374. Closing the Referral Loop: Receipt of Specialist Report

Percentage of patients with referrals, 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 all patients with a referral during the performance 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 performance period based on the services provided and the measure-specific denominator coding. The provider who refers the patient to another provider is the provider who should be held accountable for the performance of this measure. All MIPS eligible professionals or 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. Therefore, all MIPS-eligible professionals or eligible clinicians who refer patients towards the end of the performance period (i.e., November–December), should request that providers to whom they referred their patients share their consult reports as soon as possible in order for those patients to be counted in the measure numerator during the performance period. When providers to whom patients are referred communicate the consult report as soon as possible with the referring providers, 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 Visit Note.
  2. Open the Ocular Exam.
  3. Record the Exam and Diagnosis information.
  4. Under Plans, tap Referral.

    A referral recipients window opens.

  5. Tap Close.

    To satisfy this measure you will send the CCD electronically via direct messaging. To avoid also sending a fax, tap Close.

  6. Document the rest of the exam and finalize it.

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 Eyefinity EHR 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 a Category for the attachment.

  7. Click Save.

Record the referral to another provider:

  1. In a patient’s exam record in ExamWRITER, record the office visit (92xxx or 99xxx).
  2. Click Patient Hx.
  3. Click the Exam Hx tab and click New Referral.
  4. Select the Referring Provider, Refer to Provider, Reason, SNOMED, Referral Date, and Expected Return Date and click Save.
  5. Click Create CDA Transition of Care and click Exit.

When your practice receives the report from the referred provider, complete the following steps:

  1. Open the patient’s exam. This can be the finalized exam from the patient’s exam, or it can be a new exam if you’re seeing the patient again.
  2. Click Patient Hx.
  3. Click the Exam Hx tab and double-click the referral listed under Patient Referral to Other Providers.
  4. Select the Actual Return Date if the patient returned, select the Specialist Report Received check box, and click Save.
  5. Click the eDocuments tab.
  6. Click Show eDocs.
  7. Click Add.
  8. Select Receipt of Specialist Report from the Document Type drop-down menu.
  9. Scan the physical report or browse for an electronic file received from the referred provider.
  10. Click Save/Exit.

    Attaching the report with ECR Vault does not advance the numerator at this time. You must attach it using eDocs.

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
  • EHR (ExamWRITER only)
  • Registry (Eyefinity EHR only)
  • AAO IRIS

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
EHR (ExamWRITER only) 7.59–12.23 12.24–17.92 17.93–24.99 25.00–34.34 34.35–47.82 47.83–64.85 64.86–86.12 ≥ 86.13
Registry (Eyefinity EHR only) 63.18–84.30 84.31–94.11 94.12–98.51 98.52–99.99 — — — 100.00
AAO IRIS 63.18–84.30 84.31–94.11 94.12–98.51 98.52–99.99 — — — 100.00

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, 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 performance period:

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 Achieving this Measure in ExamWRITER.

Performance Met

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

G9969

Performance Not Met

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

G9970