2023 NACOR XML schema changes effective April 3
March 13, 2023

2023 NACOR XML schema changes effective April 3

AQI has made minimal changes for the 2023 NACOR XML Schema updates. AQI will require all data submissions to use the 2023 version by April 3, 2023. Until then the 2022 XML Version will be accepted. The updates are as follows:

  • Updated "Copyright (C) 2022" to "Copyright (C) 2023"
  • Removed AQIXMLVersionType enumeration "2022V1.0" added AQIXMLVersionType enumeration "2023V1.0"
  • Removed AQIXMLVersionType enumeration "2022V1.0R" added AQIXMLVersionType enumeration "2023V1.0R"
  • Modified Elements: ProcedureName. Changed ProcedureName nillable="true" to nillable="false" (ProcedureName must have a text value)

Visit AQI's Developers Resources page for the XML Schema and documentation. For questions, email askaqi@asahq.org.

FTP processing will resume in early April. If you submit a file to the FTP during this interim period, the file will be processed as usual when the hold is lifted. If there is an issue with your practice's data, submit a help desk ticket by emailing nacorsupport@asahq.org.

Register for 2023 NACOR reporting

Quality reporting practices can now begin the enrollment process for the Anesthesia Quality Institute's (AQI) 2023 NACOR Quality Reporting by completing the 2023 online order form. NACOR is a designated QR and QCDR for the Centers for Medicare & Medicaid Services' Quality Payment Program.

All new and returning practices, including Quality Concierge practices, need to complete a 2023 registration form (regardless of reporting tier). 

AQI's NACOR quality reporting options include the following offerings in 2023 to ensure that NACOR remains the leader in anesthesiology: Quality Concierge, NACOR Quality Reporting, NACOR Benchmarking and NACOR Basic.

For more information, please email askaqi@asahq.org.

2023 AQI QCDR Measure Specifications

The following updates were made to the 2023 QCDR Measure Specification book:

  • Page 5 – Quantum 31 was added to the Measures Removed from the 2023 AQI NACOR QCDR Measure Set
  • ABG 41 – A correction was made to the denominator criteria for ABG 41. Practices interested in reporting this measure can submit the surgical CPT code and / or the ASA CPT code. Both codes are NOT required.
  • ABG 43 – AQI was notified by ABG that an update was made to the denominator exclusions criteria. General Anesthesia was removed as a denominator exclusion (11A89). Patients receiving general anesthesia for an applicable anesthesia service in a non-operating room setting are included in the denominator for this measure.

The newest version of the 2023 QCDR Measure specification book can be found here.

2023 MIPS Value Pathway

For Performance Year 2023, CMS approved the "Patient Safety and Support of Positive Experiences with Anesthesia MVP." MVP scoring and special status designations do not differ from Traditional MIPS policies. Those groups choosing to report the MVP in 2023 will only need to report four quality measures, 1 high-weighted or 2 medium weighted improvement activities (or one Patient Centered Medical Home Improvement Activity) and promoting interoperability measures (optional depending on your special status designation). CMS will calculate the Medicare Spending Per Beneficiary (MSPB) Clinician measure for the Cost Performance Category.

Eligible clinicians and their groups will need to choose four measures from this designated list:

  • Q404: Anesthesiology Smoking Abstinence
  • Q424: Perioperative Temperature Management
  • Q430: Prevention of Post-Operative Nausea and Vomiting (PONV) - Combination Therapy
  • Q463: Prevention of Post-Operative Vomiting (POV) - Combination Therapy (Pediatrics)
  • Q477: Multimodal Pain Management
  • AQI48: Patient-Reported Experience with Anesthesia
  • AQI69: Intraoperative Antibiotic Redosing.

Eligible clinicians and their groups also have a set of eleven (11) improvement activities to choose:

  • IA_BE_6: Regularly Assess Patient Experience of Care and Follow Up on Findings (High)
  • IA_BE_22: Improved practices that engage patients pre-visit (Medium)
  • IA_BMH_2: Tobacco use (Medium)
  • IA_CC_2: Implementation of improvements that contribute to more timely communication of test results (Medium)
  • IA_CC_15: PSH Care Coordination (High)
  • IA_CC_19: Tracking of clinician’s relationship to and responsibility for a patient by reporting MACRA patient relationship codes (High)
  • IA_EPA_1: Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient’s Medical Records (High)
  • IA_PCMH: Electronic submission of Patient Centered Medical Home accreditation.
  • IA_PSPA_1: Participation in an AHRQ-listed patient safety organization (Medium)
  • IA_PSPA_7: Use of QCDR data for ongoing practice assessment and improvements (Medium)
  • IA_PSPA_16: Use of decision support and standardized treatment protocols (Medium)

Individuals and groups will need to register with CMS during the 2023 performance period to report an MVP. MVP registration, including the subgroup participation option, opens Monday April 3rd and closes Thursday, November 30, 2023 at 8 p.m. ET.  More information can be found on the Quality Payment Program website in the resource library.

2022 Reporting Deadlines

NACOR Registration: October 3, 2022

January through November 2022 data submission: January 31, 2023

Individual Quality Reporting Consent Submission: January 31, 2023

Improvement Activity Attestation: January 31, 2023

CMS Opt-Out for Individual Reporting: January 31, 2023

TIN/NPI Reconciliation: January 31, 2023

All data submissions: February 15, 2023

Contact AQI

Register: qcdr@asahq.org

NACOR Dashboard support: NACORSupport@asahq.org

Ask AQI: AskAQI@asahq.org

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