CMS Update on eCQM Value Sets for 2017 Performance Period

cms-twitter-200In response to your feedback and in recognition of the large volume of changes introduced into International Classification of Diseases (ICD)-10 in FY 2017, the Centers for Medicare & Medicaid Services (CMS) (@CMSGov) and the National Library of Medicine (NLM) (@NLM_SIS) will update all impacted electronic clinical quality measure (eCQM) value sets for the 2017 performance period.

On October 1, 2016, new International Classification of Diseases (ICD)-10-CM and ICD-10-PCS code sets went into effect. Updating of these codes traditionally occurs on an annual basis, however, during the immediate years leading up to the ICD-9 to ICD-10 transition there was an extended freeze to code updates to support a smooth transition. Therefore, for fiscal year (FY) 2017, updates and revisions include changes since the last completed update (October 1, 2013).

2017 Performance Year
CMS will issue an addendum to the 2016 eCQM Specifications (ie. 2016 Annual Update published in April 2016) to update relevant ICD-10-CM and ICD-10-PCS eCQM value sets for the 2017 performance year. These changes will affect electronic reporting of eCQMs for the following programs:

  • The Hospital Inpatient Quality Reporting (IQR) Program;
  • The Medicare Electronic Health Record Incentive Program for eligible hospitals and critical access hospitals;
  • The Merit-based Incentive Payment System (MIPS) for MIPS eligible clinicians.

Please note that these changes will only affect the value sets for the eCQMs. 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.

What Changes Will Be Included In the Addendum?
The changes to the ICD-10 value sets will 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) will also be added. CMS is prioritizing these ICD-10 updates. Updates for other terminologies will take place during the 2017 Annual Update.

Where Will The Addendum Be Posted?
All changes to the eCQM value sets will be made available through the National Library of Medicine’s Value Set Authority Center starting in early to mid-January 2017. Measure implementers should review these changes to ensure their submissions comply with the updated requirements. CMS will provide a follow-up communication announcing the availability of the addendum and educational materials.

What Do I Need To Do?
At this time, no action is required. The addendum, available in January 2017, will include actionable steps for successful program participation.

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.