Numerator Setup for Quality Measures

Setup Required

1. Open a chart with ‘Level-1 MIPS Numerator’ set up. To know how to create the Level-1 main node for ‘MIPS numerator’, click here.

2. Create a Level-1 sub-component under MIPS Numerator for Quality ID #128. (While creating this component, provide MIPS numerator as the Parent component.)

Name: Quality ID #128: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Code: CPT or BILLING

3. When you save and close the component creation dialog box, you will be able to view the Quality ID #128 under ‘MIPS Numerator’ Component. Click on the component.

4. ID #128 has 2 denominator exclusions, 2 denominator exceptions, and 5 numerator criteria (Performance Met and Performance Not Met) specified. Hence, nine level 2 components are to be created.

5. Click on the symbol seen on the top right portion of the Level-2 area (see arrow mark in the above image); Level-2 component creation dialog box appears. Provide the first denominator exception in the Name field and the corresponding CPT Code in the Code field. Click on Save.

6. Repeat Step 6 for the rest of the parameters of ID  #128.

7. Save the chart. Next time the provider opens the chart for a patient, he may check the boxes whichever applicable.

Setup Required

1. Open a chart with ‘Level-1 MIPS Numerator’ set up. To know how to create the Level-1 main node for ‘MIPS numerator’, click here.

2. Create a Level-1 sub-component under MIPS Numerator for Quality ID #47. (While creating this component, provide MIPS numerator as the Parent component.)

Name: Quality ID #47 (NQF 0326): Advance Care Plan

Code: CPT or BILLING

3. When you save and close the component creation dialog box, you will be able to view the Quality ID #47under ‘MIPS Numerator’ Component. Click on the component.

4. Create level-2 components for numerator criteria and denominator exclusion of CQM ID# 47. This quality ID has one denominator exclusion and, three numerator criteria specified (2 performance Met and 1 performance Not Met component). Hence, a total of four Level-2 components are to be created.

5. Click on the symbol seen on the top right portion of the Level-2 area (see arrow mark in the above Image); Level-2 component creation dialog box appears. Provide the denominator exclusion in the Name and CPT code in the Code field.

Name: Denominator Exclusion: G9692 – Hospice services received by patient any time during the measurement period.

Code: G9692

Click on Save.

6. Repeat Step 5 for the remaining criteria as follows:

A. Name: Performance Met: 1123F – Advance Care Planning discussed and documented; advance care plan or surrogate decision maker documented in the medical record

Code: 1123F

B. Name: Performance Met: 1124F – Advance Care Planning discussed and documented in the medical record; patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan.

Code: 1124F

C. Name: Performance Not Met (1123F with 8P): Advance Care Planning not documented, reason not otherwise specified

Code: 1123F with 8P

7. Save the chart. Next time the provider opens the chart for a patient, he may check the boxes whichever applicable.