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Knowledge Now!

Data Flow: CMS 50


December 7, 2015
Audience: EMR users who are responsible for configuring or monitoring provider reporting data for Meaningful Use
or other supported performance programs (such as PQRS) within CQR.

Measure Definition
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.
Measure Requirements from the GE Quality Reporting Guide

Three components are required to meet the measure: an office visit, referral order, and documentation of a
consult report in return
Denominator counts one for every patient who was referred by one provider to another and the patient had
a visit during the reporting or measurement period
Validate the data mapping for CMS 50 Data Mapping Webinar & Slides

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Office Visit Data Mapping for the Denominator Face-to-Face Interaction Grouping Value Set

Referral Order Code Data Mapping for the Denominator Referral Grouping Value Set

Numerator counts one for every patient in the denominator for which the referring provider has received a
report from the provider the patient was referred
Consult Report Data Mapping for the Numerator Consultant Report Grouping Value Set

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Measure Setup

CEMR: Go>Setup>Settings>Orders> Codes & Categories > Services for Office Visit
If not using CPT codes for E&M services or billing via EMR, using SCT-308335008 as an alternative
CPS: Administration>Codes>Charts>Codes & Categories>Services for Office Visit
If not using CPT codes for E&M services or billing via EMR, using SCT-308335008 as an alternative

CEMR: Go>Setup>Settings>Orders > Codes & Categories > Referrals for Outbound Referral Order
CPS: Administration>Codes>Charts>Codes & Categories> Referrals for Outbound Referral Order

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CEMR: Go>Setup>Settings>Orders > Codes & Categories > Services for Marking Receipt of Consult Reports
CPS: Administration>Codes>Charts>Codes & Categories> Services for Marking Receipt of Consult Reports
Set to a status of complete upon signature always complete order before place the receipt of report order

Referral Loop - CCC form is a workflow option to indicate when the report is received
When you perform the update, make sure the Authorized By provider in Order Details matches the original
provider on the outbound referral order

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You may also choose to create an encounter type to also close the loop on the report receipt
Change the provider to match the original provider on the outbound referral order

Validating Data Send to Clinical Quality Reporting (CQR)

In CQR, navigate to Insight > Calculation > Enter Provider Name > Search for Patient
Look for the three key pieces of data below to fulfill the measure, track progress, and confirm proper
workflow

1.Office Visit

3. Consult Report Receipt

2. Referral Order

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Important References for More Detailed Information


Quality Reporting Guide Updated Monthly
Centricity Practice Solution
Centricity EMR
Customer Service Portal for Quality Reporting
Centricity Practice Solution
Centricity EMR

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