Source: https://www.federalregister.gov/documents/2013/11/04/2013-26290/2014-edition-electronic-health-record-certification-criteria-revision-to-the-definition-of-common
Timestamp: 2016-12-10 16:37:22
Document Index: 781124838

Matched Legal Cases: ['§\u2009170', '§\u2009170', '§\u2009170', '§\u2009170', '§\u2009170', '§\u2009170', 'art1', 'art 170', 'art2', '§\u2009170', '§\u2009170', '§\u2009170', '§\u2009170']

:: 2014 Edition Electronic Health Record Certification Criteria: Revision to the Definition of “Common Meaningful Use (MU) Data Set”
A Rule by the Health and Human Services Department on 11/04/2013
65884-65887
https://www.federalregister.gov/d/2013-26290
11/01/2013 at 08:45 am.
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The 2014 Edition Final Rule adopted a definition for the term Common MU Data Set at 45 CFR 170.102. The definition was created to reduce the repetitiveness of certification criteria and to make the certification criteria more concise. The definition includes types of data that are common among five certification criteria (the “view, download, and transmit to a 3rd party,” “clinical summary,” “transitions of care—receive, display, and incorporate transition of care/referral summaries,” “transitions of care—create and transmit transition of care/referral summaries,” and “data portability” certification criteria) and meant to mirror the data specified by the Centers for Medicare & Medicaid Services (CMS) in the MU objectives and measures to which these certification criteria correlate.
Paragraph 15 requires that (in all certification criteria in which this definition is referenced) EHR technology must demonstrate for testing and certification that it can represent procedures in “[a]t a minimum, the version of the standard specified in § 170.207(a)(3) or § 170.207(b)(2).” In other words, procedures can be represented in Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT®) or the combination of Health Care Financing Administration Common Procedure Coding System (HCPCS) and Current Procedural Terminology, Fourth Edition (CPT-4) vocabularies.
In Paragraph 15, we also provide the option for EHR technology developers to represent procedures in either the Current Dental Terminology (CDT) (the standard specified at § 170.207(b)(3)) or International Classification of Diseases, 10th Revision, Procedure Coding Start Printed Page 65886System (ICD-10-PCS) (the standard specified at § 170.207(b)(4)) in addition to, but not in lieu of, the required vocabulary standards mentioned above.
On July 29, 2013, the HIT Standards Committee transmitted a recommendation to the National Coordinator stating that we should adopt CDT as a “required” vocabulary standard for EHR technology testing and certification.[1] It is our understanding that this recommendation sought to emphasize that the EHR technology testing and certification process should support and make available as a pathway for certification the representation of dental procedures using CDT alone, rather than its current “optional” designation as a standard to be used in addition to SNOMED CT® or CPT-4/HCPCS. In consideration of that recommendation, we conducted fact-finding with experts in CDT and EHR technology developers who develop products that use this terminology to better understand how our decision to designate CDT as “optional” has impacted EHR technology testing and certification. We also sought to determine whether either of the two required vocabulary standards adopted to represent procedures (namely, SNOMED CT® or CPT-4/HCPCS) is sufficiently equivalent to CDT such that a regulatory change would be unnecessary.
Accordingly, we have revised Paragraph 15 of the Common MU Data Set definition at § 170.102 to include CDT in Paragraph 15(i) as a vocabulary standard to which EHR technology can be tested and certified to represent dental procedures (instead of SNOMED CT® or CPT-4/HCPCS) in the limited circumstance where EHR technology is primarily developed to record dental procedures. ICD-10-PCS (now Paragraph 15(ii)) continues to be designated optional for testing and certification. III. Waiver of Proposed Rulemaking
Based on the HITSC's recommendation and our own fact-finding discussed above, we believe it would be contrary to the public interest to undergo notice and comment rulemaking to revise Paragraph 15 of the Common MU Data Set definition at § 170.102. It is our understanding from stakeholders that if this revision is not made in a timely manner, some EHR technology developers may not be able to achieve certification at all for their products and, as a result, may forgo seeking certification altogether. Such a result could significantly curtail the market for certified EHR technology developed to meet the needs of certain types of health care professionals (for example, doctors of dental surgery and dental medicine). Additionally, in cases where these EHR technology developers would forge ahead to get their products certified based on the current Common MU Data Set definition, we anticipate that they would incur unnecessary costs (which potentially could be passed on to customers) associated with incorporating SNOMED CT® or CPT-4/HCPCS into their products solely because they must demonstrate compliance with these standards for certification. This change to the regulation will relieve a burden on some Start Printed Page 65887developers by allowing their products to be certified to CDT alone.
Start Amendment Part1. The authority citation for part 170 continues to read as follows:End Amendment Part
Start Amendment Part2. Section 170.102 is amended by revising paragraph (15) of the Common MU Data Set definition to read as follows:End Amendment Part
(i)(A) At a minimum, the version of the standard specified in § 170.207(a)(3) or § 170.207(b)(2); or
(B) For EHR technology primarily developed to record dental procedures, the standard specified in § 170.207(b)(3).
(ii) Optional. The standard specified at § 170.207(b)(4).
http://www.healthit.gov/​facas/​FACAS/​health-it-standards-committee/​health-it-standards-committee-recommendations-national-coordinator.