CMS 50 - Closing the Referral Loop: Receipt of Specialist Report

CMS50v5 (2017)

CMS50v6 (2018)

CMS50v7 (2019)

Description:  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.

Initial Patient Population:  Number of patients, regardless of age, who were referred by one provider to another provider, and who had a visit during the measurement period.

Denominator:  Equals Initial Population

Numerator: Number of patients with a referral, for which the referring provider received a report from the provider to whom the patient was referred.

Inverse Measure:  No

Clinical Instructions

Ensure the system is configured to order, track, and archive referrals appropriately. This includes configuration for scanning and indexing functionality, so that reports, consultations, referral letters, or the like can be scanned into and indexed within the system and be tracked appropriately. With configurations in place, use the encounter visit orders to refer a patient out, and when the receipt of the appropriate report/consultation is received, link to the referral order and complete.

  • While documenting the Visit Encounter, use the Visit Orders to create a Referral.
    Note
    * The out-of-the-box referral order document type (ORDREF) needs to be saved with LOINC 47045-0.
  • The Ordering Provider field must be the performing provider (i.e., not the nurse, MA, or staff) in order for the performing provider to satisfy the measure.  
  • All referral orders created for a patient during the reporting period must be Completed in order for the patient to count in the numerator.

Evidence

Initial Patient Population

Name Value Set
Encounter, Performed: Ophthalmological Services 2.16.840.1.113883.3.526.3.1285
Encounter, Performed: Office Visit 2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up 2.16.840.1.113883.3.464.1003.101.12.1025
Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up 2.16.840.1.113883.3.464.1003.101.12.1023
Encounter, Performed: Preventive Care Services, Initial Office Visit, 0 to 17 2.16.840.1.113883.3.464.1003.101.12.1022
Encounter, Performed: Preventive Care, Established Office Visit, 0 to 17 2.16.840.1.113883.3.464.1003.101.12.1024
Intervention, Performed: Referral 2.16.840.1.113883.3.464.1003.101.12.1046

Denominator

Equals Initial Population

Numerator

Name Value Set
Communication: From Provider To Provider: Consultant Report 2.16.840.1.113883.3.464.1003.121.12.1006

Source(s)

Medical Codify

WebChart Documentation
Last Build: Wed, 08 Sep 2021 00:25:59 EDT Legacy Documentation