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Stage 1 Core Measure 3

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Measure at a Glance

Type: calculated percentage

Denominator: unique patients

Duration: calculated over the entire EHR reporting period

Objective: Maintain an up-to-date problem list of current and active diagnoses.
Measure: More than 80 percent of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient as structured data.
Exclusion: No exclusion.
There are no changes to this objective and measure regardless of when EPs attest to Stage 1 Meaningful Use.

CMS Technical Specification

TennCare Notes
The attestation portal will require the EP to enter the numerator and denominator of the measure as defined in the technical specification.

Please note this measure requires more than 80% of all unique patients. The attestation numerators and denominators are calculated to the hundredths place in the attestation portal, so while a proportion of 80.01% will be evaluated as a successful attestation, 80.00% will not.

This measure, in conjunction with Core Measures 5 and 6, requires the highest percentage of unique patients with data maintained by certified EHR technology. There are no exclusions—if an EP does not have more than 80% of her unique patients entered into the certified EHR technology, she cannot successfully attest to Stage 1 Meaningful Use.

A question at the beginning of the core measures attestation will require EPs to report how many of their unique patients have their data in the EHR system. The denominator will be all unique patients seen by the EP during the EHR reporting period, as in Core Measures 3, 5, 6, and 7. One way to approach the numerator is to use the lowest numerator of Core Measures 3, 5, and 6, but other determinations of how many patients have their data in the EHR are acceptable given the resulting percentage is greater than 80%.

Relevant CMS FAQs

  • 10150: clarifying the coding format standards

Additional Resources
None at this time.

Federal Regulations Governing This Measure

CMS' Final Rule

§ 495.6(d)(3) see objective, measure and exclusion above

Standards and Certification Final Rule

§ 170.302(c) Maintain up-to-date problem list. Enable a user to electronically record, modify, and  retrieve a patient's problem list for longitudinal care in accordance with:

  1. The standard specified in Sec. 170.207(a)(1); or
  2. At a minimum, the version of the standard specified in Sec. 170.207(a)(2).

§ 170.207(a) Problems

  1. Standard. The code set specified at 45 CFR 162.1002(a)(1) for the indicated conditions.
  2. Standard. International Health Terminology Standards Development Organization (IHTSDO) Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT ®) July 2009 version (incorporated by reference in Sec. 170.299).

§ 162.1002(a)(1) International Classification of Diseases, 9th Edition, Clinical Modification, (ICD-9-CM), Volumes 1 and 2 (including The Official ICD-9-CM Guidelines for Coding and Reporting), as maintained and distributed by HHS, for the following conditions:

  1. Diseases.
  2. Injuries.
  3. Impairments.
  4. Other health problems and their manifestations.
  5. Causes of injury, disease, impairment, or other health problems.

§ 170.299(f) U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894; Telephone 301-594-5983 or

  1. International Health Terminology Standards Development Organization Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT ®), International Release, July 2009, IBR approved for Sec. 170.207.
  2. [Reserved]