHs);
- The Merit-based Incentive Payment System (MIPS) for MIPS eligible clinicians.
What Changes are Included in the Addendum?
Changes will only affect the value sets for eCQMs remaining in the programs listed above for 2017 reporting. The Health Quality Measure Format (HQMF) specifications, the value set object identifiers (OIDs), and the measure version numbers for 2017 eCQM reporting will not change.
The changes to the ICD-10 value sets consist of deletion of expired codes and addition of relevant replacement codes. Newly available codes that represent concepts consistent with the intent of the value set and corresponding measure(s) were also added. CMS is prioritizing these ICD-10 updates. Updates for other terminologies will take place during the 2017 Annual Update.
All changes to ICD-10 value sets are detailed in revised technical release notes, including the OIDs affected and information on the codes added or deleted from the value sets.
Where is the Addendum Posted?
The following updated measure information is available on the eCQM library and the electronic Clinical Quality Improvement (eCQI) Resource Center websites, including:
- eCQM specifications, which include only measures in use for 2017 eCQM reporting
- eCQMs for Eligible Clinicians Table January 2017 and eCQMs for Eligible Hospitals Table January 2017, which include only measures in use for 2017 eCQM reporting
- Revised release notes, which provide an overview of technical changes implemented in the addendum. Two sets of release notes will be available.
-The first set provides information on ICD-10 value set updates for measures affected by this addendum.
-The second set provides information on changes from this addendum and all other updates for the measures included for 2017 eCQM reporting.
All changes to the eCQM value sets are available through the NLM’s Value Set Authority Center (https://vsac.nlm.nih.gov/). The value sets are available as a complete set, as well as value sets per measure. The Data Element Catalog on the VSAC home page contains the complete list of updated eCQMs and value set names.
What Do I Need to Do?
Measure implementers should review these changes and revise mapping of ICD-10 codes as needed to ensure their submissions comply with the updated requirements included in this addendum for 2017 reporting. Clinicians may also have to revise their workflows to comply with the ICD-10 code additions and removals included in this addendum.
More information on implementing and mapping of ICD-10 codes can be found on the CMS website at: https://www.cms.gov/Medicare/Coding/ICD10/Frequently-Asked-Questions.html.
Where Do I Go for Assistance?
Questions regarding the addendum, eCQM value sets, appropriateness of mapping, and non-ICD-10 code system updates should be reported to the ONC CQM Issue Tracker available at http://jira.oncprojectracking.org/browse/CQM/.