Recent CMS 2022 truncation/suppression of quality measures due to ICD-10 code updates

CMS recently announced some of the quality measures that are being truncated or suppressed for 2022 due to ICD-10 updates from October 1, 2022. 

2022 MIPS Quality Measures Impacted by ICD-10 Updates Effective October 1, 2022

ICD-10 code updates are effective annually on October 1, but quality measure specifications can’t be updated until the next MIPS program year. CMS has analyzed and assessed the quality measures to evaluate which measures are significantly impacted (greater than 10%) by the ICD-10 code updates. 

If a MIPS quality measure is impacted by 10% or more by ICD-10 code changes, such MIPS quality measure will be:
     • Truncated, the 2022 performance period and subsequent performance score for the affected quality measure will be based only on the first 9 months of the 12-month performance period 
     OR 
     • Suppressed for the 2022 performance period. 

The criteria used to make such determination is as follows:
     • Greater than 10% code changes in the measure numerator, denominator, exclusions, and exceptions.
     • Clinical guideline changes, new products, or procedures reflected in ICD-10 code changes.
     • Feedback on a measure received from measure developers and stewards.

Measures identified for Truncation – Medicare Part B Claims Measures
Quality ID# 134 – Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Quality ID# 416 – Emergency Medicine: Emergency Department Utilization for CT for Minor Blunt Head Trauma for Patients Aged 2 Through 17 Years

Measures Identified for Truncation – MIPS Clinical Quality Measures (CQMs)
Quality ID# 6 – Coronary Artery Disease (CAD): Antiplatelet Therapy
Quality ID# 134 – Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Quality ID# 282 – Dementia: Functional Status Assessment

Measures Identified for Suppression – Electronic Clinical Quality Measures (eCQMs)
CMS 135v10 – Heart Failure (HF): Angiotensin Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS 130v10 – Colorectal Cancer Screening
CMS 2v11 – Preventive Care and Screening: Screening for Depression and Follow-Up Plan
CMS 165v10 – Controlling High Blood Pressure
CMS 155v10 – Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents
CMS 149v10 – Dementia: Cognitive Assessment
CMS 136v11 – Follow-Up Care for Children Prescribed ADHD Medication (ADD)

Notes: 
• Only quality measures supported by MEDENT are listed above. In the PDF below, the full list of measures affected is included.
• When the PDF was sent out by CMS 12/30/22, the eCQM measure versions were for 2023. CMS sent out a correction 1/4/23 indicating the measure versions should be for 2022. 

How this is being handled in MEDENT

Medicare Part B Claims-Based reporting: CMS will assess the measure for this collection type based upon the first 9 months of data submitted for 2022.

MIPS CQM (Registry) reporting: CMS will assess the measure for this collection type based upon the first 9 months of data submitted for 2022.

MIPS eCQM reporting: eCQMs are submitted to CMS via the QPP website in a QRDA III file format. This file type only includes aggregate data for the eligible clinicians/groups. CMS would not be able to determine how much of the data submitted in the QRDA III file was from the first 9 months of the year. For this reason, the eCQMs listed above will not count toward the 6 measure Quality submission requirement for 2022.

What does this mean to suppress the quality measure?
A suppressed quality measure means that your MIPS Quality score will be calculated based on the numerator and denominator of all of the measures you are reporting that are not suppressed. The quality category is calculated out of 60 points (10 points for each measure). If you reported only 6 measures and 2 of them were suppressed, your score will only be calculated out of 40 points instead of the full 60.

Note: If any of the measures you intend to report for 2022 submission are suppressed, you will still report these measures in your submission to CMS. This is how CMS will know to calculate your Quality score. You may, of course, submit more than 6 measures if you would like to.

Should you have any questions or concerns regarding the above notice, please submit an online support ticket at www.medent.com/support_access