374. Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, on or before October 31, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred.

This measure is to be submitted a minimum of once per performance period for the first referral for all patients during the measurement period. This measure may be submitted by MIPS-eligible clinicians who perform the quality actions described in the measure for the patients for whom a referral was made during the measurement period based on the services provided and the measure-specific denominator coding. The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure. All MIPS-eligible clinicians reporting on this measure should note that all data for the reporting year is to be submitted by the deadline established by CMS; however, only first referrals made between January 1–October 31 (the measurement period) will count towards the denominator to allow adequate time for the referring clinician to collect the consult report by the end of the performance period. When clinicians to whom patients are referred communicate the consult report as soon as possible with the referring clinicians, it ensures that the communication loop is closed in a timely manner and that the data is included in the submission to CMS.

Document the referral for the denominator:

  1. In Eyefinity EHR, create a New Visit or a New Order (nonvisit order).
  2. Select a Diagnosis.
  3. Select a referral Plan and tap Save.
  4. Locate the Referral plan and tap Resume.

    A list of referral recipients opens. If you need to add a referral contact, go to Managing Referral Contacts.

  5. Tap Close.
  6. Document the rest of the visit and Finalize.

After the exam is finalized, send the CCD:

  1. Return to the Patient Overview.
  2. Tap the finalized visit note.
  3. Tap the More action bar icon and tap Send CCDA.

    A message window opens.

  4. Tap or type the first few letters of the provider to whom you’re referring the patient and select the provider’s name from the list.

    If you don’t see the provider you’re looking for, open Eyefinity EHR on the web, click the Document Management tab, add the provider and their HISP Address, and return to the Select Referral Recipient window within the exam.

  5. Edit the Subject as needed.
  6. Compose a short message that is relevant to the case.

  7. Tap Send.

When the consult report is received, perform the following steps:

  1. Log in to Encompass on the web.
  2. Search for the patient and open the Patient Chart.
  3. Click the Manage Attachments action bar icon.
  4. Attach the inbound fax or upload a scanned copy of the consult report.

    Once attached or uploaded, the file appears in the list of attachments.

  5. Locate the report in the attachments list and select the Visit during which the referral was made.
  6. Select Referral from the Category drop-down.

  7. Click Save.

Eyefinity products and documentation refer to the MIPS quality numbers. Other measure numbering systems are listed here for your reference.

Quality 374
NQF —
CMS 50
  • Registry
  • MVP

This topic describes how points are calculated for this measure. To learn more about scoring, go to Scoring.

Benchmarks are displayed here as both a chart and a table. The chart gives you a visual representation and helps you quickly compare benchmarks across different reporting methods. The table lists the specific benchmark criteria for each available reporting method.

 

Submission Method 3rd Decile 4th Decile 5th Decile 6th Decile 7th Decile 8th Decile 9th Decile 10th Decile
Registry 90.00– 97.36 97.37– 99.99 — — — — — 100
MVP 90.00– 97.36 97.37– 99.99 — — — — — 100

Number of patients, regardless of age, who had one or more visits during the measurement period:

92002, 92004, 92012, 92014, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 90791, 90792, 90839, 96112, 96116, 96136, 96138, 96156, 98000, 98001, 98002, 98003, 98004, 98005, 98006, 98007, 98008, 98009, 98010, 98011, 98012, 98013, 98014, 98015, 98016, 99381*, 99382*, 99383*, 99384*, 99385*, 99386*, 99387*, 99391*, 99392*, 99393*, 99394*, 99395*, 99396*, 99397*

AND [registry reporting only] who was referred to another provider or specialist during the on or before October 31:

G9968

AND [EHR reporting only] who were referred to another provider documented with one of the following SNOMED codes:

103696004, 103697008, 103698003, 103699006, 103704003, 183515008, 183517000, 183528001, 183529009, 183530004, 183541002, 183555005, 183557002, 183561008, 183567007, 183569005, 183583007, 183591003, 183878008, 183879000, 183880002, 183881003, 183882005, 183884006, 183885007, 183886008, 183887004, 183888009, 183889001, 183890005, 183891009, 183892002, 183893007, 183894001, 183895000, 183896004, 183897008, 183899006, 183900001, 183901002, 183902009, 183903004, 183904005, 183905006, 183906007, 183907003, 183908008, 183909000, 183910005, 183911009, 183913007, 183914001, 183915000, 183916004, 266747000, 274410002, 306241009, 306242002, 306243007, 306245000, 306247008, 306250006, 306252003, 306253008, 306254002, 306255001, 306256000, 306257009, 306258004, 306259007, 306260002, 306261003, 306262005, 306263000, 306264006, 306265007, 306266008, 306267004, 306268009, 306269001, 306270000, 306271001, 306272008, 306273003, 306274009, 306275005, 306276006, 306277002, 306278007, 306279004, 306280001, 306281002, 306282009, 306284005, 306285006, 306286007, 306287003, 306288008, 306289000, 306290009, 306291008, 306293006, 306294000, 306295004, 306296003, 306297007, 306298002, 306299005, 306300002, 306301003, 306302005, 306303000, 306304006, 306305007, 306306008, 306307004, 306308009, 306309001, 306310006, 306311005, 306312003, 306313008, 306314002, 306315001, 306316000, 306317009, 306318004, 306320001, 306338003, 306341007, 306342000, 306343005, 306351008, 306352001, 306353006, 306354000, 306355004, 306356003, 306357007, 306358002, 306359005, 306360000, 306361001, 306736002, 307063001, 307777008, 308439003, 308447003, 308449000, 308450000, 308451001, 308452008, 308453003, 308454009, 308455005, 308456006, 308459004, 308465004, 308469005, 308470006, 308471005, 308472003, 308473008, 308474002, 308475001, 308476000, 308477009, 308478004, 308479007, 308480005, 308481009, 308482002, 308483007, 308484001, 308485000, 309046007, 309623006, 309626003, 309627007, 309629005, 310515004, 312487009, 312488004, 390866009, 401266006, 406158007, 406159004, 408285001, 415277000, 416116000, 416999007, 425971006, 428441000124100, 428451000124103, 428461000124101, 428471000124108, 428481000124106, 428491000124109, 428541000124104, 429365000, 433151006, 448761000124106, 448771000124104, 54395008, 698563003, 698599008, 703974003, 703975002, 703976001, 716634006

[EHR reporting only] Number of patients with a referral, for which the referring provider (you) received a report from the provider to whom the patient was referred, documented with one of the following SNOMED codes:

371530004, 371531000, 371545006

You cannot manually enter SNOMED codes. To complete this measure, you must follow the steps listed under 374. Closing the Referral Loop: Receipt of Specialist Report.

Performance Met

[Registry reporting only] Clinician who referred the patient to another clinician received a report from the clinician to whom the patient was referred:

G9969

Performance Not Met

[Registry reporting only] Clinician who referred the patient to another clinician did not receive a report from the clinician to whom the patient was referred:

G9970