CMS 68v14: Documentation of Current Medications in the Medical Record
Measure: Percentage of visits for patients for which the eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter | ||
Measure Type | High Priority Measure | Scoring |
Process | Yes | A higher percentage indicates better quality |
Denominator | All visits occurring during the 12 month measurement period |
Numerator | Eligible clinician attests to documenting, updating or reviewing the patient's current medications using all immediate resources available on the date of the encounter |
Denominator Exceptions | Documentation of a medical reason(s) for not documenting, updating, or reviewing the patient’s current medications list (e.g., patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status) |
Denominator Exclusions | None |
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Patients who meet the following criteria will be included in the denominator:
- Have at least one eligible encounter during the Measurement Period finalized by the EC
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CPT: 59400, 59510, 59610, 59618, 90791, 90792, 90832, 90834, 90837, 90839, 92002, 92004, 92012, 92014, 92507, 92508, 92526, 92537, 92538, 92540, 92541, 92542, 92544, 92545, 92547, 92548, 92549, 92550, 92557, 92567, 92568, 92570, 92588, 92626, 92650, 92651, 92652, 92653, 96116, 97161, 97162, 97163, 97164, 97165, 97166, 97167, 97168, 97802, 97803, 97804, 98960, 98961, 98962, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99221, 99222, 99223, 99236, 99281, 99282, 99283, 99284, 99285, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99339, 99340, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397, 99495, 99496, 96156, 96158, 97129, 99424, 99491
HCPCS: G0101, G0108, G0270, G0402, G0438, G0439
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To document a denominator-eligible visit as a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add the code listed below:
CPT: 92622
Order Status must be marked as Complete and encounter must be finalized by the EC.
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A patient will be counted as an exception if a medication reconciliation was not performed due to an urgent medical situation.
To document an exception, go to Encounter > Medications and select the Medication Reconciliation Not Performed Due to Urgent Medical Situation checkbox.
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A patient will be counted in the numerator if a medication reconciliation is performed at every eligible encounter during the Measurement Period.
To document a medication reconciliation was performed for the patient, go to Encounter > Medications and select the Medication Reconciliation Performed checkbox.
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