Closing the Referral Loop: Receipt of Specialist Report eCQM CMS50v11

Description

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

Guidance

The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure.

Only the first referral made between January 1 – October 31 of the measurement period will be considered for this measure to allow adequate time for the referring clinician to collect the consult report by the end of the measurement period.

If there are multiple referrals for a patient during the measurement period, use the first referral.

The clinician to whom the patient was referred is responsible for sending the consultant report that will fulfill the communication. Note: this is not the same clinician who would report on the measure.

The consultant report that will successfully close the referral loop should be related to the first referral for a patient during the measurement period. If there are multiple consultant reports received by the referring clinician that pertain to a particular referral, use the first consultant report to satisfy the measure. Eligible clinicians reporting on this measure should note that all data for the performance period is to be submitted by the deadline established by CMS. Therefore, eligible clinicians who refer patients towards the end of the performance period (i.e., October), should request that clinicians to whom they referred their patients share their consult reports as soon as possible in order for those patients to be counted in the measure numerator during the measurement period. When clinicians to whom patients are referred communicate the consult report as soon as possible with the referring clinician, it ensures that the communication loop is closed in a timely manner and that the data are included in the submission to CMS.

This eCQM is a patient-based measure.

This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM

Initial Population

Number of patients, regardless of age, who had an encounter during the measurement period and were referred by one clinician to another clinician on or before October 31.

Encounter Codes

92002, 92004, 92012, 92014, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397

CPT codes can be entered into the billing section for the encounter. Below is an example from the appointment window.

99213_Office_Visit_Code_In_Appointment_Window.png

With a referral from one clinician to another

SNOMED CT codes can be entered in the patient's chart under the Intervention area of the CQMs section. Click the +New button.

BMI_Chart_CQMs_Interventions_.png

You can enter the code or search by keyword. Select an appointment, performed or ordered, and then click Create.

Referral_Search_and_Create_intervention_Side_by_Side.png

SNOMED Codes

103696004 Patient referral to specialist (procedure)
103697008 Patient referral for dental care (procedure)
103698003 Patient referral to non-physician provider (procedure)
103699006 Patient referral to dietitian (procedure)
103704003 Patient referral to sex therapist (procedure)
183515008 Referral to physician (procedure)
183517000 Referral to pediatrician (procedure)
183528001 Referral to psychiatrist for the elderly mentally ill (procedure)
183529009 Referral to oncologist (procedure)
183530004 Referral to diabetologist (procedure)
183541002 Referral to surgeon (procedure)
183555005 Burns referral (procedure)
183557002 Referral to cardiothoracic surgeon (procedure)
183561008 Referral to general practitioner (procedure)
183567007 Referral to hematologist (procedure)
183569005 Refer to terminal care consult (procedure)
183583007 Refer to mental health worker (procedure)
183591003 Refer to partner (procedure)
183878008 Private referral to general surgeon (procedure)
183879000 Private referral to ophthalmologist (procedure)
183880002 Private referral to ear, nose and throat surgeon (procedure)
183881003 Private referral to orthopedic surgeon (procedure)
183882005 Private referral to neurosurgeon (procedure)
183884006 Private referral to pediatric surgeon (procedure)
183885007 Private referral to obstetrician (procedure)
183886008 Private referral to gynecologist (procedure)
183887004 Private referral to plastic surgeon (procedure)
183888009 Private referral to oral surgeon (procedure)
183889001 Private referral to urologist (procedure)
183890005 Private referral to thoracic surgeon (procedure)
183891009 Private referral to vascular surgeon (procedure)
183892002 Private referral to maxillofacial surgeon (procedure)
183893007 Private referral cardiothoracic surgeon (procedure)
183894001 Private referral to physician (procedure)
183895000 Private referral to general physician (procedure)
183896004 Private referral to pediatrician (procedure)
183897008 Private referral to dermatologist (procedure)
183899006 Private referral to cardiologist (procedure)
183900001 Private referral to immunologist (procedure)
183901002 Private referral to neurologist (procedure)
183902009 Private referral to geriatrician (procedure)
183903004 Private referral to gastroenterologist (procedure)
183904005 Private referral to psychiatrist (procedure)
183905006 Private referral to venereologist (procedure)
183906007 Private referral to rheumatologist (procedure)
183907003 Private referral to chest physician (procedure)
183908008 Private referral to psychogeriatrician (procedure)
183909000 Private referral to oncologist (procedure)
183910005 Private referral to diabetologist (procedure)
183911009 Private referral to radiotherapist (procedure)
183913007 Private referral to geneticist (procedure)
183914001 Private referral to anesthetist (procedure)
183915000 Private referral to endocrinologist (procedure)
183916004 Private referral to nephrologist (procedure)
266747000 Referral to private doctor (procedure)
274410002 Dental referral - child (procedure)
306241009 Referral to audiological physician (procedure)
306242002 Referral to audiological scientist (procedure)
306243007 Referral to community doctor in audiology (procedure)
306245000 Referral to hearing therapist (procedure)
306247008 Referral to pediatric audiologist (procedure)
306250006 Referral to genetic counselor (procedure)
306252003 Referral to mental health counselor (procedure)
306253008 Referral to doctor (procedure)
306254002 Referral to Accident and Emergency doctor (procedure)
306255001 Referral to anesthetist (procedure)
306256000 Referral to radiotherapist (procedure)
306257009 Referral to family planning doctor (procedure)
306258004 Referral to intensive care specialist (procedure)
306259007 Referral to adult intensive care specialist (procedure)
306260002 Referral to pediatric intensive care specialist (procedure)
306261003 Referral to community pediatrician (procedure)
306262005 Referral to neonatologist (procedure)
306263000 Referral to pediatric neurologist (procedure)
306264006 Referral to pediatric oncologist (procedure)
306265007 Referral to pain management specialist (procedure)
306266008 Referral to pathologist (procedure)
306267004 Referral to blood transfusion doctor (procedure)
306268009 Referral to chemical pathologist (procedure)
306269001 Referral to general pathologist (procedure)
306270000 Referral to medical microbiologist (procedure)
306271001 Referral to neuropathologist (procedure)
306272008 Referral to clinical allergist (procedure)
306273003 Referral to chest physician (procedure)
306275005 Referral to respiratory physician (procedure)
306276006 Referral to clinical neurophysiologist (procedure)
306277002 Referral to clinical physiologist (procedure)
306278007 Referral to endocrinologist (procedure)
306279004 Referral to clinical geneticist (procedure)
306280001 Referral to clinical cytogeneticist (procedure)
306281002 Referral to clinical molecular geneticist (procedure)
306282009 Referral to genitourinary physician (procedure)
306284005 Referral to infectious diseases physician (procedure)
306285006 Referral to medical ophthalmologist (procedure)
306286007 Referral to nephrologist (procedure)
306287003 Referral to nuclear medicine physician (procedure)
306288008 Referral to palliative care physician (procedure)
306289000 Referral to rehabilitation physician (procedure)
306290009 Referral to rheumatologist (procedure)
306291008 Referral to child and adolescent psychiatrist (procedure)
306293006 Referral to liaison psychiatrist (procedure)
306294000 Referral to psychiatrist for mental handicap (procedure)
306295004 Referral to rehabilitation psychiatrist (procedure)
306296003 Referral to public health physician (procedure)
306297007 Referral to obstetrician and gynecologist (procedure)
306298002 Referral to occupational health physician (procedure)
306299005 Referral to radiologist (procedure)
306300002 Referral to breast surgeon (procedure)
306301003 Referral to thoracic surgeon (procedure)
306302005 Referral to cardiac surgeon (procedure)
306303000 Referral to dental surgeon (procedure)
306304006 Referral to orthodontist (procedure)
306305007 Referral to pediatric dentist (procedure)
306306008 Referral to restorative dentist (procedure)
306307004 Referral to endocrine surgeon (procedure)
306308009 Referral to gastrointestinal surgeon (procedure)
306309001 Referral to general gastrointestinal surgeon (procedure)
306310006 Referral to upper gastrointestinal surgeon (procedure)
306311005 Referral to colorectal surgeon (procedure)
306312003 Referral to hand surgeon (procedure)
306313008 Referral to hepatobiliary surgeon (procedure)
306314002 Referral to pancreatic surgeon (procedure)
306315001 Referral to plastic surgeon (procedure)
306316000 Referral to transplant surgeon (procedure)
306317009 Referral to trauma surgeon (procedure)
306318004 Referral to urologist (procedure)
306320001 Referral to clinical nurse specialist (procedure)
306338003 Referral to nurse practitioner (procedure)
306341007 Referral to community-based midwife (procedure)
306342000 Referral to hospital-based midwife (procedure)
306343005 Referral to psychotherapist (procedure)
306351008 Referral to community-based podiatrist (procedure)
306352001 Referral to hospital-based podiatrist (procedure)
306353006 Referral to community-based dietitian (procedure)
306354000 Referral to hospital-based dietitian (procedure)
306355004 Referral to community-based occupational therapist (procedure)
306356003 Referral to social services department occupational therapist (procedure)
306357007 Referral to hospital-based occupational therapist (procedure)
306358002 Referral to community-based physiotherapist (procedure)
306359005 Referral to hospital-based physiotherapist (procedure)
306360000 Referral to community-based speech and language therapist (procedure)
306361001 Referral to hospital-based speech and language therapist (procedure)
306736002 Referral to general dental surgeon (procedure)
307063001 Referral to clinical hematologist (procedure)
307777008 Referral to vascular surgeon (procedure)
308439003 Referral to midwife (procedure)
308447003 Referral to physiotherapist (procedure)
308449000 Referral to chiropractor (procedure)
308450000 Referral to osteopath (procedure)
308451001 Referral to podiatrist (procedure)
308452008 Referral to speech and language therapist (procedure)
308453003 Referral to occupational therapist (procedure)
308454009 Referral to orthoptist (procedure)
308455005 Referral to orthotist (procedure)
308456006 Referral to audiologist (procedure)
308459004 Referral to psychologist (procedure)
308465004 Referral to optometrist (procedure)
308469005 Referral to geneticist (procedure)
308470006 Referral to general physician (procedure)
308471005 Referral to cardiologist (procedure)
308472003 Referral to dermatologist (procedure)
308473008 Referral to clinical immunologist (procedure)
308474002 Referral to neurologist (procedure)
308475001 Referral to care of the elderly physician (procedure)
308476000 Referral to gastroenterologist (procedure)
308477009 Referral to psychiatrist (procedure)
308478004 Referral to general surgeon (procedure)
308479007 Referral to ophthalmologist (procedure)
308480005 Referral to ear, nose and throat surgeon (procedure)
308481009 Referral to orthopedic surgeon (procedure)
308482002 Referral to neurosurgeon (procedure)
308483007 Referral to pediatric surgeon (procedure)
308484001 Referral to obstetrician (procedure)
308485000 Referral to gynecologist (procedure)
309046007 Private referral to surgeon (procedure)
309623006 Child referral to optician (procedure)
309626003 Child referral - school psychologist (procedure)
309627007 Child referral - clinical psychologist (procedure)
309629005 Child referral - community dentist (procedure)
310515004 Referral to medical oncologist (procedure)
312487009 Referral to pediatric cardiologist (procedure)
312488004 Referral to community child health doctor (procedure)
390866009 Referral to mental health team (procedure)
401266006 Referral to drug abuse counselor (procedure)
406158007 Referral to oral surgeon (procedure)
406159004 Referral to maxillofacial surgeon (procedure)
408285001 Referral to pediatric dietitian (procedure)
415277000 Referral to pediatric endocrinologist (procedure)
416116000 Referral to home registered dietitian (procedure)
416999007 Private referral to physiotherapist (procedure)
425971006 Referral to pediatric pulmonologist (procedure)
428441000124100 Referral to nurse anesthetist (procedure)
428451000124103 Referral to physician assistant (procedure)
428461000124101 Referral to nutrition professional (procedure)
428471000124108 Referral to clinical psychologist (procedure)
428481000124106 Referral to clinical social worker (procedure)
428491000124109 Referral to anesthesiologist assistant (procedure)
428541000124104 Referral to nurse midwife (procedure)
429365000 Referral to pediatric gastroenterologist (procedure)
433151006 Referral to educational psychologist (procedure)
448761000124106 Referral to endovascular specialist (procedure)
448771000124104 Referral to prosthetist (procedure)
54395008 Patient referral for medical consultation (procedure)
698563003 Referral to bariatric surgeon (procedure)
698599008 Private referral to breast surgeon (procedure)
703974003 Private referral to colorectal surgeon (procedure)
703975002 Private referral to podiatrist (procedure)
703976001 Private referral to radiologist (procedure)
716634006 Referral to neurological physiotherapist (procedure)

Denominator

Equals Initial Population

Denominator Exclusions

None

Denominator Exceptions

None

Numerator

Number of patients with a referral on or before October 31, for which the referring clinician received a report from the clinician to whom the patient was referred.

The LOINC codes for the report can be entered in the patient's chart under the Communication area of the CQMs section. Click the +New button.

Chart_CQMs_Communication.png

You can enter the code or search by keyword. Select an appointment, performed or ordered, and then click Create.

Referral_Create_Communication_Search_and_Save_Side_by_Side.png

LOINC Codes

11488-4 Consult note
34099-2 Cardiology Consult note
34100-8 Intensive care unit Consult note
34101-6 General medicine Outpatient Consult note
34102-4 Psychiatry Hospital Consult note
34103-2 Pulmonary Consult note
34104-0 Hospital Consult note
34749-2 Anesthesiology Outpatient Consult note
34756-7 Dentistry Consult note
34758-3 Dermatology Consult note
34760-9 Diabetology Consult note
34761-7 Gastroenterology Consult note
34764-1 General medicine Consult note
34776-5 Geriatric medicine Consult note
34777-3 Obstetrics and Gynecology Consult note
34779-9 Hematology+Medical oncology Consult note
34781-5 Infectious disease Consult note
34783-1 Kinesiotherapy Consult note
34785-6 Mental health Consult note
34788-0 Psychiatry Consult note
34791-4 Psychology Consult note
34795-5 Nephrology Consult note
34797-1 Neurology Consult note
34798-9 Neurological surgery Consult note
34800-3 Nutrition and dietetics Consult note
34803-7 Occupational medicine Consult note
34805-2 Oncology Consult note
34807-8 Ophthalmology Consult note
34810-2 Optometry Consult note
34812-8 Oral and Maxillofacial Surgery Consult note
34814-4 Orthopaedic surgery Consult note
34816-9 Otolaryngology Consult note
34820-1 Pharmacology Consult note
34822-7 Physical medicine and rehab Consult note
34824-3 Physical therapy Consult note
34826-8 Plastic surgery Consult note
34828-4 Podiatry Consult note
34831-8 Radiation oncology Consult note
34833-4 Recreational therapy Consult note
34837-5 Respiratory therapy Consult note
34839-1 Rheumatology Consult note
34841-7 Social worker Consult note
34845-8 Speech-language pathology+Audiology Consult note
34847-4 Surgery Consult note
34849-0 Cardiothoracic surgery Consult note
34851-6 Urology Consult note
34853-2 Vascular surgery Consult note
34855-7 Occupational therapy Consult note
34879-7 Endocrinology Consult note
51845-6 Outpatient Consult note
51846-4 Emergency department Consult note
51854-8 Long term care facility Consult note
64056-5 General medicine Medical student Hospital Consult note
64068-0 Surgery Medical student Hospital Consult note
64072-2 Critical care medicine Medical student Hospital Consult note
64076-3 Cardiothoracic surgery Medical student Hospital Consult note
64080-5 Pulmonary Medical student Hospital Consult note
68469-6 Pastoral care Hospital Consult note
68486-0 Cardiology Medical student Hospital Consult note
68551-1 Dermatology Hospital Consult note
68566-9 Obstetrics and Gynecology Hospital Consult note
68570-1 Occupational therapy Hospital Consult note
68575-0 Ophthalmology Hospital Consult note
68586-7 Pharmacology Hospital Consult note
68590-9 Physical therapy Hospital Consult note
68597-4 Plastic surgery Hospital Consult note
68619-6 Adolescent medicine Hospital Consult note
68633-7 Allergy and Immunology Hospital Consult note
68639-4 Audiology Hospital Consult note
68648-5 Child and adolescent psychiatry Hospital Consult note
68651-9 Clinical biochemical genetics Hospital Consult note
68661-8 Clinical genetics Hospital Consult note
68670-9 Developmental-behavioral pediatrics Hospital Consult note
68681-6 Multi-specialty program Hospital Consult note
68685-7 Neonatal perinatal medicine Hospital Consult note
68694-9 Neurological surgery Hospital Consult note
68705-3 Neurology with special qualifications in child neurology Hospital Consult note
68716-0 Pain medicine Hospital Consult note
68727-7 Pediatric cardiology Hospital Consult note
68746-7 Pediatric gastroenterology Hospital Consult note
68757-4 Pediatric hematology-oncology Hospital Consult note
68765-7 Pediatric infectious diseases Hospital Consult note
68787-1 Pediatric pulmonology Hospital Consult note
68802-8 Pediatric surgery Hospital Consult note
68812-7 Pediatric urology Hospital Consult note
68821-8 Pediatrics Hospital Consult note
68837-4 Primary care Hospital Consult note
68846-5 Speech-language pathology Hospital Consult note
68852-3 Transplant surgery Hospital Consult note
68864-8 Pediatric transplant hepatology Hospital Consult note
68869-7 Pediatric nephrology Hospital Consult note
68874-7 Pediatric otolaryngology Hospital Consult note
68879-6 Pediatric rheumatology Hospital Consult note
68892-9 Pediatric dermatology Hospital Consult note
68897-8 Pediatric endocrinology Hospital Consult note
72555-6 Interventional radiology Consult note
73575-3 Radiology Consult note
75424-2 Audiology Consult note
75465-5 Orthotics prosthetics Consult note
77403-4 Anesthesiology Consult note
77429-9 Allergy and Immunology Consult note
78250-8 Colon and rectal surgery Consult note
78251-6 Hematology Consult note
78252-4 Multi-specialty program Consult note
78253-2 Family medicine Consult note
78254-0 Clinical genetics Consult note
78405-8 Neonatal perinatal medicine Consult note
78406-6 Nurse practitioner Consult note
78496-7 Critical care medicine Consult note
78498-3 Cardiopulmonary Consult note
78567-5 Pain medicine Consult note
78568-3 Palliative care Consult note
78726-7 Pediatrics Consult note
78732-5 Trauma Consult note
78738-2 Sports medicine Consult note
79428-9 Rapid response team Consult note
80396-5 Gynecologic oncology Consult note
80575-4 Cardiac surgery Consult note
80664-6 Clinical neurophysiology Consult note
80666-1 Vascular neurology Consult note
80673-7 Maternal and fetal medicine Consult note
80736-2 Blood banking and transfusion medicine Consult note
80801-4 Surgical oncology Consult note
81191-9 Chemical pathology Consult note
81192-7 Clinical pathology Consult note
81193-5 Medical microbiology - pathology Consult note
81196-8 Clinical pharmacology Consult note
82356-7 Obstetrics Midwife Consult note
82359-1 Reproductive endocrinology and infertility Consult note
83570-2 Diabetology Nurse Consult note
83578-5 Hematology+Medical oncology Nurse Consult note
83609-8 Psychiatry Nurse Consult note
83621-3 Geriatric medicine Nurse Consult note
83653-6 Pain medicine Team Consult note
83685-8 Hematology+Medical oncology Attending Consult note
83720-3 Physical medicine and rehab Long term care facility Consult note
83722-9 Physical medicine and rehabilitation Nurse Consult note
83868-0 Preventive medicine Consult note
83873-0 Primary care Consult note
83888-8 Psychiatry Long term care facility Consult note
83909-2 Public health Consult note
83912-6 Pulmonary Patient's home Consult note
83926-6 Recreational therapy Long term care facility Consult note
83931-6 Research Consult note
83941-5 Respiratory therapy Patient's home Consult note
83960-5 Social worker Patient's home Consult note
83967-0 Social worker Long term care facility Consult note
83984-5 Speech-language pathology Consult note
83992-8 Spinal cord injury medicine Consult note
83996-9 Spinal cord injury medicine Patient's home Consult note
84035-5 Transplant surgery Consult note
84071-0 Chiropractic medicine Consult note
84115-5 Geriatric medicine Long term care facility Consult note
84126-2 Surgery of the hand Consult note
84131-2 Primary care Patient's home Consult note
84142-9 Hematology+Medical oncology Hospital Consult note
84145-2 Hematology+Medical oncology Outpatient Consult note
84152-8 Hepatology Consult note
84173-4 Interventional cardiology Consult note
84190-8 Medical toxicology Consult note
84213-8 Mental health Team Consult note
84231-0 Neurology Telehealth Consult note
84241-9 Nurse Consult note
84280-7 Nutrition and dietetics Patient's home Consult note
84292-2 Nutrition and dietetics Team Consult note
84303-7 Wound care management Consult note
84312-8 Vocational rehabilitation Consult note
84324-3 Physical therapy Long term care facility Consult note
84349-0 Pastoral care Consult note
84352-4 Palliative care Team Consult note
84358-1 Palliative care Patient's home Consult note
84394-6 Occupational therapy Patient's home Consult note
84398-7 Occupational therapy Long term care facility Consult note
85174-1 Custodial care facility Consult note
85208-7 Telehealth Consult note
85222-8 Case manager Consult note
85232-7 Tumor board Consult note
85237-6 Acupuncture Consult note
85238-4 Internal medicine Consult note
85517-1 Bariatric surgery Consult note
85519-7 Child and adolescent psychology Consult note
85866-2 Sleep medicine Consult note
85871-2 Womens health Consult note
85882-9 Ophthalmology Teleimaging Consult note
85884-5 Epilepsy Consult note
85886-0 Clinical cardiac electrophysiology Consult note
85890-2 Neuropsychology Consult note
85899-3 Community health care Consult note
86451-2 Ethics Consult note
87233-3 Dialysis Consult note
87254-9 Addiction medicine Consult note
87627-6 Brain injury Consult note
88351-2 Polytrauma Consult note
88640-8 Community health care Adult day care center Consult note
88644-0 Outpatient hospital Consult note
89031-9 Hematology Telehealth Consult note
89032-7 Nephrology Telehealth Consult note
89033-5 Urology Telehealth Consult note
89216-6 Gynecology Consult note
89227-3 Obstetrics Consult note
89446-9 Obstetrics Hospital Consult note
89447-7 Gynecology Hospital Consult note
89551-6 Environmental health Consult note
90006-8 Pharmacogenomics Consult note
90012-6 Burn management Consult note
90343-5 Nuclear medicine Consult note
90354-2 Obesity medicine Consult note
90709-7 Adolescent medicine Consult note
90710-5 Developmental-behavioral pediatrics Consult note
90712-1 Sleep medicine Telehealth Consult note
90714-7 Pain medicine Telehealth Consult note
90715-4 Palliative care Telehealth Consult note
90717-0 Heart failure+Transplant cardiology Consult note
90771-7 Heart failure Consult note
91986-0 Integrative medicine Consult note
92910-9 Spinal surgery Consult note
92912-5 Eating disorders Consult note
92915-8 Immunology Consult note
93024-8 Pharmacist Consult note
93413-3 Mechanical circulatory support Consultation note
93955-3 Wound, Ostomy, and Continence Care Consult note
371530004 Clinical consultation report (record artifact)
371531000 Report of clinical encounter (record artifact)
371545006 Confirmatory consultation report (record artifact)
721916007 Physician consulting initial evaluation note (record artifact)
721927009 Referral note (record artifact)

Numerator Exclusions

None

Measure Information