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I wanted to attest OCT 1 to MU 1 only to find out in mid september AC was not populating the denom/numerators for the adult CQM. I was told by tech support that I could enter zeros in all the categories . I checked with my REGIONAL EXT CENTER FOR CMS AND THEY SAID THIS WAS NOT THE CASE. It was not a percentage that you had to pass but the software had to demonstrate it could populate those areas. Given that the government has now criminalized this process and I was not willing to attest to something that simply was not true. After much money and time spent, I am done with this. This has been an awful experience and should not have happened. Gwendolyn L. O'Guin,D.O. South Portland, Maine Family Practice.

Hi Gwendolyn,

I am sorry for the conflicting information you received on reporting CQMs. I did some research and according to documents on the CSM website, 0's are considered reportable. Here is the link to the document I am referencing: http://www.cms.gov/Regulations-and-.../Downloads/EP_Attestation_User_Guide.pdf

See page 50 of the document?from CMS?about reporting 2014 cqms, which says:

"Step 24 ? Clinical Quality Measures (CQMs 1 of 9)
Each EP must report on nine CQMs. Zero is an acceptable denominator provided that this value was produced by certified EHR technology"

Also according to the CQM user guide (http://www.cms.gov/Regulations-and-...rograms/Downloads/CQM_EPs_2012_02_02.pdf) "If you reported 0 for all 3 core measures, you must report on all 3 alternate core measures even if you will report zeroes for all 6 measures. Note: All values reported should be the values produced by the certified EHR technology."

So unless CMS has changed regulations and not informed anyone (which is always a possibility with them), it seems that 0's are acceptable. If you find any written documentation that contradicts this information, please don't hesitate to forward it along to me. my address is mdabeck@amazingcharts.com.

Dear Mark: you can have zeros for the DENOMINATOR , it says nothing about the numerator. This a copy paste of the rule: Each EP must report on nine CQMs. Zero is an acceptable denominator provided that this value was produced by certified EHR . Amazing charts was not capturing anything for the numerator so I would be attesting to all zeros. There is nothing in the rule that's states I can do that. Gwendolyn

The denominator is your overall patients that would qualify for the measure and would be your larger number of the two. Of you have a 0 for your denominator, then your numerator would be 0 as well. For example, For hypertension and blood pressure measurement your denominator is the number of patients who are 18 years and older who are diagnosed with hypertension. Your numerator is those patients in your denominator that have a controlled blood pressure. If you have no patients that qualify for your denominator (giving you a 0) then there will be a 0 as well for your numerator.

Gosh Mark:I do not want to beat this to death. But I have all that information, HTN, colon, breast cervical screening vaccinations etc and NONE of it is showing. It does not make any sense. Then how does AC pick that data up and populate the numerator and denominator?

Even if you don't use AC for billing, make sure that you choose a visit level before signing off the note. Otherwise, some of the data doesn't get saved for the MU reports.

how is AC picking up the numerator and denominator for the CQMS IT IS NOT through the level visit UNLESS they are using G codes for pap, mammos colon screening. this is version 7 i am using .My billing codes are fine and there is no problem there. i am finding it very interesting that no one has answered this question. it is simple: what do i do on AC to show a number in the numerator And Denominator that i have done breast, cervical sreening on a patient

Gwendolyn,
Most of the health maintenance items are picked up from what you enter in DECISION SUPPORT. These must be entered while you are doing the note, before signing off. Things like demographics and vital signs are picked up from their respective boxes in AC. Then, you must attach a CPT code to the visit when signing off for AC to count it.

You can click the teal MU box at the top of the current note to see if it is picking up your entries before signing off.

This is how it works in V6. I don't know whether it is different in V7.

MU topics were covered years ago:
Zeros for MU

This is why there may be little interest, it's old news.....

Use the board search function in the MU forum, search for all posts, you can go back to 2011 when we learned about snafus, and the information you need may be there.

Thanks, Donna. I wasn't clear in my response to gwendolyn above.

As Donna says in her 2011 note (link "Zeros for MU" above), you have to click one of the circles to designate a visit CPT code (ie: 99212, 99213, etc) on the billing page (image below). Then when you sign the note, it registers either the diagnosis (ie: #401.9 HYPERTENSION) or the patient education topic that you chose in Decision Support. So you get a numerator & denominator for that CQM topic.

Hi John I am on Version 7 and I have used decision support for everything as well as correct CPT codes. AC did not pick this up. I worked with tech support on this and we tried several ways to get it to populate using a dummie patient ie decision support, ORDER requisition as AC instructions indicated we needed to use, this is not the answer on Version 7. As someone posted above this is old news, it is not old news when you are trying to do this by the deadline Oct 1st. As I said earlier, the tech guy felt it was tied to G codes for cancer screenings and who knows what else. Clearly no one knows. It really does not matter now, since I am screwed. Lot of work frustration money and time. Thank you for trying to clear this up but it is not clear. Gwendolyn

As you pointed out, my comments only apply to version 6.6x, which I am using. If I recall back to 2011 correctly, most of us didn't realize that we needed that extra step before the CQMs would populate on the report, until Donna and others posted that fact on the User Board. I am not certain if AC Support at that time realized that problem or just were unable to explain it.

I find it absurd that you are being told that it's a problem with G codes or something. After AC pushed out version 7 to meet MU guidelines six months late, and then AC Support unable to troubleshoot this central issue with a core MU function, you should have been automatically moved up to a higher Support level.

Maybe email directly to Trish Viveiros, Director of Client Services (pviveirosATamazingcharts.com) with a copy to John Squire, President & COO (jsquireATamazingcharts.com). In any case please follow up here if you get this solved (I'm even more fearful of version 7 now!)

Another thought about qualifying to attest for the July-Aug-Sep quarter:

In the link to the CMS document provided by Mark@ AC above, look at this statement near the bottom of page 27: "At the EP?s discretion, the numerators and denominators of certain measures may be calculated using only the patient records maintained in certified EHR technology. The EP may also elect to calculate the numerators and denominators of these measures using ALL patient records." My interpretation is that running a report using the AC Reports Module (NOT the MU Wizard) to find the number of patients that meet a certain criteria in that time interval is the numerator, and ALL patients seen in that time is the denominator. You can report those numbers even if the MU Wizard didn't save them correctly.

I realize that this is not what you were told by your Regional Extension Center, but I don't think they understood your problem. You do have a non-zero numerator for these measures; its just that the MU Wizard didn't save them correctly.

Just a thought. Good luck.