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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
GE Healthcare 2015
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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
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
2. Referral Order
GE Healthcare 2015
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GE Healthcare 2015
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