MIPS Quality Measure Claim Edit Maintenance

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To make MIPS quality measure claim edit modifications, select Configuration then Maintenance then MIPS Quality Claim from the ClaimStaker toolbar. The MIPS Quality Measure Claim Edit Maintenance page appears.

There are several columns on this page.

The Edit Number, Edit Name, Edit Category, and Edit Severity columns relate specifically to the MIPS claim edits.

The check boxes under the Medicare column allow you select which MIPS quality measure claim edits will be applied to your submission files.

Screenshot of the MIPS Quality Measure Claim Edit Maintenance table with five columns and three rows of edits. Some edits are enabled for Medicare by the selection of check boxes under the Medicare column.

Viewing MIPS quality measure claim edits

The MIPS quality measure claim edits are sorted by edit number. To learn more about a specific MIPS edit, select the edit name under the Edit Name column. A description of the edit appears.

Screenshot of the MIPS Quality Measure Claim Edit Maintenance table. After selecting an edit name link under Edit Name column, a description of the edit opens. Edit 9021 is selected. A description opens that says, This measure determines the percentage of surgical patients aged 18 years and older who underwent procedures with indications for a first or second generation cephalosporin prophylactic antibiotic and who had an order for a first of second generation cephalosporin antimicrobial prophylaxis.

Selecting MIPS quality measure claim edits

To select the MIPS quality measure claim edits that will apply to your submission files for Medicare claims, select the check box under the Medicare column for each desired edit and check (enable) or uncheck (disable) the edit.

Screenshot of the MIPS Quality Measure Edit Maintenance table. The check box under the Medicare column for edit 9023 is being selected.

When finished modifying your edits, select Apply. A message displays indicating the edits were successfully updated.

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