Value Set Mapping issues
Data Repository Talk

Value Set Synchronization Challenges

There can be a resulting discrepancy between the codes published by IMO and those that CMS is considering valid for any given calendar year because activities are not coordinated in timing.


UPDATE:  On September 15, 2017 the CMS has issued an addendum to the electronic clinical quality measure (eCQM) annual update specifications published in April 2016.  The addendum updates the eCQM value sets, technical release notes and the binding parameter specifications for the 4th Quarter 2017 reporting period for Eligible Hospitals (EHs) and Critical Access Hospitals (CAHs).  For more information, the addendum is available on the eCQI Resource Center for Eligible Hospitals and Critical Access Hospitals.  These changes affect electronic reporting of eCQMs for the Hospital Inpatient Quality Reporting (IQR) and Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs for EHs and CAHs.  This update will resolve the example listed below, if the 4th Quarter is used for reporting.  If reporting on any of the first 3 quarters of 2017, this issue will persist.

Our example is only one code that was affected, there may be others.

Description of issue that will affect Quarters 1-3 Reporting

IMO will routinely update the nomenclature code contents (numerical values and human-readable terms represented by languages such as SNOMED CT, LOINC and ICD-10) contained in their concept codes in order to stay current with evolving regulations and revisions made to these standard vocabularies.  However, CMS publishes their Value Sets which are designed to electronically capture the required data criteria per each specific quality measure up to a year in advance.  These Value Sets contain what CMS has defined as the acceptable codes from these standard vocabularies.  Because these two activities are not coordinated in timing there can be a resulting discrepancy between the codes published by IMO and those that CMS is considering valid for any given calendar year.

Our advice is that you check the contents of each IMO Concept Code to detect any codes in them that may not be valid in the eCQM Value Sets you are using to report.  For Acmeware customers, when validating OneView Reports, a hint may be a noticeable pattern of patients Not Meeting a measure because of a repeated lack of a documentation point the measure is looking for.  You may discover this being caused when IMO’s Concept Code has different standard vocabulary codes contained in it that do not correlate to the eCQM data criteria per CMS.  A better practice would be to double check the code contents for each of the IMO Concept Codes you have mapped to queries being reported on in OneView and confirm that the concept codes contained in them are valid per CMS for that reporting year.

Please be informed that IMO has updated the Concept Code IMO-PROB-10084069 on 8/9/17.ad

If you have accepted an update after this date, this will impact any queries you have mapped to this Concept Code “Patient Refused Evaluation or Treatment.” It is contained in several of this year’s eCQMs.

The SNOMEDCT code now contained in this Concept Code is valid for reporting CMS eQCMs for the 4th Quarter 2017. Any queries mapped to this revised concept code will not meet the specifications for Quarters 1-3 of the 2017 reporting period.

The rationale for this revision was that the SNOMEDCT code 183944003 “Care/Help refused by patient (situation)” was retired in July 2017. IMO selected a replacement  SNOMEDCT code which is 183956002 “Procedure refused (situation)”. CMS had already published their Value Set Data Criteria for 2017 and 2018 and the retired code still exists in the Value Sets. However, the revised Concept Code will not be valid until next year’s reporting peroid. It is contained in three value sets for the 2018 reporting peroid.

In short, if you are using the Concept Code IMO-PROB-10084069 and have taken this IMO update, you will need to manually map any queries using this IMO Concept Code to the presently valid SNOMEDCT code 183944003. Screen shots below on how this can be done. You should choose the naming convention that works for your organization. We suggest you make a note to check this IMO code next year however, as long as CMS leaves the Value Sets containing it, it will still work for OneView Reports.

IMO Concept Codes

Nomenclature Mapping


By Theresa Jasset at 20 Sep 2017, 16:31 PM
Share this post via

Comments

 

Post a comment

Please correct the following:
Tags
Latest Comments
By Bill Presley at 4 May 2015, 17:09 PM

Authors
Glen D'Abate
Ian Proffer
Bill Presley
Jamie Gerardo
Geoff Grouten
Ken MacPherson
Alexis Donnaruma
Taylor Solari
Theresa Jasset
Categories
Tutorial
Project
Company Information
Reports
News
Event
Subscribe






rss feedRSS