I don't use the billing system in AC either Neil.
You are correct in that not all MU data is collecting unless you select a CPT and sign the note. Most the data is collected upon signing the note however.
Some of the CQM and all of the Alternate CQM data is not recorded correctly unless you add ICD-9 diagnosis codes and select a CPT billing code prior to signing the note.
You don't have to enter ICD-9 and CPT codes for all patients however, rather just do it for the ones that have measures you want to report on. Again I'm talking about the Alternate CQM. Core and Menu items don't fully depend upon the ICD9/CPT codes being entered.
For example, under the Alternate CQM's you track diagnostic imaging in the setting of low back pain. You would enter the dx of Lumbago 724.2, select CPT 99213 or whatever, then sign the note. But don't use the AC pre-formatted order for xray. You will therefore run the MU Report and find the numerator and denominator have both increased by one unit.
I'm not aware of any Core or Menu items that are negatively impacted by NOT using ICD9/CPT codes. Can you think of any specific examples where you are finding the issue?
