CQM Measure CMS50v5 Closing the Referral Loop: receipt of the specialist report

CQM Measure CMS50v5 Closing the referral loop: receipt of the specialist report

NQS Domain: Care Coordination

Description: Percentage of patients with referrals regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred.

Denominator Logic

AND Patient had one or more appointment scheduled during measurement period, with CPT code [99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397] entered

AND
        OR Patient had outbound referral sent during measurement period (via Message Center)
        OR Patient had Intervention Referral (CQM ValueSet:2.16.840.1.113883.3.464.1003.101.12.1046) recorded during measurement period.

Numerator Logic

OR Patient had Patient Communication Consultant Report (CQM ValueSet: 2.16.840.1.113883.3.464.1003.121.12.1006) reported after referral sent
OR Patient had Patient Communication Consultant Report (CQM ValueSet: 2.16.840.1.113883.3.464.1003.121.12.1006) reported Intervention Referral ordered during measurement period.

For more information, please visit the CMS website here.

How To (Website)

Step 1: Access the patient record and click “CQMs”

Step 2: Next, in the "Intervention" section, tap "New":

 

Step 3: Create the Intervention Referral:

 

Step 4: Finally, in the CQMs area of the patient record, click "New" in the Communication section to create a Patient Communication:

 

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