uds reporting guide - micromd · uds reporting guide overview this document contains a basic...

UDS REPORTING 2 0 1 5 R E P O R T S G U I D E

1

Table of Contents

UDS Reporting Guide. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Changes in 2015 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Service Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Table 3a – Universal Patients by Age and Gender. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Table 3b – Patients By Race, Ethnicity and Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Table 4 – Universal Selected Patient Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Table 4 (continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Table 5 – Universal Staffing and Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8TABLE 5 (Continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Table 6a – Universal Selected Diagnosis and Services Rendered. . . . . . . . . . . . . . . . . . . . . 10TABLE 6A (Continued) Selected Services rendered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12TABLE 6A (Continued) Selected Services rendered . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Table 6b – Quality of Care Indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Lines 1‐9 Prenatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Line 10 – Childhood Immunization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17Line 11 – Cervical Cancer Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38Line 12 – Weight Assessment and Counseling for Children and Adolescents . . . 42Line 13 – Adult Weight Screening and Follow‐Up . . . . . . . . . . . . . . . . . . . . . . . . . . 50Line 16 – Asthma Pharmacologic Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66Line 19 – Colorectal Cancer Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84Line 20 – Newly Identified HIV Cases with Timely follow‐Up . . . . . . . . . . . . . . . . 88Line 21 – Depression Screening and Follow‐Up . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Table 7 – Health Outcomes and Disparities – Universal . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106Table 7 (continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107Table 7 (continued) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108Table 9 – Patient Related Revenue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

How Table 9 is calculated in MicroMD PM: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

UDS REPORTING GUIDE

OVERVIEWThis document contains a basic reference to assist users in understanding UDS Reporting. We have organized these tables by report and table. Users will also find directions for finding the appropriate

location within MicroMD® where the system actually pulls information to create the report.

Requirements

The information in this document is effective for MicroMD PM version 9.0.7 or higher. Please contact MicroMD support staff to upgrade from an earlier version.

CHANGES IN 2015Please see the chapter for the specified table for more details.

Table 4: Line 9a added for tracking patients who are insured by both Medicare and Medicaid.

Table 6a: Line 1‐2a (Newly Diagnosed HIV) removed. New Column added to show valid ICD‐10 Codes.

Table 7: Column removed from Diabetes section of the report. Populating Hypertension and Diabetes

data from MicroMD EMR.

Overview 1

UDS Reporting Guide MicroMD

SERVICE AREA

Line # Description

All Reporting Period: 1/1/2014 through 12/31/2014

Patients By ZIP CODE

Zip Code

(a)

None / Uninsured

(b)

Medicaid/CHIP/Other Public

(c)

Medicare

(d)

PrivateInsurance

(e)

89512 3 4 2 6

44512 7 0 0 21

89431 6 6 1 0

89502 6 1 2 1

Other Zip Codes 16 6 9 9

Unknown Zip Code 0 0 0 0

TOTAL 38 17 14 37

This report is a listing of patients (and their primary insurance plans) by zip code. Insurance is pulled from the Active Primary Plan of the Primary Medical Plan Set (in Patient Profile Detail).

ZIP Codes with ten (10) or fewer patients are reported in the “Other Zip Codes” line.

The Service Date must be within the specified date range on the report.

The total number of patients should match with the totals for Table 3a.

Service Area2


TABLE 3A – UNIVERSAL PATIENTS BY AGE AND GENDERLine # Description1‐38 Reporting Period: January 1, 2014 through December 31, 2014

TABLE 3A ‐ UNIVERSAL PATIENTS BY AGE AND GENDER

Age Groups Male Patients(a)

Female Patients(b)

Number of Patients

1 Under age 1 3 3

2 Age 1 0 4

3 Age 2 0 0

4 Age 3 1 3

5 Age 4 2 1

6 Age 5 3 2

7 Age 6 1 2

8 Age 7 4 4

9 Age 8 2 4

10 Age 9 1 0

11 Age 10 1 1

12 Age 11 2 2

13 Age 12 3 1

14 Age 13 4 3

15 Age 14 0 2

16 Age 15 1 1

17 Age 16 1 3

18 Age 17 0 3

19 Age 18 2 1

20 Age 19 0 2

21 Age 20 1 1

22 Age 21 0 1

23 Age 22 1 1

24 Age 23 0 2

25 Age 24 0 026 Ages 25‐29 3 1327 Ages 30‐34 2 828 Ages 35‐39 5 1029 Ages 40‐44 4 830 Ages 45‐49 8 831 Aged 50‐54 6 1132 Ages 55‐59 11 1133 Ages 60‐64 6 834 Ages 65‐69 6 735 Ages 70‐74 2 836 Ages 75‐79 2 3

Table 3a – Universal Patients by Age and Gender 3


37 Ages 80‐84 0 238 Age 85 and over 2 639 TOTAL PATIENTS

(Sum lines 1‐38)90 150

Number of males and females in each age or age range. Un‐duplicated users.

The Service Date must be within the specified date range on the report.

Total patients on 3A must equal Total Patients on Table 3B Line 8 and Table 4 Line 6.

Data comes from the Patient Demographics screen.

For Patients where age < 1, report looks at patients born 7/1 of the previous year thru 12/31 of the reporting year.*

*Age is calculated by the age of the patient as of the date entered into the “Age computed as of” field on the Report Options Screen.

Table 3a – Universal Patients by Age and Gender4


TABLE 3B – PATIENTS BY RACE, ETHNICITY AND LANGUAGE Line

#Description

All (1‐8)

Reporting Period: January 1, 2014 through December 31, 2014

TABLE 3B ‐ UNIVERSAL PATIENTS BY RACE, ETHNICITY AND LANGUAGE

PATIENTS BY RACE HISPANIC NON‐HISPANIC

UNREPORTED / REFUSED

TOTAL

NUMBER OF PATIENTS

1. Asian 9 16 0 25

2a. Native Hawaiian 0 3 0 3

2b. Other Pacific Islander 1 1 0 2

2. TOTAL HAWAIIAN/PACIFIC ISLANDER(SUM LINES 2a + 2b)

1 4 0 5

3. Black or African American 2 17 0 19

4. American Indian / Alaska Native (including Latino or Hispanic) 0 3 0 3

5. White (including Latino or Hispanic Descent) 9 73 0 82

6. More than one Race 3 2 0 5

7. Unreported / Refused to report 14 5 82 101

8. TOTAL PATIENTS(SUM LINES 1+2+3 TO 7)

38 120 82 240

USERS BY LANGUAGE NUMBER (A)

NUMBER OF PATIENTS

PATIENTS BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH 15

Number of patients in each race and ethnicity.

Un‐duplicated Users.

The Service Date must be within the specified date range on the report.Race, Ethnicity and Language are all pulled from Patient Demographics.

Table 3b – Patients By Race, Ethnicity and Language 5


TABLE 4 – UNIVERSAL SELECTED PATIENT CHARACTERISTICSLine # Description1‐6 Reporting Period: January 1, 2014 through December 31, 2014

TABLE 4 ‐ UNIVERSAL SELECTED PATIENT CHARACTERISTICS

CHARACTERISTIC NUMBER OF PATIENTS (a)

INCOME AS A PERCENT OF POVERTY LEVEL

1. 100% and below 52

2. 101‐150% 16

3. 151‐200% 5

4. Over 200% 22

5. Unknown 145

6. TOTAL (SUM LINES 1‐5) 240

Income as a percent of poverty level.

Comes from Family Size/Income on Patient Profile Detail.

Poverty amounts are set on the report options screen.

7‐12 PRINCIPAL THIRD PARTY MEDICAL INSURANCE SOURCE 0‐17 YEARS OLD (a)

18 AND OLDER(b)

7. None / Uninsured 6 13

8a. Regular Medicaid (Title XIX) 5 4

8b. CHIP Medicaid 0 0

8. Total Medicaid (Line 8a+8b) 5 4

9. Medicare (Title XVIII) 1 5

9a. Dually Eligible (Medicare + Medicaid)(This is a subset of Line 9)

1 2

10a. Other Public Insurance Non‐CHIP (Specify:) 0 0

10b. Other Public Insurance CHIP 0 1

10. Total Public Insurance (Line 10a+10b) 0 1

11. Private Insurance 1 12

12. TOTAL (Sum Lines 7+8+9+10+11) 13 35

Principal Third Party Medical Insurance Source

Pulled from the Active Primary Plan of the Primary Medical Planset (in Patient Profile Detail).

New this year: Line 9a tracks patients who have Primary Medicare and Secondary Medicaid.

Table 4 – Universal Selected Patient Characteristics6


TABLE 4 (CONTINUED)13A‐13C

MANAGED CARE UTILIZATIONPayor Category Medicaid

(a)Medicare

(b)Other Public Including Non‐Medicaid S‐CHIP

(c)

Private (d)

Total (e)

13a. Capitated Member Months 24 0 0 31 55

13b. Fee‐for‐service Member Months 252 0 0 31 283

13c. TOTAL MEMBER MONTHS (13A + 13B) 276 0 0 62 338

Managed Care Utilization.

Pulled from the Primary Plans of the Primary Medical Planset (in Patient Profile Detail) with effective

dates during the service period.

Compares the plan’s effective start date and effective end date and counts the range that occurs within

the reporting period. This is used to determine the number of months.

14‐25 CHARACTERISTICS ‐ SPECIAL POPULATIONS NUMBER OF PATIENTS (A)

14. MIGRANT (330g grantees only) 8

15. SEASONAL (330g grantees only) 0

17. PERMANENT (330g grantees only) 1

16. TOTAL AGRICULTURAL WORKERS OR DEPENDENTS(All grantees report this line)

9

17. Homeless Shelter (330h grantees only) 1

18. Transitional (330h grantees only) 0

19. Doubling Up (330h grantees only) 0

20. Street (330h grantees only) 1

21. Other (330h grantees only) 3

22. Unknown (330h grantees only) 5

23. TOTAL HOMELESS (All grantees report this line) 10

24. TOTAL SCHOOL‐BASED HEALTH CENTER PATIENTS(All grantees report this line)

2

25. TOTAL VETERANS (All grantees report this line) 5

26. PUBLIC HOUSING PATIENTS (All grantees report this line) 1

Characteristics – Special Populations.

Pulled from the Patient Profile tab in the Social section.

Table 4 (continued) 7


TABLE 5 – UNIVERSAL STAFFING AND UTILIZATION

Line # DescriptionAll (1‐34) Reporting Period: January 1, 2004 through December 31, 2004

TABLE 5 ‐ UNIVERSAL STAFFING AND UTILIZATION

Personnel by Major Service Category FTEs (a)

Clinic Visits (b)

Patients(c)

Family Practitioners 15.00 300

2 General Practitioners 0.00 0

3 Internists 0.00 0

4 Obstetrician / Gynecologists 0.00 0

5 Pediatricians 0.00 0

7 Other Specialty Physicians 0.12 1

8 Total Physicians (Lines 1‐7) 15.12 301

9a Nurse Practitioners 2.00 9

9b Physician Assistants 1.00 2

10 Certified Nurse Midwives 0.00 0

10a Total Mid‐Level Practitioners 3.00 11

11 Nurses 0.00 0

12 Other Medical Personnel 0.00

13 Laboratory Personnel 0.00

14 X‐Ray Personnel 0.00

15 Total Medical (Lines 8+10a‐14) 18.12 312 174

16 Dentists 1.00 1

30d Hardware Staff 0.00 0

17 Dental Hygienists 2.00 159

33 Communication to the Mute 0.00 0

18 Dental assistants, Aids, Techs 0.00

19 Total Dental Services (Lines 16‐18) 3.00 160 97

20a Psychiatrists 0.00 0

20a1 Licensed Clinical Psychologists 0.00 0

20a2 Licensed Clinical Social Workers 0.00 0

20b Other Licensed Mental Health Providers 0.00 0

20c Other Mental Health Staff 0.00 0

20 Mental Health (Lines 20a‐c) 0.00 0 0

21 Substance Abuse Services 0.00 0 0

22 Other Professional Services(Specify__________)

0.00 0 0

22a Ophthalmologists 0.00 0

22b Optometrists 0.00 0

22c Optometric Assistants 0.00

22d Total Vision Services (Lines 22a‐c) 0.00 0 0

23 Pharmacy Personnel 0.00

24 Case Managers 0.00 0

25 Patient / Community Education Specialists 0.00 0

26 Outreach workers 0.00

27 Transportation Staff 0.00

27a Eligibility Assistance Workers 0.00

Table 5 – Universal Staffing and Utilization8


TABLE 5 (Continued)27b Interpretation Staff 0.00

28 Other Enabling Services 0.00

29 Total Enabling Services (Lines 24‐28) 0.00 0 0

29a Other Programs / Services(Specify___________)

0.00

30a Management and Support Staff 0.00

30b Fiscal and Billing Staff 0.00

30c IT Staff 0.00

30 Total Administration Staff(Lines 30a‐c)

0.00

31 Facility Staff 0.00

32 Patient Support Staff 0.00

33 Total Admin & Facility (Lines 30‐32) 0.00

34 TOTAL(Lines 15+19+20+21+22+22d+23+29+29a+33)

21.12 472

Must create service categories in Practice Setup under Aux > MicroMD CHC > Setup >

Practice (Service Categories Tab).

Must have Service Category linked to procedures in Aux > MicroMD CHC > Setup >

Procedures if they are to be counted as an encounter/visit.

Must have Provider Information completed in the provider section under Aux >

MicroMD CHC > Setup > Provider indicating the major service category they are linked

to for the report.

Must not have duplicate count between major service categories. Un‐duplicated totals

for patient column within each major service category.

Client must calculate each provider’s full‐time equivalency and link it to the provider

detail under MicroMD CHC > Setup.

TABLE 5 (Continued) 9


TABLE 6A – UNIVERSAL SELECTED DIAGNOSIS AND SERVICES RENDEREDLine # Description1‐20d Reporting Period: January 1, 2014 through December 31, 2014

TABLE 6A ‐ UNIVERSAL SELECTED DIAGNOSIS AND SERVICES RENDERED

Diagnostic Category Applicable

ICD‐9‐CM

Code

Applicable

ICD‐10‐CM

Code

Visits with

diagnosis

Regardless of primacy

(A)

Total Patients

with diagnosis

Regardless of primacy

(B)

Selected Infections and Parasitic Diseases

1‐2. Symptomatic and Asymptomatic HIV 042, 079.53, V08 B20, B97.35, O98.7, Z21 0 0

3. Tuberculosis 010.xx‐018.xx A15 thru A19 1 1

4. Syphilis and other sexually

transmitted diseases

090.xx‐099.xx A50 thru A64

(Exclude A63.0),M02.3, N34.1

2 1

4a. Hepatitis B 070.20, 070.22,

070.30, 070.32

V02.61

B16.0‐B16.2, B16.9,B17.0,

B18.0, B18.1, B19.10,

B19.11, Z22.51

1 1

4b. Hepatitis C 070.41, 070.44, 070.51, 070.54, 070.70, 070.71,

V02.62

B17.10, B17.11, B18.2, B19.20, B19.21, Z22.52

1 1

Selected Diseases of the Respiratory System

5. Asthma 493.xx J45 7 5

6. Chronic Bronchitis and emphysema 490.xx ‐ 492.xx J40 thru J44,

and J47

7 7

Selected Other Medical Conditions

7. Abnormal breast findings, female 174.xx, 198.81, 233.0x,

283.3, 793.8x

C50.01, C50.11, C50.21,

C50.31, C50.41, C50.51, C50.61, C50.71, C50.81,

C50.91, C79.81, D48.6, R92

1 1

8. Abnormal cervical findings 180.xx, 198.82, 233.1x,

795.0x

C53, C79.82, D06, R87.61,

R87.810, R87.820

0 0

9. Diabetes mellitus 250.xx, 648.0x E1‐ thru E13, O24 (Exclude O24.41)

45 34

10. Heart disease (selected) 391.xx ‐ 392.0x,

410.xx ‐ 429.xx

I01, I02 (exclude I02.9), I20

thru I25, I 26 thru I28, I30

thru I52

9 7

11. Hypertension 401.xx ‐ 405.xx I10 thru I15 32 24

12. Contact dermatitis and other eczema 692.xx L23 thru L25, L30 (Exclude L30.1, L30.3, L30.5, L30.5),

L55 thru L59 (Exclude

L57.0 thru L57.4)

0 0

13. Dehydration 276.5x E86 0 0

14. Exposure to heat or cold 991.xx ‐ 992.xx T33.XXXA, T34.XXXA, T67.XXXA, T68.XXXA,

T69.XXXA

2 2

14a. Overweight and obesity ICD‐9: 278.0 ‐ 278.03 or

V85.xxexcluding V85.0, V85.1,

V85.51, V85.52

E66, Z68 (Excluding Z68.1,

Z68.20‐24, Z68.51, Z68.52

2 2

Will count diagnosis codes referenced by a transaction line (regardless of whether or not the

code is the primary diagnosis).

Must have the service date in date range specified.

New this year: This report will look at both ICD‐9 and ICD‐10 codes. The visit will be counted

as long as long as the diagnosis code matches either the referenced ICD‐9 OR ICD‐10 codes.

Also, Line 1‐2a (First‐time diagnosis of HIV) has been removed.

Table 6a – Universal Selected Diagnosis and Services Rendered10


TABLE 6A (Continued)

Line # DescriptionSelected Childhood Conditions (limited to ages 0 thru 17)

15. Otitis media and eustachian tube disorders

381.xx ‐ 382.xx H65 thru H69 1 1

16. Selected perinatal medical

conditions

770.xx; 771.xx;

773.xx; 774.xx‐779.xx

(excluding 779.3x)

A33, P20 thru P29

(excluding P22.0, P29.3);

P35 thru P96 (excluding P50, P52, P54, P91.6,

P92, P96.81), R78.81,

R78.89

0 0

17. Lack of expected normal physiological development (such

as delayed milestone; failure to

gain weight; failure to thrive); Nutritional deficiencies in

children only. Does not include

sexual or mental development,

260.xx ‐ 269.xx (excluding 268.2)

779.3x

783.3x ‐ 783.4x

E40 ‐ E46, E50 thru E63 (excluding E64), P92,

R62 (excluding R62.7),

R63.2, R63.3

0 0

Selected Mental Health and Substance Abuse Conditions

18. Alcohol related disorders 291.xx; 303.xx; 305.0x; 357.5x

F10, G62.1 3 3

19. Other substance related

disorders (excluding tobacco use

disorders)

292.1x ‐ 292.8x,

292.9, 304.xx, 305.2x

‐ 305.9x; 357.6x, 648.3x

F11 thru F19 (excluding

F17), G62.0, O99.32

0 0

19a. Tobacco use disorder 305.1 F17 0 0

20a. Depression and other mood

disorders

296.xx; 330.4,

301.13; 311.xx

F30 thru F39 8 8

20b. Anxiety disorders including PTSD 300.0x; 300.2x;

300.3; 308.3; 309.81

F40 thru F42, F43.0,

F43.1

13 10

20c. Attention deficit and disruptive behavior disorders

312.8x; 312.9x; 313.81; 314.xx

F90 thru F91 0 0

20d. Other mental disorders (includes

mental retardation)

290.xx, 293.xx ‐

302.xx (excluding

296.xx, 300.0x, 300.2x, 300.3, 300.4,

301.13) 306.xx ‐

319.xx (excluding 307.xx, 308.3,

309.81, 311.xx,

312.8x, 312.9x, 313.81, 314.xx)

F01 thru F09, F20 thru

F29, F43 thru F48

(excluding F43.1), F50 thru F59 (excluding F55),

F60 thru F99 (excluding

F84.2, F90, F91, F98), R45.1, R45.2, R45.5,

R45.6, R45.7, R45.81,

R45.82, R48.0

83 6

Will count diagnosis codes referenced by a transaction line (regardless of whether or not the code is the primary diagnosis).


New this year: This report will look at both ICD‐9 and ICD‐10 codes. The visit will be counted as long as the diagnosis code

matches either the referenced ICD‐9 OR ICD‐10 codes.

Table 6a – Universal Selected Diagnosis and Services Rendered 11


TABLE 6A (CONTINUED) SELECTED SERVICES RENDERED

Line # Description

21‐26d. Service Category Applicable ICD‐9‐CM or CPT‐4 Code

Applicable ICD‐10‐CM or CPT‐4 Code

Number of Visits

(A)

Number of Patients

(B)

Selected Diagnostic Tests/Screening/Preventative Services

21. HIV test CPT‐4:86698; 86701‐

86703; 87390‐87391

CPT‐4:86698; 86701‐

86703; 87390‐87391

2 1

21a. Hepatitis B test CPT‐4:86704, 86706,

87515‐87517

CPT‐4:86704, 86706,

87515‐87517

0 0

21b. Hepatitis C test CPT‐4: 86803‐86804, 87520‐87522

CPT‐4: 86803‐86804, 87520‐87522

0 0

22. Mammogram CPT‐4: 77052, 77057;

OR

ICD‐9: v76.11, v76.12

CPT‐4: 77052, 77057;

OR

ICD‐10: Z12.31

1 1

23. Pap test CPT‐4:88141‐88155;

88164‐88167, 88174‐88175 OR ICD‐9: V72.3;

V72.31; V72.32; V76.2

CPT‐4:88141‐88155;

88164‐88167, 88174‐88175 OR ICD‐10:

Z01.41‐Z01.42, Z12.4

9 8

24. Selected immunizations:

Hepatitis A, Hemophilus, Influenza B (HiB), Influenza virus,

Pneumococcal, Diphtheria,

Tetanus, Pertussis (DTaP) (DTP) (DT), Mumps, Measles, Rubella,

Poliovirus, Varicella, Hepatitis B

(child)

CPT‐4: 90633‐90634;

90645‐90648; 90670; 90696‐907202; 90704‐

90716; 90718‐90723;

90743‐90744; 90748

CPT‐4: 90633‐90634;

90645‐90648; 90670; 90696‐907202; 90704‐

90716; 90718‐90723;

90743‐90744; 90748

7 7

24a. Seasonal Flu Vaccine CPT‐4: 90654‐90662, 90672‐90673, 90685‐

90688

CPT‐4: 90654‐90662, 90672‐90673, 90685‐

90688

4 4

25. Contraceptive management ICD‐9: V25.xx ICD‐10: Z30 1 1

26. Health supervision of an infant or child (ages 0 thru 11)

CPT‐4: 99391‐99393; 99381‐99383

CPT‐4: 99391‐99393; 99381‐99383

6 6

26a. Childhood lead test screening (9

to 72 months)

CPT‐4: 83655 CPT‐4: 83655 1 1

26b. Screening, Brief Intervention, and

Referral (SBIRT)

CPT‐4: 99408‐99409 CPT‐4: 99408‐99409 0 0

26c. Smoke/tobacco counseling: Smoking cessation treatment

CPT‐4: 99406 and 99407; HPCS: S9075 CPT‐II:

4000F, 4001F

CPT‐4: 99406 and 99407; HPCS: S9075

CPT‐II: 4000F, 4001F

1 1

26d. Comprehensive and intermediate

eye exams

CPT‐4: 92002, 92004,

92012, 92014

CPT‐4: 92002, 92004,

92012, 92014

0 0

TABLE 6A (Continued) Selected Services rendered12


TABLE 6A (CONTINUED) SELECTED SERVICES RENDERED

Line # Description

27‐34 Service Category Applicable ICD‐9‐CM or CPT‐4 Code

Applicable ICD‐10‐CM or CPT‐4 Code

Number of Visits

(A)

Number of Patients

(B)

Selected Dental Services

27. I. Emergency Services ADA: D9110 ADA: D9110 0 0

28. II. Oral Exams ADA: D0120, D0140, D0145, D0150, D0160,

D0170, D0171, D0180

ADA: D0120, D0140, D0145, D0150, D0160,

D0170, D0171, D0180

0 0

29. Prophylaxis ‐ adult or child ADA: D1110, D1120 ADA: D1110, D1120 1 1

30. Sealants ADA: D1351 ADA: D1351 0 0

31. Fluoride treatment ‐ adult or child

ADA: D1206, D1208 ADA: D1206, D1208 0 0

32. III. Restorative Services ADA: D21xx‐D29xx ADA: D21xx‐D29xx 0 0

33. IV. Oral Surgery (extractions only) ADA: D7111, D7140,

D7210, D7220, D7230, D7240, D7241, D7250,

D7251, D7260, D7261,

D7270, D72712, D7280, D7290‐D7294

ADA: D7111, D7140,

D7210, D7220, D7230, D7240, D7241, D7250,

D7251, D7260, D7261,

D7270, D72712, D7280, D7290‐D7294

0 0

34. V. Rehabilitative services (Endo,

Perio, Prostho, Ortho)

ADA: D3xxx, D4xxx, D5xxx,

D6xxx, D8xxx

ADA: D3xxx, D4xxx,

D5xxx, D6xxx, D8xxx

0 0

Counts both procedure codes and diagnosis codes (for certain lines).

Will count diagnosis codes referenced by a transaction line (regardless of whether or not the code is the primary diagnosis).


New this year: This report will look at both ICD‐9 and ICD‐10 codes. The visit will be counted as long as long as the diagnosis code

matches either the referenced ICD‐9 OR ICD‐10 codes. (on lines that are looking for diagnosis codes).

TABLE 6A (Continued) Selected Services rendered 13


TABLE 6B – QUALITY OF CARE INDICATORS

Lines 1-9 Prenatal Care

Line # Description

Sec. A & B(lines 1‐9)

Pregnancy data is listed in the Pregnancy History section of the Patient Profile Detail tab of

Patient Detail. This section will be hidden unless Prenatal User is checked.

This section shows pregnancy information entered in PM, as well as those entered into

Pregnancy History in the EMR. Entering a pregnancy into this section in the PM will create

a new Pregnancy History record in the EMR.

A 1‐6 Reporting Period: January 1, 2014 through December 31, 2014

TABLE 6B ‐ QUALITY OF CARE INDICATORS ‐ UNIVERSAL

Section A ‐ Age Categories for Prenatal Patients

DEMOGRAPHIC CHARACTERISTICS OF PRENATAL CARE PATIENTS

AGE NUMBER OF PATIENTS (a)

1. Less than 15 years 1

2. Ages 15‐19 0

3. Ages 20‐24 0

4. Ages 25‐44 0

5. Ages 45 and older 1

6. TOTAL PATIENTS (SUM LINES 1‐5) 2

Prenatal User must be checked on the Patient Profile Detail tab of Patient Detail.

A pregnancy must exist where EITHER the first care date OR the delivery date is within the

service date range of the report.

B 7‐9 Section B ‐ Trimester of Entry into Prenatal Care

Trimester of first known visit for

women receiving prenatal care

during reporting year

Women having first visit with grantee (a)

Women having first visit with another provider (b)

7. First trimester 0 0

8. Second trimester 0 0

9. Third trimester 0 0

Prenatal User must be checked on the Patient Profile Detail tab of Patient Detail.



Table 6b – Quality of Care Indicators14


Clinical Data Instructions

Table 6b (10‐21) is different from the rest of the UDS tables. These lines closely resemble Clinical Quality Measures. In the PM, there is a window that shows whether or not a particular patient currently meets the criteria for these measures.

Figure 1‐1 CHC UDS Clinical Data window

To determine if a patient currently meets the criteria for these measures, follow the steps below.

NOTE | For a patient to appear anywhere on the UDS report, they must have a qualifying visit. If a patient does not appear in Table 3a of the UDS reports, they will not appear anywhere else in the UDS reports.

Procedure Details

1. Go to Maint > Patient and select a patient.

2. Double‐click the patient to open the Patient

Detail window.

Table 6b – Quality of Care Indicators 15


3. Go to the Patient Profile Detail tab and click the

Clinical Quality Measure Data at the bottom of

the window.

This opens the Patient ‐ CHC UDS Clinical Data window (shown below).

If the practice is PM‐only (does not use the MicroMD EMR), each criteria in this window can be checked‐off if it applies to that patient for the selected year.

If the practice also uses the MicroMD EMR, the checkboxes will not be available for manual updating. However, by selecting a year and clicking the Refresh from EMR button. This will refresh the patient’s data from the EMR.

An overnight process runs each day to update this data based on things that have changed in the EMR. However, if a practice feels that the numbers are not up to date, the UDS Clinical data can be manually refreshed for all patients.

4. Open Aux > MicroMD CHC > Utilities > Refresh Clinical Data

5. Click the Refresh All from EMR button. As noted on the window, this will refresh the Clinical Quality Measures data from the EMR, which will be displayed in table 6b.



Line 10 – Childhood Immunization

Procedure Details

Description The performance measure is “Percentage of children with their 3rd birthday during the measurement year or January 1st of the following year who are fully immunized before their third birthday.”

This is similar to NQF 0038, except there are differences in dates and which vaccinations are needed.

Denominator: Patients whose 3rd birthday occurs during the measurement year

AND

Who have had at least 1 Encounter of Office Visit or Face‐to‐Face Interaction or Preventive Care ‐ Established Office Visit, 0 to 17 or Preventive Care‐ Initial Office Visit, 0 to 17 or Home Healthcare Services during the Measurement period (This encounter must occur before the Patient’s 3rd birthday).

Encounters with Encounter Level Specified (CPT codes)

NOTE | Reporting will also look at Encounter Plan ‐‐Procedure Orders for Face to Face Interaction (SNOMED codes).

(Must also fit criteria to be on the UDS report, if a patient is not listed in table 3a, they will not be counted in table 6a.)

Numerator: Number of children among those included in the denominator who were fully immunized before their 3rd birthday. A child is fully immunized if s/he has been vaccinated or there is documented evidence of contraindication for the vaccine or a history of illness for ALL of the following prior to their third birthday.

(10a) 4 DTP/DTaP

(10b) 3 IPV

(10c) 1 MMR

(10d) 3 Hib

(10e) 3 HepB

(10f) 1VZV (Varicella)

(10g) 4 Pneumococcal conjugate

How to meet each condition for this measure, found in the PM under Maint ‐> Patient Details ‐> Patient Profile Detail ‐> Clinical Quality Measure Data



10a [Used to calculate Numerator]

“An initial DTaP vaccination followed by at least three DTaP, DT or individual diphtheria and tetanus shots, on or before the child's third birthday. Vaccines administered prior to 42 days after birth cannot be counted. (Count as compliant anyone who is allergic to DTaP vaccine or who has encephalopathy or progressive neurological disorder.)”

*Patients who received 4 or more DTaP Immunizations (see code list)

*Date Range > =42 days and < 36 months after patient’s date of birth.

Encounter Plan > Immunization Orders (CPT and SNOMED codes of Vaccine Administered)

MedInfo > Health Maintenance > Immunizations (CVX codes of Vaccine)

OR

*Patient has diagnosis of Encephalopathy or Anaphylactic Reaction to DTaP Vaccine (see code list for ICD and SNOMED codes)

* Date Range: Beginning date prior to end of the measurement period and end date (if exists) to be prior to end of the measurement period

MedInfo > Medical > Problem List (Active, Inactive or Resolved)

Encounter Assessments

MedInfo > Histories > Hospitalization History (Diagnosis codes)

MedInfo > Histories > Medical History (Diagnosis codes)

MedInfo > Histories > Surgical Procedures > Medical Details (Diagnosis codes in before or after operation fields)

MedInfo > Orders > Laboratory Orders (Diagnosis codes)

OR

*Patient has a Medication Allergy of DTaP Vaccine

MedInfo > Medical > Allergies (use allergy with a description that includes “DTap’’ or “Dipht’’ or “Diphtheria”)



10b [Used to calculate Numerator]

“At least three polio vaccinations (IPV) with different dates of service on or before the child's third birthday. IPV administered prior to 42 days after birth cannot be counted. (Count as compliant anyone who is allergic to IPV vaccine, neomycin, streptomycin or polymyxin.)”

*Patients who received 3 or more Inactivated Polio Vaccine (IPV) Immunizations (see code list)

*Date Range > =42 days and < 36 months after patient’s date of birth.


MedInfo > Health Maintenance > Immunizations CVX codes of Vaccine)

OR

*Patient has diagnosis of Anaphylactic Reaction to Inactivated Polio Vaccine (IPV) or Anaphylactic Reaction to Streptomycin or Anaphylactic Reaction to Polymyxin or Anaphylactic Reaction to Neomycin (see code list for SNOMED codes)

* Date Range: Beginning date prior to end of the measurement period and end date (if exists) prior to end of the measurement period







OR

*Patient has a Medication Allergy of IPV Vaccine or Polio or Streptomycin or Neomycin or Polymyxin

MedInfo > Medical > Allergies (use allergy with a description that includes “IPV” or “polio” or “Streptomycin” or “Polymyxin” or “Neomycin”)



10c [Used to calculate Numerator]

“At least one measles, mumps and rubella (MMR) vaccination on or before the child's third birthday. (Count as compliant anyone who is allergic to MMR vaccine (or its individual vaccines) or who has ever had cancer of lymphoreticular or histiocytic tissue, or who currently has HIV disease, multiple myeloma, leukemia, or immunodeficiency).”

*Patients who received 1 or more Measles, Mumps and Rubella (MMR) Vaccine Immunizations (see code list)

*Date Range < 36 months after patient’s date of birth.



OR

*Patient has diagnosis of Disorders of the Immune System or HIV or Malignant Neoplasm of Lymphatic Tissue or Anaphylactic Reaction to Neomycin (see code list for ICD and SNOMED codes)

* Date Range: Beginning date prior to end of the measurement period and end date (if exists) prior to end of the measurement period.


Medical Assessments





OR

*Patient has a Medication Allergy of M:MR Vaccine or Neomycin

MedInfo > Medical > Allergies (use allergy with a description that includes “MMR” or “measles” or “mumps” or “rubella” or “Neomycin”)

OR

**Patient met all of the following conditions:

a) Patient had diagnosis of Measles (see code list for ICD and SNOMED codes)

*** Date Range: Beginning date prior to end of the measurement period and end date (if exists) prior to end of the measurement period









OR

***Patient had Measles Antigen Test done with result As Seropositive' (see code list for LOINC codes)

***Date Range: Beginning date prior to end of the measurement period

MedInfo > Medical > Lab Results

AND

b) Patient had diagnosis of Mumps (see code list for ICD and SNOMED codes)

*** Date Range: Beginning date prior to end of the measurement period and end date (if exists) prior to end of the measurement period







OR

***Patient had Mumps Antigen Test done with result As 'Seropositive' (see code list for LOINC codes)

***Date Range: Beginning date prior to end of measurement period


AND

c) Patient had diagnosis of Rubella (see code list for ICD and SNOMED codes)

*** Date Range: Beginning date prior to end of the measurement period and end date (if exists) prior to end of the measurement period.









OR

***Patient had Rubella Antigen Test done with result As 'Seropositive' (see code list for LOINC codes)

***Date Range: Beginning date prior to end of measurement period


10d [Used to

calculate

Numerator]

“Two H influenza type B (HiB) vaccinations, with different dates of service on or before the child's third birthday. HiB administered prior to 42 days after birth cannot be counted. (Count as compliant anyone who is allergic to HiB vaccine).”

*Patients who received 3 or more Haemophilus Influenza B (HiB) Vaccine Immunizations (see code list)

*Date Range >= 42 days and < 36 months after patient’s date of birth.



OR

*Patient has diagnosis of Anaphylactic Reaction to Haemophilus Influenza B (HiB) Vaccine (see code list for SNOMED codes)








OR

*Patient has a Medication Allergy of Haemophilus Influenza B (HiB) Vaccine

MedInfo > Medical > Allergies (use allergy with a description that includes “Hemophilus” or “Haem”)



10e [Used to

calculate

Numerator]

“Three hepatitis B vaccinations, with different dates of service on or before the child's third birthday. (Count as compliant anyone who is allergic to the hepatitis B vaccine or Baker's Yeast.)”

*Patients who received 3 or more Hepatitis B Vaccine Immunizations (see code list)

*Date Range: < 36 months after patient’s date of birth.



OR

*Patient has diagnosis of Anaphylactic Reaction to Hepatitis B Vaccine or Anaphylactic Reaction to Common Baker's Yeast or Hepatitis B (see code list for ICD and SNOMED codes)








OR

*Patient has a Medication Allergy of Hepatitis B Vaccine or Yeast

MedInfo > Medical > Allergies (use allergy with a description that includes “hepatitis B” or “yeast”)

OR

*Patient had Hepatitis B Antigen Test done with result As 'Seropositive' (see code list for LOINC codes)

*Date Range: Beginning date prior to end of the Measurement period




10f [Used to

calculate

Numerator]

“At least one chicken pox vaccination (VZV) on or after the child's first birthday and on or before the child's third birthday. (Count as compliant anyone who is allergic to the VZV vaccine, or who has ever had cancer of lymphoreticular or histiocytic tissue, or who currently has HIV disease, multiple myeloma, leukemia, or immunodeficiency).”

*Patients who received 1 or more Varicella Zoster Vaccine (VZV) Immunizations (see code list)

*Date Range >= 12 months and < 36 months after patient’s date of birth.



OR

*Patient has diagnosis of Disorders of the Immune System or HIV or Malignant Neoplasm of Lymphatic Tissue or Anaphylactic Reaction to Neomycin or Varicella Zoster (see code list for ICD and SNOMED codes)








OR

*Patient has a Medication Allergy of Varicella Zoster Vaccine or Neomycin

MedInfo > Medical > Allergies (use allergy with a description that includes “Varicella” or “VZV” or “zoster” or “Neomycin”)

OR

*Patient had Varicella Zoster Antigen Test done with result As 'Seropositive' (see code list for LOINC codes)

*Date Range: Beginning date prior to end of the Measurement period




Code Lists for Measure

10g [Used to

calculate

Numerator]

“At least four pneumococcal conjugate vaccinations on or before the child's third birthday. (Count as compliant anyone who is allergic to the pneumococcal conjugate vaccine).”

*Patients who received 4 or more Pneumococcal Conjugate Vaccine Immunizations (see code list)

*Date Range < 36 months after patient’s date of birth.



OR

*Patient has diagnosis of Anaphylactic Reaction to Pneumococcal Conjugate Vaccine (see code list for SNOMED codes)

*Date Range: Beginning date prior to end of the measurement period and end date (if exists) prior to end of the measurement period







OR

*Patient has a Medication Allergy of Pneumococcal Conjugate Vaccine

MedInfo > Medical > Allergies (use allergy with a description that includes “pneumoc”)

Diagnosis, Active:

Anaphylactic Reaction to Common Baker's Yeast:

SNOMED

34015007, 419447004

Diagnosis, Active:

Anaphylactic Reaction to DTaP Vaccine:

SNOMED

219084006, 293108006, 293109003, 293115003



Diagnosis, Active:

Anaphylactic Reaction to Haemophilus Influenza B (HiB) Vaccine:

SNOMED

293127000

Diagnosis, Active:

Anaphylactic Reaction to Hepatitis B Vaccine:

SNOMED

293110008

Diagnosis, Active:

Anaphylactic Reaction to Inactivated Polio Vaccine (IPV):

SNOMED

293117006

Diagnosis, Active:

Anaphylactic Reaction to Neomycin:

SNOMED

292927007

Diagnosis, Active:

Anaphylactic Reaction to Pneumococcal Conjugate Vaccine:

SNOMED

293116002

Diagnosis, Active:

Anaphylactic Reaction to Polymyxin:

SNOMED

292992006

Diagnosis, Active:

Anaphylactic Reaction to Streptomycin:

SNOMED

292925004

Diagnosis, Active:

Disorders of the Immune System:

ICD9

279.00, 279.01, 279.02, 279.03, 279.04, 279.05, 279.06, 279.09, 279.10, 279.11, 279.12, 279.13, 279.19, 279.2, 279.3, 279.41, 279.49, 279.50, 279.51, 279.52, 279.53, 279.8, 279.9

Diagnosis, Active:


ICD10

D80.0, D80.1, D80.2, D80.3, D80.4, D80.5, D80.6, D80.7, D80.8, D80.9, D81.0, D81.1, D81.2, D81.6, D81.7, D81.89, D81.9, D82.0, D82.1, D82.2, D82.3, D82.4, D82.8, D82.9, D83.0, D83.1, D83.2, D83.8, D83.9, D84.0, D84.1, D84.8, D84.9, D89.3, D89.810, D89.811, D89.812, D89.813, D89.82, D89.89, D89.9, M35.9



Diagnosis, Active:


SNOMED

103077004, 103078009, 103079001, 103080003, 103081004, 105601003, 105602005, 111396008, 111584000, 111585004, 111587007, 116133005, 127067009, 129639005, 129641006, 129642004, 129643009, 14333004, 17182001, 18827005, 190979003, 190980000, 190981001, 190993005, 190995003, 190996002, 190997006, 190998001, 191001007, 191002000, 191008001, 191018006, 191338000, 191345000, 191347008, 191352003, 203592006, 21527007, 22406001, 23238000, 234416002, 234423001, 234424007, 234425008, 234426009, 234433009, 234436001, 234437005, 234532001, 234533006, 234534000, 234539005, 234540007, 234541006, 234542004, 234543009, 234544003, 234546001, 234547005, 234548000, 234549008, 234550008, 234551007, 234552000, 234553005, 234554004, 234555003, 234556002, 234557006, 234558001, 234559009, 234560004, 234561000, 234562007, 234563002, 234564008, 234565009, 234566005, 234570002, 234571003, 234572005, 234573000, 234574006, 234576008, 234577004, 234578009, 234579001, 234580003, 234581004, 234582006, 234583001, 234584007, 234585008, 234586009, 234587000, 234588005, 234589002, 234590006, 234591005, 234593008, 234594002, 234595001, 234596000, 234597009, 234598004, 234599007, 234600005, 234601009, 234602002, 234603007, 234604001, 234605000, 234607008, 234608003, 234609006, 234611002, 234612009, 234613004, 234614005, 234615006, 234616007, 234617003, 234618008, 234619000, 234620006, 234621005, 234622003, 234623008, 234624002, 234625001, 234626000, 234627009, 234628004, 234629007, 234630002, 234631003, 234632005, 234633000, 234634006, 234635007, 234636008, 234637004, 234638009, 234639001, 234640004, 234641000, 234642007, 234643002, 234645009, 24181002, 241955009, 24419001, 24743004, 247860002, 248693006, 24974008, 25109007, 26252007, 263661007, 267538002, 267540007, 267543009, 276628009, 29260007, 29272001, 302874002, 303011007, 31323000, 32092008, 33286000, 3439009, 350353007, 351287008, 359791000, 36070007, 36138009, 362993009, 363009005, 363040003, 36980009, 37548006, 387759001, 3902000, 39674000, 398250003, 40197009, 402483002, 402791005, 402792003, 403837005, 409089005, 414850009, 416729007, 417167007, 41814009, 421312009, 425229001, 442459007, 4434006, 44940001, 45390000, 45841007, 46359005, 47144000, 47318007, 48119005, 49555001, 50926003, 55444004, 55602000, 56918001, 58034007, 58606001, 60743005, 62479008, 63484008, 65623009, 65880007, 66876008, 68504005, 70349007, 71436005, 71610005, 71904008, 72050006, 76243000, 77070006, 77121009, 77330006, 77358003, 78378009, 7990002, 80369006, 81166004, 82286005, 82317007, 82966003, 88714009, 89454001, 89655007, 9893005



Diagnosis, Active, Resolved:

Encephalopathy:

ICD9

323.51


Encephalopathy:

ICD10

G04.01, G04.02, G04.32


Encephalopathy:

SNOMED

192704009, 192710009, 192711008, 192712001, 192717007, 192718002, 192719005, 192720004, 192721000, 192722007, 192723002, 192724008, 31367003

Diagnosis, Active:

HIV:

ICD9

042, V08

Diagnosis, Active:

HIV:

ICD10

B20, Z21

Diagnosis, Active:

HIV:

SNOMED

111880001, 186706006, 186707002, 186708007, 186709004, 186717007, 186718002, 186719005, 186721000, 186723002, 186725009, 186726005, 230180003, 230201009, 230598008, 235009000, 235726002, 240103002, 276666007, 315019000, 359791000, 397763006, 398329009, 402915006, 402916007, 40780007, 48794007, 52079000, 5810003, 62246005, 62479008, 77070006, 79019005, 86406008, 87117006, 91947003

Diagnosis, Active, Inactive:

Hepatitis B:

ICD9

070.20, 070.21, 070.22, 070.23, 070.30, 070.31, 070.32, 070.33, V02.61


Hepatitis B:

ICD10

B16.0, B16.1, B16.2, B16.9, B17.0, Z22.51


Hepatitis B:

SNOMED

1116000, 111891008, 13265006, 186623005, 186624004, 186626002, 186639003, 235864009, 235869004, 235871004, 26206000, 29062009, 38662009, 424099008, 424340000, 424460009, 442134007, 442374005, 446698005, 50167007, 53425008, 60498001, 61977001, 66071002, 76795007



Diagnosis, Active:

Malignant Neoplasm of Lymphatic Tissue:

ICD9

200.00, 200.01, 200.02, 200.03, 200.04, 200.05, 200.06, 200.07, 200.08, 200.10, 200.11, 200.12, 200.13, 200.14, 200.15, 200.16, 200.17, 200.18, 200.20, 200.21, 200.22, 200.23, 200.24, 200.25, 200.26, 200.27, 200.28, 200.30, 200.31, 200.32, 200.33, 200.34, 200.35, 200.36, 200.37, 200.38, 200.40, 200.41, 200.42, 200.43, 200.44, 200.45, 200.46, 200.47, 200.48, 200.50, 200.51, 200.52, 200.53, 200.54, 200.55, 200.56, 200.57, 200.58, 200.60, 200.61, 200.62, 200.63, 200.64, 200.65, 200.66, 200.67, 200.68, 200.70, 200.71, 200.72, 200.73, 200.74, 200.75, 200.76, 200.77, 200.78, 200.80, 200.81, 200.82, 200.83, 200.84, 200.85, 200.86, 200.87, 200.88, 201.00, 201.01, 201.02, 201.03, 201.04, 201.05, 201.06, 201.07, 201.08, 201.10, 201.11, 201.12, 201.13, 201.14, 201.15, 201.16, 201.17, 201.18, 201.20, 201.21, 201.22, 201.23, 201.24, 201.25, 201.26, 201.27, 201.28, 201.40, 201.41, 201.42, 201.43, 201.44, 201.45, 201.46, 201.47, 201.48, 201.50, 201.51, 201.52, 201.53, 201.54, 201.55, 201.56, 201.57, 201.58, 201.60, 201.61, 201.62, 201.63, 201.64, 201.65, 201.66, 201.67, 201.68, 201.70, 201.71, 201.72, 201.73, 201.74, 201.75, 201.76, 201.77, 201.78, 201.90, 201.91, 201.92, 201.93, 201.94, 201.95, 201.96, 201.97, 201.98, 202.00, 202.01, 202.02, 202.03, 202.04, 202.05, 202.06, 202.07, 202.08, 202.10, 202.11, 202.12, 202.13, 202.14, 202.15, 202.16, 202.17, 202.18, 202.20, 202.21, 202.22, 202.23, 202.24, 202.25, 202.26, 202.27, 202.28, 202.30, 202.31, 202.32, 202.33, 202.34, 202.35, 202.36, 202.37, 202.38, 202.40, 202.41, 202.42, 202.43, 202.44, 202.45, 202.46, 202.47, 202.48, 202.50, 202.51, 202.52, 202.53, 202.54, 202.55, 202.56, 202.57, 202.58, 202.60, 202.61, 202.62, 202.63, 202.64, 202.65, 202.66, 202.67, 202.68, 202.70, 202.71, 202.72, 202.73, 202.74, 202.75, 202.76, 202.77, 202.78, 202.80, 202.81, 202.82, 202.83, 202.84, 202.85, 202.86, 202.87, 202.88, 202.90, 202.91, 202.92, 202.93, 202.94, 202.95, 202.96, 202.97, 202.98



Diagnosis, Active:


ICD10

C81.00, C81.01, C81.02, C81.03, C81.04, C81.05, C81.06, C81.07, C81.08, C81.09, C81.10, C81.11, C81.12, C81.13, C81.14, C81.15, C81.16, C81.17, C81.18, C81.19, C81.20, C81.21, C81.22, C81.23, C81.24, C81.25, C81.26, C81.27, C81.28, C81.29, C81.30, C81.31, C81.32, C81.33, C81.34, C81.35, C81.36, C81.37, C81.38, C81.39, C81.40, C81.41, C81.42, C81.43, C81.44, C81.45, C81.46, C81.47, C81.48, C81.49, C81.70, C81.71, C81.72, C81.73, C81.74, C81.75, C81.76, C81.77, C81.78, C81.79, C81.90, C81.91, C81.92, C81.93, C81.94, C81.95, C81.96, C81.97, C81.98, C81.99, C82.00, C82.01, C82.02, C82.03, C82.04, C82.05, C82.06, C82.07, C82.08, C82.09, C82.10, C82.11, C82.12, C82.13, C82.14, C82.15, C82.16, C82.17, C82.18, C82.19, C82.20, C82.21, C82.22, C82.23, C82.24, C82.25, C82.26, C82.27, C82.28, C82.29, C82.30, C82.31, C82.32, C82.33, C82.34, C82.35, C82.36, C82.37, C82.38, C82.39, C82.40, C82.41, C82.42, C82.43, C82.44, C82.45, C82.46, C82.47, C82.48, C82.49, C82.50, C82.51, C82.52, C82.53, C82.54, C82.55, C82.56, C82.57, C82.58, C82.59, C82.60, C82.61, C82.62, C82.63, C82.64, C82.65, C82.66, C82.67, C82.68, C82.69, C82.80, C82.81, C82.82, C82.83, C82.84, C82.85, C82.86, C82.87, C82.88, C82.89, C82.90, C82.91, C82.92, C82.93, C82.94, C82.95, C82.96, C82.97, C82.98, C82.99, C83.00, C83.01, C83.02, C83.03, C83.04, C83.05, C83.06, C83.07, C83.08, C83.09, C83.10, C83.11, C83.12, C83.13, C83.14, C83.15, C83.16, C83.17, C83.18, C83.19, C83.30, C83.31, C83.32, C83.33, C83.34, C83.35, C83.36, C83.37, C83.38, C83.39, C83.50, C83.51, C83.52, C83.53, C83.54, C83.55, C83.56, C83.57, C83.58, C83.59, C83.70, C83.71, C83.72, C83.73, C83.74, C83.75, C83.76, C83.77, C83.78, C83.79, C83.80, C83.81, C83.82, C83.83, C83.84, C83.85, C83.86, C83.87, C83.88, C83.89, C83.90, C83.91, C83.92, C83.93, C83.94, C83.95, C83.96, C83.97, C83.98, C83.99, C84.00, C84.01, C84.02, C84.03, C84.04, C84.05, C84.06, C84.07, C84.08, C84.09, C84.10, C84.11, C84.12, C84.13, C84.14, C84.15, C84.16, C84.17, C84.18, C84.19, C84.40, C84.41, C84.42, C84.43, C84.44, C84.45, C84.46, C84.47, C84.48, C84.49, C84.60, C84.61, C84.62, C84.63, C84.64, C84.65, C84.66, C84.67, C84.68, C84.69, C84.70, C84.71, C84.72, C84.73, C84.74, C84.75, C84.76, C84.77, C84.78, C84.79, C84.90, C84.91, C84.92, C84.93, C84.94, C84.95, C84.96, C84.97, C84.98, C84.99, C84.A0, C84.A1, C84.A2, C84.A3, C84.A4, C84.A5, C84.A6, C84.A7, C84.A8, C84.A9, C84.Z0, C84.Z1, C84.Z2, C84.Z3, C84.Z4, C84.Z5, C84.Z6, C84.Z7, C84.Z8, C84.Z9, C85.10, C85.11, C85.12, C85.13, C85.14, C85.15, C85.16, C85.17, C85.18, C85.19, C85.20, C85.21, C85.22, C85.23, C85.24, C85.25, C85.26, C85.27, C85.28, C85.29, C85.80, C85.81, C85.82, C85.83, C85.84, C85.85, C85.86, C85.87, C85.88, C85.89, C85.90, C85.91, C85.92, C85.93, C85.94, C85.95, C85.96, C85.97, C85.98, C85.99, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.4, C91.40, C91.41, C91.42, C96.0, C96.2, C96.4, C96.9, C96.A, C96.Z



Diagnosis, Active:


SNOMED

188561006, 277608004, 109962001, 109964000, 109965004, 109966003, 109967007, 109968002, 109969005, 109970006, 109971005, 109972003, 109975001, 109976000, 109977009, 109978004, 109979007, 110007008, 118599009, 118600007, 118601006, 118602004, 118605002, 118606001, 118607005, 118608000, 118609008, 118610003, 118612006, 118613001, 118614007, 118615008, 118617000, 118618005, 127220001, 128874001, 128875000, 13048006, 186723002, 188487008, 188489006, 188492005, 188493000, 188498009, 188500005, 188501009, 188502002, 188503007, 188504001, 188505000, 188506004, 188507008, 188510001, 188511002, 188512009, 188513004, 188514005, 188515006, 188516007, 188517003, 188524002, 188526000, 188529007, 188531003, 188534006, 188536008, 188537004, 188538009, 188541000, 188544008, 188547001, 188548006, 188551004, 188554007, 188558005, 188559002, 188562004, 188565002, 188566001, 188567005, 188568000, 188569008, 188570009, 188572001, 188575004, 188576003, 188577007, 188578002, 188579005, 188580008, 188582000, 188585003, 188586002, 188587006, 188589009, 188590000, 188591001, 188592008, 188593003, 188609000, 188612002, 188613007, 188627002, 188630009, 188631008, 188632001, 188633006, 188634000, 188635004, 188637007, 188640007, 188641006, 188642004, 188645002, 188648000, 188649008, 188651007, 188660004, 188672005, 188674006, 188675007, 188676008, 188679001, 188718006, 232075002, 236513009, 240531002, 254792006, 255101006, 255102004, 269476000, 274905008, 276811008, 276815004, 276836002, 277473004, 277474005, 277545003, 277567002, 277568007, 277609007, 277610002, 277611003, 277612005, 277613000, 277614006, 277615007, 277616008, 277617004, 277618009, 277622004, 277623009, 277624003, 277625002, 277626001, 277627005, 277628000, 277629008, 277632006, 277637000, 277641001, 277642008, 277643003, 277651000, 277653002, 277654008, 277664004, 278051002, 278052009, 285776004, 302841002, 302842009, 302845006, 302848008, 303017006, 303055001, 303056000, 303057009, 307341004, 307622006, 307623001, 307624007, 307625008, 307633009, 307634003, 307635002, 307636001, 307637005, 307646004, 307647008, 307649006, 307650006, 308121000, 31047003, 363484005, 371134001, 373168002, 400001003, 400122007, 402880009, 402881008, 402882001, 404103007, 404104001, 404105000, 404106004, 404107008, 404108003, 404109006, 404110001, 404111002, 404112009, 404113004, 404114005, 404115006, 404116007, 404117003, 404118008, 404119000, 404120006, 404121005, 404122003, 404123008, 404125001, 404126000, 404127009, 404128004, 404129007, 404130002, 404131003, 404132005, 404133000, 404134006, 404135007, 404136008, 404137004, 404138009, 404139001, 404140004, 404141000, 404142007, 404143002, 404144008, 404145009, 404146005, 404147001, 404148006, 404149003, 404150003,404157000,



Diagnosis, Active:


SNOMED (con’t)

404169008, 413537009, 414166008, 414780005, 414785000, 415112005, 420302007, 420519005, 420788006, 421246008, 421283008, 421835000, 422052002, 422853008, 426071002, 426336007, 426885008, 441559006, 441962003, 442537007, 443487006, 444597005, 444910004, 445269007, 445406001, 447100004, 447656001, 447658000, 447766003, 447805007, 447806008, 447989004, 448212009, 448213004, 448217003, 448220006, 448231003, 448254007, 448269008, 448317000, 448319002, 448354009, 448371005, 448372003, 448376000, 448384001, 448386004, 448387008, 448447004, 448465000, 448468003, 448553002, 448555009, 448560008, 448561007, 448607004, 448609001, 448663003, 448666006, 448672006, 448709005, 448738008, 448774004, 448865007, 448867004, 448995000, 449053004, 449058008, 449059000, 449063007, 449065000, 449072004, 449074003, 449075002, 449173006, 449176003, 449177007, 449216004, 449217008, 449218003, 449219006, 449220000, 449221001, 449222008, 449292003, 449307001, 449318001, 449418000, 449419008, 58961005, 92508006, 92509003, 92510008, 92511007, 92512000, 92513005, 92514004, 92515003, 92516002, 93133006, 93134000, 93135004, 93136003, 93137007, 93138002, 93139005, 93140007, 93141006, 93144003, 93145002, 93146001, 93147005, 93148000, 93149008, 93150008, 93151007, 93152000, 93182006, 93183001, 93184007, 93185008, 93186009, 93187000, 93188005, 93189002, 93190006, 93191005, 93192003, 93193008, 93194002, 93195001, 93196000, 93197009, 93198004, 93199007, 93200005, 93201009, 93202002, 93203007, 93204001, 93205000, 93206004, 93207008, 93208003, 93487009, 93488004, 93489007, 93492006, 93493001, 93494007, 93495008, 93496009, 93497000, 93498005, 93500006, 93501005, 93505001, 93506000, 93507009, 93509007, 93510002, 93514006, 93515007, 93516008, 93518009, 93519001, 93520007, 93521006, 93522004, 93523009, 93524003, 93525002, 93526001, 93527005, 93528000, 93530003, 93531004, 93532006, 93533001, 93534007, 93536009, 93537000, 93541001, 93542008, 93543003, 93545005, 93546006, 93547002, 93548007, 93549004, 93550004, 93551000, 93552007, 93554008, 93555009, 93720005, 94686001, 94687005, 94688000, 94690004, 94707004, 94708009, 94709001, 94710006, 94711005, 94712003, 94714002, 94715001, 95186006, 95187002, 95188007, 95192000, 95193005, 95194004, 95224004, 95225003, 95226002, 95230004, 95231000, 95260009, 95261008, 95263006, 95264000


Measles:

ICD9

055.0, 055.1, 055.2, 055.71, 055.79, 055.8, 055.9




Measles:

ICD10

B05.0, B05.1, B05.2, B05.3, B05.4, B05.81, B05.89, B05.9


Measles:

SNOMED

111873003, 14189004, 186561002, 186562009, 192685000, 195900001, 233625007, 240483006, 240484000, 28463004, 38921001, 406592004, 60013002, 74918002


Mumps:

ICD9

072.0, 072.1, 072.2, 072.3, 072.71, 072.72, 072.79, 072.8, 072.9


Mumps:

ICD10

B26.0, B26.1, B26.2, B26.3, B26.81, B26.82, B26.83, B26.84, B26.85, B26.89, B26.9


Mumps:

SNOMED

10665004, 111870000, 17121006, 235123001, 236771002, 237443002, 240526004, 240527008, 240529006, 31524007, 31646008, 36989005, 40099009, 44201003, 63462008, 72071001, 74717002, 75548002, 78580004, 89764009


Rubella:

ICD9

056.00, 056.01, 056.09, 056.71, 056.79, 056.8, 056.9


Rubella:

ICD10

B06.00, B06.01, B06.02, B06.09, B06.81, B06.82, B06.89, B06.9


Rubella:

SNOMED

10082001, 111867004, 111868009, 13225007, 1857005, 186567003, 186570004, 19431000, 232312000, 240485004, 253227001, 36653000, 64190005, 79303006, 84611003

Diagnosis, Active, Inactive, Resolved:

Varicella

Zoster: ICD9

052.0, 052.1, 052.2, 052.7, 052.8, 052.9, 053.0, 053.10, 053.11, 053.12, 053.13, 053.14, 053.19, 053.20, 053.21, 053.22, 053.29, 053.71, 053.79, 053.8, 053.9


Varicella

Zoster: ICD10

B01.0, B01.11, B01.12, B01.2, B01.81, B01.89, B01.9, B02.0, B02.1, B02.21, B02.22, B02.23, B02.24, B02.29, B02.30, B02.31, B02.32, B02.33, B02.34, B02.39, B02.7, B02.8, B02.9




Varicella

Zoster: SNOMED

10491005, 10698009, 111859007, 111861003, 186524006, 186525007, 195911009, 21954000, 230176008, 230198004, 230262004, 230536009, 232400003, 235059009, 23737006, 240468001, 240470005, 240471009, 240472002, 240473007, 240474001, 24059009, 309465005, 36292003, 38907003, 397573005, 400020001, 402897003, 402898008, 410500004, 410509003, 421029004, 422127002, 422446008, 422471006, 422666006, 423333008, 423628002, 424353002, 424435009, 42448002, 424801004, 424941009, 425356002, 426570007, 428633000, 4740000, 49183009, 55560002, 87513003

Encounter, Performed:

Face‐to‐Face Interaction:

SNOMED

12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 4525004, 87790002, 90526000


Home Healthcare Services:

CPT

99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350


Office Visit:

CPT

99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215


Preventive Care ‐ Established Office Visit, 0 to 17:

CPT

99391, 99392, 99393, 99394


Preventive Care‐ Initial Office Visit, 0 to 17:

CPT

99381, 99382, 99383, 99384

Laboratory Test, Result:

Hepatitis B Antigen Test:

LOINC

32019‐2, 32178‐6


Measles Antigen Test:

LOINC

21500‐4, 21501‐2, 21502‐0, 22498‐0, 22499‐8, 22501‐1, 22502‐9, 22505‐2, 22506‐0, 41501‐8, 5243‐1, 5245‐6, 9565‐3


Mumps Antigen Test:

LOINC

21401‐5, 21402‐3, 22413‐9, 22414‐7, 22416‐2, 22417‐0, 22419‐6, 22420‐4, 25418‐5, 31130‐8, 31131‐6, 31132‐4, 31133‐2, 5249‐8, 5250‐6, 6477‐4, 6479‐0, 7966‐5, 9567‐9


Rubella Antigen Test:

LOINC

22497‐2, 40542‐3, 41763‐4, 42967‐0, 46109‐5, 46110‐3, 49107‐6, 50694‐9, 5333‐0




Varicella Zoster Antigen Test:

LOINC

21592‐1, 21594‐7, 21595‐4, 21596‐2, 22601‐9, 22602‐7, 22605‐0, 22606‐8, 26723‐7, 33327‐8, 44771‐4, 5401‐5, 5402‐3, 6569‐8, 6570‐6

Medication, Administered:

DTaP Vaccine: CVX

106, 110, 120, 130, 20, 50


Haemophilus Influenza B (HiB) Vaccine:

CVX

120, 48, 49, 50, 51


Hepatitis B Vaccine:

CVX

08, 104, 110, 44, 51


Inactivated Polio Vaccine (IPV):

CVX

10, 110, 130


Measles, Mumps and Rubella (MMR) Vaccine:

CVX

03, 94


Pneumococcal Conjugate Vaccine:

CVX

100, 133, 33


Varicella Zoster Vaccine (VZV):

CVX

21, 94

Procedure, Performed:

DTaP Vaccine Administered:

CPT

90698, 90700, 90721, 90723


DTaP Vaccine Administered:

SNOMED

412755006, 412756007, 412757003, 414001002, 414259000, 414620004, 415507003, 415712004


Haemophilus Influenza B (HiB) Vaccine Administered:

CPT

90645, 90646, 90647, 90648, 90721, 90748


Haemophilus Influenza B (HiB) Vaccine Administered:

SNOMED

127787002, 170343007, 170344001, 170345000, 414001002, 414259000, 415507003, 415712004




Hepatitis B Vaccine Administered:

CPT

90723, 90740, 90744, 90747, 90748


Hepatitis B Vaccine Administered:

SNOMED

116802006, 16584000, 170370000, 170371001, 170372008, 170373003, 170374009, 170434002, 170435001, 170436000, 170437009, 312868009, 396456003


Inactivated Polio Vaccine (IPV) Administered:

CPT

90698, 90713, 90723


Inactivated Polio Vaccine (IPV) Administered:

SNOMED

396456003, 414001002, 414259000, 414619005, 414620004, 415507003, 415712004, 416144004, 416591003, 417211006, 417384007, 417615007


Measles, Mumps and Rubella (MMR) Vaccine Administered:

CPT

90707


Measles, Mumps and Rubella (MMR) Vaccine Administered:

SNOMED

170433008, 38598009


Pneumococcal Conjugate Vaccine Administered:

CPT

90669, 90670


Pneumococcal Conjugate Vaccine Administered:

SNOMED

434751000124102


Varicella Zoster Vaccine (VZV) Administered:

CPT

90710, 90716


Varicella Zoster Vaccine (VZV) Administered:

SNOMED

425897001, 428502009, 68525005



Attribute: Result:

Seropositive:

SNOMED

4879001



Line 11 – Cervical Cancer Screening

Name Details

Description The performance measure is “Percentage of women 21 ‐ 64 years of age who received one or more Pap tests to screen for cervical cancer.” (Note – this is the same measure that had been previously called “Women 24 through 64” for clarity purposes. No women aged 21, 22, or 23 should be included in the calculation of this measure.)

This is partially related to Clinical Quality Measure NQF 0032 (but with some major differences)

Denominator: Number of all female patients age 24 ‐ 64 years of age during the measurement year who had at least one medical visit during the reporting year


Numerator: (11a) Documentation exists that the patient received one or more documented Pap tests during the measurement year or during the two years prior to the measurement year.

OR

(11c) Documentation exists that the patient received at least one pap test accompanied by an HPV test during the measurement year (or in the four years prior to the measurement year) – and was at least 30 at the time

Exclusion (11b) Documentation exists that the patient has had a hysterectomy and has no residual cervix


11a

[Used to calculate Numerator]

“Documentation exists that the patient received one or more documented Pap tests during the measurement year or during the two years prior to the measurement year.”

* Patients who are female

AND

* Patients between 23 and 63 years old at the beginning of the measurement period. (Patients who turn 24 – 64 during the measurement period)

*Patients who had a Lab Test with results of Pap Test (see code list for LOINC codes)

*Date Range: performed <= 3 year(s) before end of the measurement period

MedInfo > Medical > Lab Result



11b


“Documentation exists that the patient has had a hysterectomy and has no residual cervix.”

*Patients who have had a procedure performed of Hysterectomy with No Residual Cervix (see code list for CPT and SNOMED codes )

*Date Range: performed before or during the Measurement Period.

MedInfo > Orders > Procedure Order (Performed)

MedInfo > Orders > Procedure Diagnostic Test (Performed)

MedInfo > Histories > Hospitalization History

MedInfo > Histories > Surgical Procedures

MedInfo > Histories > Surgical History

NOTE | Reporting will look at Procedure names in Surgical History

11c


“Documentation exists that the patient received at least one pap test accompanied by an HPV test during the measurement year (or in the four years prior to the measurement year) – and was at least 30 at the time.”

* Patients between 29 and 63 years old at the beginning of the measurement period. (Patients who turn 30 – 64 during the measurement period)

AND

*Patients who had a Lab Test with results of Pap Test (see code list for LOINC codes)



AND

*Patients who had an HPV test performed (see code list for CPT codes)


Encounter Plan that has been performed


MedInfo > Health Maintenance > Screening and Prevention





Pap Test:

LOINC

10524‐7, 18500‐9, 19762‐4, 19764‐0, 19765‐7, 19766‐5, 19774‐9, 33717‐0, 47527‐7, 47528‐5


Hysterectomy with No Residual Cervix:

CPT

56308, 51925, 57540, 57545, 57550, 57555, 57556, 58150, 58152, 58200, 58210, 58240, 58260, 58262, 58263, 58267, 58270, 58275, 58280, 58285, 58290, 58291, 58292, 58293, 58294, 58548, 58550, 58552, 58553, 58554, 58570, 58571, 58572, 58573, 58951, 58953, 58954, 58956, 59135




Hysterectomy with No Residual Cervix: SNOMED

112918004, 116140006, 116142003, 116143008, 116144002, 236888001, 236891001, 24293001, 265056007, 27185000, 27950001, 287924009, 30160001, 307771009, 309880009, 31545000, 35955002, 359971002, 359974005, 359977003, 359983000, 361222003, 361223008, 413145007, 414575003, 41566006, 43791001, 441820006, 446446002, 446679008, 447771005, 448539002, 54490004, 59750000, 63516002, 75835007, 77902002, 86477000, 88144003

Total hysterectomy with unilateral removal of tube (procedure), Radical vaginal hysterectomy (procedure), Ward‐Mayo operation for vaginal hysterectomy (procedure), Tuffier operation for vaginal hysterectomy (procedure), Mayo operation for vaginal hysterectomy (procedure), Heaney operation for vaginal hysterectomy (procedure), Wertheim‐Meigs abdominal hysterectomy (procedure), Wertheim operation (procedure), Vaginal hysterectomy with conservation of ovaries (procedure), Laparoscopic total abdominal hysterectomy and bilateral salpingo‐oophorectomy (procedure), Excision of cervical stump by vaginal approach (procedure), Vaginal hysterectomy with total colpectomy (procedure), Laparoscopy assisted vaginal hysterectomy with bilateral salpingo‐oophorectomy (procedure), Total abdominal hysterectomy and removal of vaginal cuff (procedure), Total laparoscopic excision of uterus by abdominal approach (procedure), Abdominal hysterectomy and excision of periuterine tissue (procedure), Vaginal hysterectomy and excision of periuterine tissue (procedure), Vaginal hysterectomy with repair of enterocele (procedure), Total hysterectomy with unilateral removal of tube and ovary (procedure), Vaginal hysterectomy with colpo‐urethrocystopexy, Pereyra type (procedure), Laparoscopic‐assisted vaginal hysterectomy (procedure), Vaginal hysterectomy with partial colpectomy (procedure), Total hysterectomy with removal of both tubes and ovaries (procedure), Removal of ectopic interstitial uterine pregnancy requiring total hysterectomy (procedure)

Procedure Performed:HPV TestCPT

87620, 87621, 87622



Line 12 – Weight Assessment and Counseling for Children and Adolescents

Name Details

Description The performance measure is “Percentage of patients aged 28 until 17 who had evidence of BMI percentile documentation AND who had documentation of counseling for nutrition AND who had documentation of counseling for physical activity during the measurement year.” Note that, while this measure is titled “2 until 17,” health centers should only review the charts of children who were at least 3 years old during the measurement year.

This is related to Clinical Quality Measure NQF 0024

Denominator: Patients who were 3 to 17 during the measurement year AND had at least one medical visit during the reporting year AND were seen for the first time prior to their 17th birthday.

(Must also fit criteria to be on the UDS report, if a patient is not listed in table 3a, they will not be counted in table 6a.).

Numerator: (12a) Patient had their BMI percentile documented during the measurement year

AND

(12b) Documentation exists that patient received counseling on physical activity during the measurement year.

AND

(12c) Documentation exists that patient received counseling on nutrition during the measurement year.

Exclusion: (12d) The patient was pregnant when the BMI Percentile was documented


12a [Used to calculate Numerator]

“Patient had their BMI percentile documented during the measurement year”

** Vital Signs Recorded: Height and Weight to calculate BMI

** Date Range: During the Measurement Period

MedInfo > Medical > Vital Signs

12b [Used to calculate Numerator]

“Documentation exists that patient received counseling on physical activity during the measurement year. Do not count charts that only show that a well child visit was provided unless there is specific documentation of physical activity counseling.”

** Patients who had an Intervention Performed of Counseling for Physical Activity (see code list for SNOMED codes)

** Date Range: During the Measurement Period

MedInfo > Orders > Referral Orders

MedInfo > Orders > Procedure Orders (Performed)


Encounter Plan ‐‐ Procedure Orders



Code Lists for Measure:

12c [Used to calculate Numerator]

“Documentation exists that patient received counseling on nutrition during the measurement year. Do not count charts that only show that a well child visit was provided unless there is specific documentation of nutritional counseling.”

** Patients who had an Intervention Performed of Counseling for Nutrition (see code list for CPT and SNOMED codes)

** Date Range: during the Measurement Period





12d [Determine Exclusion]

“The patient was pregnant when the BMI Percentile was documented”

**Patients who have an active diagnosis of Pregnancy recorded in their chart (see code list for ICD‐9 and SNOMED codes)

**Date Range: Beginning during the measurement period

MedInfo > Medical > Problem List Entry

Encounter with an Assessment

Diagnosis, Active:

Pregnancy: ICD9

633.11, 633.21, 633.81, 633.91, 640.01, 640.03, 640.83, 641.03, 641.13, 641.21, 641.23, 641.31, 641.33, 641.81, 641.83, 641.91, 641.93, 642.01, 642.02, 642.03, 642.11, 642.12, 642.13, 642.21, 642.22, 642.23, 642.31, 642.32, 642.33, 642.62, 642.63, 642.71, 642.72, 642.73, 642.91, 642.92, 642.93, 643.01, 643.03, 643.81, 643.91, 643.93, 644.03, 644.13, 644.21, 645.11, 645.13, 645.21, 645.23, 646.01, 646.03, 646.11, 646.12, 646.13, 646.21, 646.22, 646.23, 646.31, 646.33, 646.41, 646.42, 646.43, 646.51, 646.52, 646.53, 646.61, 646.62, 646.63, 646.71, 646.73, 646.81, 646.82, 646.83, 646.91, 646.93, 647.01, 647.02, 647.03, 647.11, 647.12, 647.13, 647.21, 647.22, 647.23, 647.31, 647.32, 647.33, 647.41, 647.42, 647.43, 647.51, 647.52, 647.53, 647.61, 647.62, 647.63, 647.81, 647.82, 647.83, 647.91, 647.92, 647.93, 648.01, 648.02, 648.03, 648.11, 648.12, 648.13, 648.21, 648.22, 648.23, 648.31, 648.32, 648.33, 648.41, 648.42, 648.43, 648.51, 648.52, 648.53, 648.61, 648.62, 648.63, 648.71, 648.72, 648.73, 648.81, 648.82, 648.83, 648.91, 648.92, 648.93, 649.01, 649.02, 649.03, 649.11, 649.12, 649.13, 649.21, 649.22, 649.23, 649.31, 649.32, 649.33, 649.41, 649.42, 649.43, 649.51, 649.53, 649.61, 649.62, 649.63, 649.71, 649.73, 651.01, 651.03, 651.11, 651.13, 651.21, 651.23, 651.31, 651.33, 651.41, 651.43, 651.51, 651.53, 651.61, 651.63, 651.71, 651.73, 651.81, 651.83, 651.91, 651.93, 652.01, 652.03, 652.11, 652.13, 652.21, 652.23, 652.31, 652.33, 652.41, 652.43, 652.51, 652.53, 652.61, 652.63, 652.71, 652.73, 652.81, 652.83, 652.91, 652.93, 653.01, 653.03, 653.11, 653.13, 653.21, 653.23, 653.31, 653.33, 653.41, 653.43, 653.51, 653.53, 653.61, 653.63, 653.71, 653.73, 653.81, 653.83, 653.91, 653.93, 654.01, 654.02, 654.03, 654.11, 654.12, 654.13, 654.21, 654.23, 654.31, 654.32, 654.33, 654.41, 654.42, 654.43, 654.51, 654.52, 654.53, 654.61, 654.62, 654.63, 654.71, 654.72, 654.73, 654.81, 654.82,

Name Details



654.83, 654.91, 654.92, 654.93, 655.01, 655.03, 655.11, 655.13, 655.21, 655.23, 655.31, 655.33, 655.41, 655.43, 655.51, 655.53, 655.61, 655.63, 655.71, 655.73, 655.81, 655.83, 655.91, 655.93, 656.01, 656.03, 656.11, 656.13, 656.21, 656.23, 656.31, 656.33, 656.41, 656.43, 656.51, 656.53, 656.61, 656.73, 656.81, 656.83, 656.91, 656.93, 657.01, 657.03, 658.01, 658.03, 658.11, 658.13, 658.21, 658.23, 658.31, 658.33, 658.41, 658.43, 658.81, 658.83, 658.91, 658.93, 659.01, 659.03, 659.11, 659.13, 659.21, 659.23, 659.31, 659.33, 659.41, 659.43, 659.51, 659.53, 659.61, 659.63, 659.71, 659.73, 659.81, 659.83, 659.91, 659.93, 660.01, 660.03, 660.11, 660.13, 660.21, 660.23, 660.31, 660.33, 660.41, 660.43, 660.51, 660.53, 660.61, 660.63, 660.71, 660.73, 660.81, 660.83, 660.91, 660.93, 661.01, 661.03, 661.11, 661.13, 661.21, 661.23, 661.31, 661.33, 661.41, 661.43, 661.91, 661.93, 662.01, 662.03, 662.11, 662.13, 662.21, 662.23, 662.31, 662.33, 663.01, 663.03, 663.11, 663.13, 663.21, 663.23, 663.31, 663.33, 663.41, 663.43, 663.51, 663.61, 663.63, 663.81, 663.83, 663.91, 663.93, 664.01, 664.11, 664.21, 664.31, 664.51, 664.61, 664.81, 664.91, 665.01, 665.03, 665.11, 665.31, 665.41, 665.51, 665.61, 665.71, 665.72, 665.81, 665.83, 665.91, 665.92, 665.93, 666.02, 666.12, 666.22, 666.32, 667.02, 667.12, 668.01, 668.02, 668.03, 668.11, 668.12, 668.13, 668.21, 668.22, 668.23, 668.81, 668.82, 668.83, 668.91, 668.92, 668.93, 669.01, 669.02, 669.03, 669.11, 669.12, 669.13, 669.51, 669.61, 669.71, 669.81, 669.82, 669.83, 669.91, 669.92, 669.93, 670.02, 671.01, 671.02, 671.03, 671.11, 671.12, 671.13, 671.21, 671.22, 671.23, 671.31, 671.33, 671.42, 671.51, 671.52, 671.53, 671.81, 671.82, 671.83, 671.91, 671.92, 671.93, 672.02, 673.01, 673.02, 673.03, 673.11, 673.12, 673.13, 673.21, 673.22, 673.23, 673.31, 673.32, 673.33, 673.81, 673.82, 674.01, 674.02, 674.03, 674.12, 674.22, 674.32, 674.42, 674.51, 674.52, 674.53, 674.82, 674.92, 675.01, 675.02, 675.03, 675.11, 675.12, 675.13, 675.21, 675.22, 675.23, 675.81, 675.82, 675.83, 675.91, 675.92, 675.93, 676.01, 676.02, 676.03, 676.11, 676.12, 676.13, 676.21, 676.22, 676.23, 676.31, 676.32, 676.41, 676.42, 676.43, 676.51, 676.52, 676.53, 676.61, 676.62, 676.63, 676.81, 676.82, 676.83, 676.91, 676.92, 676.93, 678.01, 678.03, 678.11, 678.13, 679.01, 679.02, 679.03, 679.11, 679.12, 679.13, V22.0, V22.1, V22.2, V23.0, V23.1, V23.2, V23.3, V23.41, V23.49, V23.5, V23.7, V23.81, V23.82, V23.83, V23.84, V23.85, V23.86, V23.89



Diagnosis, Active:

Pregnancy: ICD10

O00.1, O00.2, O00.8, O00.9, O09.00, O09.01, O09.02, O09.03, O09.10, O09.11, O09.12, O09.13, O09.211, O09.212, O09.213, O09.219, O09.291, O09.292, O09.293, O09.299, O09.30, O09.31, O09.32, O09.33, O09.40, O09.41, O09.42, O09.43, O09.511, O09.512, O09.513, O09.519, O09.521, O09.522, O09.523, O09.529, O09.611, O09.612, O09.613, O09.619, O09.621, O09.622, O09.623, O09.629, O09.70, O09.71, O09.72, O09.73, O09.811, O09.812, O09.813, O09.819, O09.821, O09.822, O09.823, O09.829, O09.891, O09.892, O09.893, O09.899, O09.90, O09.91, O09.92, O09.93, O10.011, O10.012, O10.013, O10.019, O10.111, O10.112, O10.113, O10.119, O10.211, O10.212, O10.213, O10.219, O10.311, O10.312, O10.313, O10.319, O10.411, O10.412, O10.413, O10.419, O10.911, O10.912, O10.913, O10.919, O11.1, O11.2, O11.3, O11.9, O12.00, O12.01, O12.02, O12.03, O12.10, O12.11, O12.12, O12.13, O12.20, O12.21, O12.22, O12.23, O13.1, O13.2, O13.3, O13.9, O14.00, O14.02, O14.03, O14.10, O14.12, O14.13, O14.20, O14.22, O14.23, O14.90, O14.92, O14.93, O15.00, O15.02, O15.03, O16.1, O16.2, O16.3, O16.9, O20.0, O20.8, O20.9, O21.0, O21.1, O21.2, O21.8, O21.9, O22.00, O22.01, O22.02, O22.03, O22.10, O22.11, O22.12, O22.13, O22.20, O22.21, O22.22, O22.23, O22.30, O22.31, O22.32, O22.33, O22.40, O22.41, O22.42, O22.43, O22.50, O22.51, O22.52, O22.53, O22.8X1, O22.8X2, O22.8X3, O22.8X9, O22.90, O22.91, O22.92, O22.93, O23.00, O23.01, O23.02, O23.03, O23.10, O23.11, O23.12, O23.13, O23.20, O23.21, O23.22, O23.23, O23.30, O23.31, O23.32, O23.33, O23.40, O23.41, O23.42, O23.43, O23.511, O23.512, O23.513, O23.519, O23.521, O23.522, O23.523, O23.529, O23.591, O23.592, O23.593, O23.599, O23.90, O23.91, O23.92, O23.93, O24.011, O24.012, O24.013, O24.019, O24.111, O24.112, O24.113, O24.119, O24.311, O24.312, O24.313, O24.319, O24.410, O24.414, O24.419, O24.811, O24.812, O24.813, O24.819, O24.911, O24.912, O24.913, O24.919, O25.10, O25.11, O25.12, O25.13, O26.00, O26.01, O26.02, O26.03, O26.10, O26.11, O26.12, O26.13, O26.20, O26.21, O26.22, O26.23, O26.30, O26.31, O26.32, O26.33, O26.40, O26.41, O26.42, O26.43, O26.50, O26.51, O26.52, O26.53, O26.611, O26.612, O26.613, O26.619, O26.711, O26.712, O26.713, O26.719, O26.811, O26.812, O26.813, O26.819, O26.821, O26.822, O26.823, O26.829, O26.831, O26.832, O26.833, O26.839, O26.841, O26.842, O26.843, O26.849, O26.851, O26.852, O26.853, O26.859, O26.86, O26.872, O26.873, O26.879, O26.891, O26.892, O26.893, O26.899, O26.90, O26.91, O26.92, O26.93, O28.0, O28.1, O28.2, O28.3, O28.4, O28.5, O28.8, O28.9, O29.011, O29.012, O29.013, O29.019, O29.021, O29.022, O29.023, O29.029, O29.091, O29.092, O29.093, O29.099, O29.111, O29.112, O29.113, O29.119, O29.121, O29.122, O29.123, O29.129, O29.191, O29.192, O29.193, O29.199, O29.211, O29.212, O29.213, O29.219, O29.291, O29.292, O29.293, O29.299, O29.3X1, O29.3X2, O29.3X3, O29.3X9, O29.40, O29.41, O29.42, O29.43, O29.5X1, O29.5X2, O29.5X3, O29.5X9, O29.60, O29.61, O29.62, O29.63, O29.8X1, O29.8X2, O29.8X3, O29.8X9, O29.90, O29.91, O29.92, O29.93, O30.001, O30.002, O30.003, O30.009, O30.011, O30.012, O30.013, O30.019, O30.021, O30.022, O30.023, O30.029, O30.031, O30.032, O30.033, O30.039, O30.041, O30.042, O30.043, O30.049, O30.091, O30.092, O30.093, O30.099, O30.101, O30.102, O30.103, O30.109, O30.111, O30.112, O30.113, O30.119, O30.121, O30.122, O30.123, O30.129, O30.191, O30.192, O30.193, O30.199, O30.201, O30.202, O30.203, O30.209, O30.211, O30.212, O30.213, O30.219, O30.221, O30.222, O30.223, O30.229, O30.291, O30.292, O30.293, O30.299, O30.801, O30.802, O30.803, O30.809, O30.811, O30.812, O30.813, O30.819, O30.821, O30.822, O30.823, O30.829, O30.891, O30.892, O30.893, O30.899, O30.90, O30.91, O30.92, O30.93, O31.00X0, O31.00X1, O31.00X2, O31.00X3, O31.00X4,



O31.00X5, O31.00X9, O31.01X0, O31.01X1, O31.01X2, O31.01X3, O31.01X4, O31.01X5, O31.01X9, O31.02X0, O31.02X1, O31.02X2, O31.02X3, O31.02X4, O31.02X5, O31.02X9, O31.03X0, O31.03X1, O31.03X2, O31.03X3, O31.03X4, O31.03X5, O31.03X9, O31.10X0, O31.10X1, O31.10X2, O31.10X3, O31.10X4, O31.10X5, O31.10X9, O31.11X0, O31.11X1, O31.11X2, O31.11X3, O31.11X4, O31.11X5, O31.11X9, O31.12X0, O31.12X1, O31.12X2, O31.12X3, O31.12X4, O31.12X5, O31.12X9, O31.13X0, O31.13X1, O31.13X2, O31.13X3, O31.13X4, O31.13X5, O31.13X9, O31.20X0, O31.20X1, O31.20X2, O31.20X3, O31.20X4, O31.20X5, O31.20X9, O31.21X0, O31.21X1, O31.21X2, O31.21X3, O31.21X4, O31.21X5, O31.21X9, O31.22X0, O31.22X1, O31.22X2, O31.22X3, O31.22X4, O31.22X5, O31.22X9, O31.23X0, O31.23X1, O31.23X2, O31.23X3, O31.23X4, O31.23X5, O31.23X9, O31.30X0, O31.30X1, O31.30X2, O31.30X3, O31.30X4, O31.30X5, O31.30X9, O31.31X0, O31.31X1, O31.31X2, O31.31X3, O31.31X4, O31.31X5, O31.31X9, O31.32X0, O31.32X1, O31.32X2, O31.32X3, O31.32X4, O31.32X5, O31.32X9, O31.33X0, O31.33X1, O31.33X2, O31.33X3, O31.33X4, O31.33X5, O31.33X9, O31.8X10, O31.8X11, O31.8X12, O31.8X13, O31.8X14, O31.8X15, O31.8X19, O31.8X20, O31.8X21, O31.8X22, O31.8X23, O31.8X24, O31.8X25, O31.8X29, O31.8X30, O31.8X31, O31.8X32, O31.8X33, O31.8X34, O31.8X35, O31.8X39, O31.8X90, O31.8X91, O31.8X92, O31.8X93, O31.8X94, O31.8X95, O31.8X99, O32.0XX0, O32.0XX1, O32.0XX2, O32.0XX3, O32.0XX4, O32.0XX5, O32.0XX9, O32.1XX0, O32.1XX1, O32.1XX2, O32.1XX3, O32.1XX4, O32.1XX5, O32.1XX9, O32.2XX0, O32.2XX1, O32.2XX2, O32.2XX3, O32.2XX4, O32.2XX5, O32.2XX9, O32.3XX0, O32.3XX1, O32.3XX2, O32.3XX3, O32.3XX4, O32.3XX5, O32.3XX9, O32.4XX0, O32.4XX1, O32.4XX2, O32.4XX3, O32.4XX4, O32.4XX5, O32.4XX9, O32.6XX0, O32.6XX1, O32.6XX2, O32.6XX3, O32.6XX4, O32.6XX5, O32.6XX9, O32.8XX0, O32.8XX1, O32.8XX2, O32.8XX3, O32.8XX4, O32.8XX5, O32.8XX9, O32.9XX0, O32.9XX1, O32.9XX2, O32.9XX3, O32.9XX4, O32.9XX5, O32.9XX9, O33.0, O33.1, O33.2, O33.3XX0, O33.3XX1, O33.3XX2, O33.3XX3, O33.3XX4, O33.3XX5, O33.3XX9, O33.4XX0, O33.4XX1, O33.4XX2, O33.4XX3, O33.4XX4, O33.4XX5, O33.4XX9, O33.5XX0, O33.5XX1, O33.5XX2, O33.5XX3, O33.5XX4, O33.5XX5, O33.5XX9, O33.6XX0, O33.6XX1, O33.6XX2, O33.6XX3, O33.6XX4, O33.6XX5, O33.6XX9, O33.7, O33.8, O33.9, O34.00, O34.01, O34.02, O34.03, O34.10, O34.11, O34.12, O34.13, O34.21, O34.29, O34.30, O34.31, O34.32, O34.33, O34.40, O34.41, O34.42, O34.43, O34.511, O34.512, O34.513, O34.519, O34.521, O34.522, O34.523, O34.529, O34.531, O34.532, O34.533, O34.539, O34.591, O34.592, O34.593, O34.599, O34.60, O34.61, O34.62, O34.63, O34.70, O34.71, O34.72, O34.73, O34.80, O34.81, O34.82, O34.83, O34.90, O34.91, O34.92, O34.93, O35.0XX0, O35.0XX1, O35.0XX2, O35.0XX3, O35.0XX4, O35.0XX5, O35.0XX9, O35.1XX0, O35.1XX1, O35.1XX2, O35.1XX3, O35.1XX4, O35.1XX5, O35.1XX9, O35.2XX0, O35.2XX1, O35.2XX2, O35.2XX3, O35.2XX4, O35.2XX5, O35.2XX9, O35.3XX0, O35.3XX1, O35.3XX2, O35.3XX3, O35.3XX4, O35.3XX5, O35.3XX9, O35.4XX0, O35.4XX1, O35.4XX2, O35.4XX3, O35.4XX4, O35.4XX5, O35.4XX9, O35.5XX0, O35.5XX1, O35.5XX2, O35.5XX3, O35.5XX4, O35.5XX5, O35.5XX9, O35.6XX0, O35.6XX1, O35.6XX2, O35.6XX3, O35.6XX4, O35.6XX5, O35.6XX9, O35.7XX0, O35.7XX1, O35.7XX2, O35.7XX3, O35.7XX4, O35.7XX5, O35.7XX9, O35.8XX0, O35.8XX1, O35.8XX2, O35.8XX3, O35.8XX4, O35.8XX5, O35.8XX9, O35.9XX0, O35.9XX1, O35.9XX2, O35.9XX3, O35.9XX4, O35.9XX5, O35.9XX9, O36.0110, O36.0111, O36.0112, O36.0113, O36.0114, O36.0115, O36.0119, O36.0120, O36.0121, O36.0122, O36.0123, O36.0124, O36.0125, O36.0129, O36.0130, O36.0131,



O36.0132, O36.0133, O36.0134, O36.0135, O36.0139, O36.0190, O36.0191, O36.0192, O36.0193, O36.0194, O36.0195, O36.0199, O36.0910, O36.0911, O36.0912, O36.0913, O36.0914, O36.0915, O36.0919, O36.0920, O36.0921, O36.0922, O36.0923, O36.0924, O36.0925, O36.0929, O36.0930, O36.0931, O36.0932, O36.0933, O36.0934, O36.0935, O36.0939, O36.0990, O36.0991, O36.0992, O36.0993, O36.0994, O36.0995, O36.0999, O36.1110, O36.1111, O36.1112, O36.1113, O36.1114, O36.1115, O36.1119, O36.1120, O36.1121, O36.1122, O36.1123, O36.1124, O36.1125, O36.1129, O36.1130, O36.1131, O36.1132, O36.1133, O36.1134, O36.1135, O36.1139, O36.1190, O36.1191, O36.1192, O36.1193, O36.1194, O36.1195, O36.1199, O36.1910, O36.1911, O36.1912, O36.1913, O36.1914, O36.1915, O36.1919, O36.1920, O36.1921, O36.1922, O36.1923, O36.1924, O36.1925, O36.1929, O36.1930, O36.1931, O36.1932, O36.1933, O36.1934, O36.1935, O36.1939, O36.1990, O36.1991, O36.1992, O36.1993, O36.1994, O36.1995, O36.1999, O36.20X0, O36.20X1, O36.20X2, O36.20X3, O36.20X4, O36.20X5, O36.20X9, O36.21X0, O36.21X1, O36.21X2, O36.21X3, O36.21X4, O36.21X5, O36.21X9, O36.22X0, O36.22X1, O36.22X2, O36.22X3, O36.22X4, O36.22X5, O36.22X9, O36.23X0, O36.23X1, O36.23X2, O36.23X3, O36.23X4, O36.23X5, O36.23X9, O36.4XX0, O36.4XX1, O36.4XX2, O36.4XX3, O36.4XX4, O36.4XX5, O36.4XX9, O36.5110, O36.5111, O36.5112, O36.5113, O36.5114, O36.5115, O36.5119, O36.5120, O36.5121, O36.5122, O36.5123, O36.5124, O36.5125, O36.5129, O36.5130, O36.5131, O36.5132, O36.5133, O36.5134, O36.5135, O36.5139, O36.5190, O36.5191, O36.5192, O36.5193, O36.5194, O36.5195, O36.5199, O36.5910, O36.5911, O36.5912, O36.5913, O36.5914, O36.5915, O36.5919, O36.5920, O36.5921, O36.5922, O36.5923, O36.5924, O36.5925, O36.5929, O36.5930, O36.5931, O36.5932, O36.5933, O36.5934, O36.5935, O36.5939, O36.5990, O36.5991, O36.5992, O36.5993, O36.5994, O36.5995, O36.5999, O36.60X0, O36.60X1, O36.60X2, O36.60X3, O36.60X4, O36.60X5, O36.60X9, O36.61X0, O36.61X1, O36.61X2, O36.61X3, O36.61X4, O36.61X5, O36.61X9, O36.62X0, O36.62X1, O36.62X2, O36.62X3, O36.62X4, O36.62X5, O36.62X9, O36.63X0, O36.63X1, O36.63X2, O36.63X3, O36.63X4, O36.63X5, O36.63X9, O36.70X0, O36.70X1, O36.70X2, O36.70X3, O36.70X4, O36.70X5, O36.70X9, O36.71X0, O36.71X1, O36.71X2, O36.71X3, O36.71X4, O36.71X5, O36.71X9, O36.72X0, O36.72X1, O36.72X2, O36.72X3, O36.72X4, O36.72X5, O36.72X9, O36.73X0, O36.73X1, O36.73X2, O36.73X3, O36.73X4, O36.73X5, O36.73X9, O36.8120, O36.8121, O36.8122, O36.8123, O36.8124, O36.8125, O36.8129, O36.8130, O36.8131, O36.8132, O36.8133, O36.8134, O36.8135, O36.8139, O36.8190, O36.8191, O36.8192, O36.8193, O36.8194, O36.8195, O36.8199, O36.8210, O36.8211, O36.8212, O36.8213, O36.8214, O36.8215, O36.8219, O36.8220, O36.8221, O36.8222, O36.8223, O36.8224, O36.8225, O36.8229, O36.8230, O36.8231, O36.8232, O36.8233, O36.8234, O36.8235, O36.8239, O36.8290, O36.8291, O36.8292, O36.8293, O36.8294, O36.8295, O36.8299, O36.8910, O36.8911, O36.8912, O36.8913, O36.8914, O36.8915, O36.8919, O36.8920, O36.8921, O36.8922, O36.8923, O36.8924, O36.8925, O36.8929, O36.8930, O36.8931, O36.8932, O36.8933, O36.8934, O36.8935, O36.8939, O36.8990, O36.8991, O36.8992, O36.8993, O36.8994, O36.8995, O36.8999, O36.90X0, O36.90X1, O36.90X2, O36.90X3, O36.90X4, O36.90X5, O36.90X9, O36.91X0, O36.91X1, O36.91X2, O36.91X3, O36.91X4, O36.91X5, O36.91X9, O36.92X0, O36.92X1, O36.92X2, O36.92X3, O36.92X4, O36.92X5, O36.92X9, O36.93X0, O36.93X1, O36.93X2, O36.93X3, O36.93X4, O36.93X5, O36.93X9, O40.1XX0, O40.1XX1, O40.1XX2, O40.1XX3, O40.1XX4, O40.1XX5, O40.1XX9, O40.2XX0, O40.2XX1, O40.2XX2, O40.2XX3, O40.2XX4, O40.2XX5, O40.2XX9, O40.3XX0, O40.3XX1, O40.3XX2, O40.3XX3, O40.3XX4, O40.3XX5, O40.3XX9, O40.9XX0, O40.9XX1, O40.9XX2, O40.9XX3, O40.9XX4, O40.9XX5, O40.9XX9, O41.00X0, O41.00X1,



O41.03X5, O41.03X9, O41.1010, O41.1011, O41.1012, O41.1013, O41.1014, O41.1015, O41.1019, O41.1020, O41.1021, O41.1022, O41.1023, O41.1024, O41.1025, O41.1029, O41.1030, O41.1031, O41.1032, O41.1033, O41.1034, O41.1035, O41.1039, O41.1090, O41.1091, O41.1092, O41.1093, O41.1094, O41.1095, O41.1099, O41.1210, O41.1211, O41.1212, O41.1213, O41.1214, O41.1215, O41.1219, O41.1220, O41.1221, O41.1222, O41.1223, O41.1224, O41.1225, O41.1229, O41.1230, O41.1231, O41.1232, O41.1233, O41.1234, O41.1235, O41.1239, O41.1290, O41.1291, O41.1292, O41.1293, O41.1294, O41.1295, O41.1299, O41.1410, O41.1411, O41.1412, O41.1413, O41.1414, O41.1415, O41.1419, O41.1420, O41.1421, O41.1422, O41.1423, O41.1424, O41.1425, O41.1429, O41.1430, O41.1431, O41.1432, O41.1433, O41.1434, O41.1435, O41.1439, O41.1490, O41.1491, O41.1492, O41.1493, O41.1494, O41.1495, O41.1499, O41.8X10, O41.8X11, O41.8X12, O41.8X13, O41.8X14, O41.8X15, O41.8X19, O41.8X20, O41.8X21, O41.8X22, O41.8X23, O41.8X24, O41.8X25, O41.8X29, O41.8X30, O41.8X31, O41.8X32, O41.8X33, O41.8X34, O41.8X35, O41.8X39, O41.8X90, O41.8X91, O41.8X92, O41.8X93, O41.8X94, O41.8X95, O41.8X99, O41.90X0, O41.90X1, O41.90X2, O41.90X3, O41.90X4, O41.90X5, O41.90X9, O41.91X0, O41.91X1, O41.91X2, O41.91X3, O41.91X4, O41.91X5, O41.91X9, O41.92X0, O41.92X1, O41.92X2, O41.92X3, O41.92X4, O41.92X5, O41.92X9, O41.93X0, O41.93X1, O41.93X2, O41.93X3, O41.93X4, O41.93X5, O41.93X9, O42.00, O42.011, O42.012, O42.013, O42.019, O42.02, O42.10, O42.111, O42.112, O42.113, O42.119, O42.12, O42.90, O42.911, O42.912, O42.913, O42.919, O42.92, O43.011, O43.012, O43.013, O43.019, O43.021, O43.022, O43.023, O43.029, O43.101, O43.102, O43.103, O43.109, O43.111, O43.112, O43.113, O43.119, O43.121, O43.122, O43.123, O43.129, O43.191, O43.192, O43.193, O43.199, O43.211, O43.212, O43.213, O43.219, O43.221, O43.222, O43.223, O43.229, O43.231, O43.232, O43.233, O43.239, O43.811, O43.812, O43.813, O43.819, O43.891, O43.892, O43.893, O43.899, O43.90, O43.91, O43.92, O43.93, O44.00, O44.01, O44.02, O44.03, O44.10, O44.11, O44.12, O44.13, O45.001, O45.002, O45.003, O45.009, O45.011, O45.012, O45.013, O45.019, O45.021, O45.022, O45.023, O45.029, O45.091, O45.092, O45.093, O45.099, O45.8X1, O45.8X2, O45.8X3, O45.8X9, O45.90, O45.91, O45.92, O45.93, O46.001, O46.002, O46.003, O46.009, O46.011, O46.012, O46.013, O46.019, O46.021, O46.022, O46.023, O46.029, O46.091, O46.092, O46.093, O46.099, O46.8X1, O46.8X2, O46.8X3, O46.8X9, O46.90, O46.91, O46.92, O46.93, O47.00, O47.02, O47.03, O47.1, O47.9, O48.0, O48.1, O60.00, O60.02, O60.03, O71.00, O71.02, O71.03, O88.011, O88.012, O88.013, O88.019, O88.111, O88.112, O88.113, O88.119, O88.211, O88.212, O88.213, O88.219, O88.311, O88.312, O88.313, O88.319, O88.811, O88.812, O88.813, O88.819, O90.3, O91.011, O91.012, O91.013, O91.019, O91.111, O91.112, O91.113, O91.119, O91.211, O91.212, O91.213, O91.219, O92.011, O92.012, O92.013, O92.019, O92.111, O92.112, O92.113, O92.119, O92.20, O92.29, O98.011, O98.012, O98.013, O98.019, O98.111, O98.112, O98.113, O98.119, O98.211, O98.212, O98.213, O98.219, O98.311, O98.312, O98.313, O98.319, O98.411, O98.412, O98.413, O98.419, O98.511, O98.512, O98.513, O98.519, O98.611, O98.612, O98.613, O98.619, O98.711, O98.712, O98.713, O98.719, O98.811, O98.812, O98.813, O98.819, O98.911, O98.912, O98.913, O98.919, O99.011, O99.012, O99.013, O99.019, O99.111, O99.112, O99.113, O99.119, O99.210, O99.211, O99.212, O99.213, O99.280, O99.281, O99.282, O99.283, O99.310, O99.311, O99.312, O99.313, O99.320, O99.321, O99.322, O99.323, O99.330, O99.331, O99.332, O99.333, O99.340, O99.341, O99.342, O99.343, O99.350, O99.351, O99.352, O99.353, O99.411, O99.412, O99.413, O99.419, O99.511, O99.512, O99.513, O99.519, O99.611, O99.612, O99.613, O99.619, O99.711, O99.712, O99.713, O99.719, O99.810, O99.820, O99.830, O99.840, O99.841, O99.842, O99.843, O99.89, O9A.111, O9A.112, O9A.113, O9A.119, O9A.211, O9A.212,



O9A.213, O9A.219, O9A.311, O9A.312, O9A.313, O9A.319, O9A.411, O9A.412, O9A.413, O9A.419, O9A.511, O9A.512, O9A.513, O9A.519, Z33.1, Z34.00, Z34.01, Z34.02, Z34.03, Z34.80, Z34.81, Z34.82, Z34.83, Z34.90, Z34.91, Z34.92, Z34.93, Z36

Diagnosis, Active:

Pregnancy:

SNOMED

102872000, 102873005, 102875003, 14418008, 169560008, 169561007, 169562000, 169563005, 169564004, 169565003, 169566002, 169567006, 169568001, 199715003, 237233002, 237238006, 237239003, 237240001, 237241002, 237242009, 237244005, 248985009, 281307002, 314204000, 41587001, 442478007, 45307008, 47200007, 57630001, 58532003, 59466002, 65727000, 72892002, 77386006, 83074005, 9279009

Intervention, Performed:

Counseling for Nutrition:

CPT

97802, 97803, 97804


Counseling for Nutrition:

SNOMED

103699006, 11816003, 183059007, 183062005, 183065007, 183067004, 183070000, 183071001, 183101003, 229807004, 229808009, 230089004, 266724001, 284352003, 285390004, 285392007, 306163007, 306164001, 306165000, 306353006, 306354000, 313076000, 361232005, 370847001, 386264009, 386469001, 400973003, 408430003, 410200000, 410270001, 410293007, 410402005, 419155003, 424753004, 429095004, 443288003, 61310001


Counseling for Physical Activity: SNOMED

103736005, 183073003, 183075005, 223440005, 281090004, 304507003, 304549008, 304558001, 310882002, 386291006, 386292004, 386463000, 390864007, 390893007, 398636004, 398752005, 410289001, 410335001, 426866005, 429778002, 439140001



Line 13 – Adult Weight Screening and Follow-Up

Name Details

Description: The performance measure is “Percentage of patients aged 18 and older who had documentation of a calculated BMI during the most recent visit or within the six months prior to that visit.”


Denominator: Number of patients who were 18 years of age or older during the measurement year, who had at least one medical visit during the reporting year


Numerator: (13a) *BMI Charted at last visit (or within 6 months of last visit)

AND

** Measured BMI is in desired BMI range [Patient DOESN’T fit 13d]

OR

***(13d) Measured BMI under or over desired BMI range

AND

***(13b) Follow‐up Plan Documented (if under/overweight)

Exclusion: (13c) Pregnant or Terminally Ill when BMI Measured


13a


“BMI Charted at last visit (or within 6 months of last visit).”

**Patients in Age Range: >= 18 years (by the end of the reporting period)

AND

** Patients Who have had at least 1 Encounter of BMI Encounter Code Set

** Date Range: During the measurement period

Encounters with Encounter Level Specified (CPT and HCPCS Codes)

Encounter Plan > Procedure Orders (CPT, CDT, HCPCS and SNOMED codes)

AND


** Date Range: Beginning Date within 6 months before or on date of Encounter of BMI Encounter Code Set


NOTE | Reporting will look at most recent record of Vital signs



13b


“Follow‐up Plan Documented (if under/overweight).”

[Patients whose weight is Above Normal]

* Patients whose most recent BMI is considered above normal

(>=25 for those aged 18 – 64, >= 30 for those aged 65+)

AND

** Patients who had an Intervention done for Above Normal Follow‐up


Encounter Plan > Procedure Orders (HCPCS, CPT and SNOMED codes)

OR

** Patients who had a Referral order created of Referrals where weight assessment may occur


MedInfo > Orders > Referral Orders (SNOMED codes)

OR

[Patients whose weight is Below Normal]

* Patients whose most recent BMI is considered below normal

(< 18.5 for those aged 18 – 64, < 22 for those aged 65+ )

AND

** Patients who had an Intervention done for Below Normal Follow‐up

** Date Range: Beginning Date within 6 months before or on date of Encounter of BMI Encounter Code Set.

Encounter Plan > Procedure Orders (HCPCS and SNOMED codes)

OR

**Patients who had a Referral order created of Referrals where weight assessment may occur.

** Date Range: Beginning Date within 6 months before or on date of Encounter of BMI Encounter Code Set.

MedInfo > Orders > Referral Orders (SNOMED codes)



13c

[Determine Exclusion]

“Pregnant or Terminally Ill when BMI Measured.”

**Patients who have an active diagnosis of Pregnancy in their chart‐(see code list for ICD‐9 and SNOMED codes)

**Date Range: Beginning date prior to end of the measurement period and end date (if exists) to be after the start of the measurement period


Encounter with an Assessment

OR

** Patients refused to get Physical Exam Performed (see code list of SNOMED codes for Patient Reason Refused or Medical or Other Reason not done) [No criteria was given for determining patients that are terminally ill, so they can be recorded this way]

** Date Range: During Encounter of BMI Encounter Code Set

Encounter Plan > Procedure Orders

13d


“Measured BMI under or over desired BMI range.”




NOTE | Reporting will look at most recent record of Vital signs

AND

*** Patient is Between 18 and 64

AND

*** BMI < 18.5 or >= 25

OR

*** Patient is 65 or older

AND

*** BMI < 22 or >= 30




Diagnosis, Active:

Pregnancy:ICD9

630, 631, 632, 633.00, 633.01, 633.10, 633.20, 633.21, 633.80, 633.81, 633.90, 633.91, 634.00, 634.01, 634.02, 634.10, 634.11, 634.12, 634.20, 634.21, 634.22, 634.30, 634.31, 634.32, 634.40, 634.41, 634.42, 634.50, 634.51, 634.52, 634.60, 634.61, 634.62, 634.70, 634.71, 634.72, 634.80, 634.81, 634.82, 634.90, 634.91, 634.92, 635.00, 635.01, 635.02, 635.10, 635.11, 635.12, 635.20, 635.21, 635.22, 635.30, 635.31, 635.32, 635.40, 635.41, 635.42, 635.50, 635.51, 635.52, 635.60, 635.61, 635.62, 635.70, 635.71, 635.72, 635.80, 635.81, 635.82, 635.90, 635.91, 635.92, 636.00, 636.01, 636.02, 636.10, 636.11, 636.12, 636.20, 636.21, 636.22, 636.30, 636.31, 636.32, 636.40, 636.41, 636.42, 636.50, 636.51, 636.52, 636.60, 636.61, 636.62, 636.70, 636.71, 636.72, 636.80, 636.81, 636.82, 636.90, 636.91, 636.92, 637.00, 637.01, 637.02, 637.10, 637.11, 637.12, 637.20, 637.21, 637.22, 637.30, 637.31, 637.32, 637.40, 637.41, 637.42, 637.50, 637.51, 637.52, 637.60, 637.61, 637.62, 637.70, 637.71, 637.72, 637.80, 637.81, 637.82, 637.90, 637.91, 637.92, 638.0, 638.1, 638.2, 638.3, 638.4, 638.5, 638.6, 638.7, 638.8, 638.9, 639.0, 639.1, 639.2, 639.3, 639.4, 639.5, 639.6, 639.8, 639.9, 640.00, 640.01, 640.03, 640.80, 640.81, 640.83, 640.90, 640.91, 640.93, 641.00, 641.01, 641.03, 641.10, 641.11, 641.13, 641.20, 641.21, 641.23, 641.30, 641.31, 641.33, 641.80, 641.81, 641.83, 641.90, 641.91, 641.93, 642.00, 642.01, 642.02, 642.03, 642.04, 642.10, 642.11, 642.12, 642.13, 642.14, 642.20, 642.21, 642.22, 642.23, 642.24, 642.30, 642.31, 642.32, 642.33, 642.34, 642.40, 642.41, 642.42, 642.43, 642.44, 642.50, 642.51, 642.52, 642.53, 642.54, 642.60, 642.61, 642.62, 642.63, 642.64, 642.70, 642.71, 642.72, 642.73, 642.74, 642.90, 642.91, 642.92, 642.93, 642.94, 643.00, 643.01, 643.03, 643.10, 643.11, 643.13, 643.20, 643.21, 643.23, 643.80, 643.81, 643.83, 643.90, 643.91, 643.93, 644.00, 644.03, 644.10, 644.13, 644.20, 644.21, 645.10, 645.11, 645.13, 645.20, 645.21, 645.23, 646.00, 646.01, 646.03, 646.10, 646.11, 646.12, 646.13, 646.14, 646.20, 646.21, 646.22, 646.23, 646.24, 646.30, 646.31, 646.33, 646.40, 646.41, 646.42, 646.43, 646.44, 646.50, 646.51, 646.52, 646.53, 646.54, 646.60, 646.61, 646.62, 646.63, 646.64, 646.70, 646.71, 646.73, 646.80, 646.81, 646.82, 646.83, 646.84, 646.90, 646.91, 646.93, 647.00, 647.01, 647.02, 647.03, 647.04, 647.10, 647.11, 647.12, 647.13, 647.14, 647.20, 647.21, 647.22, 647.23, 647.24, 647.30, 647.31, 647.32, 647.33, 647.34, 647.40, 647.41, 647.42, 647.43, 647.44, 647.50, 647.51, 647.52, 647.53, 647.54, 647.60, 647.61, 647.62, 647.63, 647.64, 647.80, 647.81, 647.82, 647.83, 647.84, 647.90, 647.91, 647.92, 647.93, 647.94, 648.00, 648.01, 648.02, 648.03, 648.04, 648.10, 648.11, 648.12, 648.13, 648.14, 648.20, 648.21, 648.22, 648.23, 648.24, 648.30, 648.31, 648.32, 648.33, 648.34, 648.40, 648.41, 648.42, 648.43, 648.44, 648.50, 648.51, 648.52, 648.53, 648.54, 648.60, 648.61, 648.62, 648.63, 648.64, 648.70, 648.71, 648.72, 648.73, 648.74, 648.80, 648.81, 648.82, 648.83, 648.84, 648.90, 648.91, 648.92, 648.93, 648.94, 649.00, 649.01, 649.02, 649.03, 649.04, 649.10, 649.11, 649.12, 649.13, 649.14, 649.20, 649.21, 649.22, 649.23, 649.24, 649.30, 649.31, 649.32, 649.33, 649.34, 649.40, 649.41, 649.42, 649.43, 649.44, 649.50, 649.51, 649.53, 649.60, 649.61, 649.62, 649.63, 649.64, 649.70, 649.71, 649.73, 650, 651.00, 651.01, 651.03, 651.10, 651.11, 651.13, 651.20, 651.21, 651.23, 651.30, 651.31, 651.33, 651.40, 651.41, 651.43, 651.50, 651.51, 651.53, 651.60, 651.61, 651.63, 651.70, 651.71, 651.73, 651.80, 651.81, 651.83, 651.90, 651.91, 651.93, 652.00, 652.01, 652.03, 652.10, 652.11, 652.13, 652.20, 652.21, 652.23, 652.30, 652.31, 652.33, 652.40, 652.41, 652.43, 652.50, 652.51, 652.53, 652.60, 652.61, 652.63, 652.70, 652.71, 652.73, 652.80, 652.81, 652.83, 652.90, 652.91, 652.93, 653.00, 653.01, 653.03,



653.10, 653.11, 653.13, 653.20, 653.21, 653.23, 653.30, 653.31, 653.33, 653.40, 653.41, 653.43, 653.50, 653.51, 653.53, 653.60, 653.61, 653.63, 653.70, 653.71, 653.73, 653.80, 653.81, 653.83, 653.90, 653.91, 653.93, 654.00, 654.01, 654.02, 654.03, 654.04, 654.10, 654.11, 654.12, 654.13, 654.14, 654.20, 654.21, 654.23, 654.30, 654.31, 654.32, 654.33, 654.34, 654.40, 654.41, 654.42, 654.43, 654.44, 654.50, 654.51, 654.52, 654.53, 654.54, 654.60, 654.61, 654.62, 654.63, 654.64, 654.70, 654.71, 654.72, 654.73, 654.74, 654.80, 654.81, 654.82, 654.83, 654.84, 654.90, 654.91, 654.92, 654.93, 654.94, 655.00, 655.01, 655.03, 655.10, 655.11, 655.13, 655.21, 655.23, 655.30, 655.31, 655.33, 655.40, 655.41, 655.43, 655.50, 655.51, 655.53, 655.60, 655.61, 655.63, 655.70, 655.71, 655.73, 655.80, 655.81, 655.83, 655.90, 655.91, 655.93, 656.00, 656.01, 656.03, 656.10, 656.11, 656.13, 656.20, 656.21, 656.23, 656.30, 656.31, 656.33, 656.40, 656.41, 656.43, 656.50, 656.51, 656.53, 656.60, 656.61, 656.63, 656.70, 656.71, 656.73, 656.80, 656.81, 656.83, 656.90, 656.91, 656.93, 657.00, 657.01, 657.03, 658.00, 658.01, 658.03, 658.10, 658.11, 658.13, 658.20, 658.21, 658.23, 658.30, 658.31, 658.33, 658.40, 658.41, 658.43, 658.81, 658.83, 658.90, 658.91, 658.93, 659.00, 659.01, 659.03, 659.10, 659.11, 659.13, 659.20, 659.21, 659.23, 659.30, 659.31, 659.33, 659.40, 659.41, 659.43, 659.50, 659.51, 659.53, 659.60, 659.61, 659.63, 659.70, 659.71, 659.73, 659.80, 659.81, 659.83, 659.90, 659.91, 659.93, 660.00, 660.01, 660.03, 660.10, 660.11, 660.13, 660.20, 660.21, 660.23, 660.30, 660.31, 660.33, 660.40, 660.41, 660.43, 660.50, 660.51, 660.53, 660.60, 660.61, 660.63, 660.70, 660.71, 660.73, 660.80, 660.81, 660.83, 660.90, 660.91, 660.93, 661.00, 661.01, 661.03, 661.10, 661.11, 661.13, 661.20, 661.21, 661.23, 661.30, 661.31, 661.33, 661.40, 661.41, 661.43, 661.90, 661.91, 661.93, 662.00, 662.01, 662.03, 662.10, 662.11, 662.13, 662.20, 662.21, 662.23, 662.30, 662.31, 662.33, 663.00, 663.01, 663.03, 663.10, 663.11, 663.13, 663.20, 663.21, 663.23, 663.30, 663.31, 663.33, 663.40, 663.41, 663.43, 663.50, 663.51, 663.53, 663.60, 663.61, 663.63, 663.80, 663.81, 663.83, 663.90, 663.91, 663.93, 664.00, 664.01, 664.04, 664.10, 664.11, 664.14, 664.20, 664.21, 664.24, 664.30, 664.31, 664.34, 664.40, 664.41, 664.44, 664.50, 664.51, 664.61, 664.64, 664.80, 664.81, 664.84, 664.90, 664.91, 664.94, 665.00, 665.01, 665.03, 665.10, 665.11, 665.20, 665.22, 665.24, 665.30, 665.31, 665.34, 665.40, 665.41, 665.44, 665.50, 665.51, 665.54, 665.60, 665.61, 665.64, 665.70, 665.71, 665.72, 665.74, 665.80, 665.81, 665.83, 665.84, 665.90, 665.91, 665.92, 665.93, 665.94, 666.00, 666.02, 666.10, 666.12, 666.14, 666.20, 666.22, 666.24, 666.30, 666.32, 667.00, 667.02, 667.04, 667.10, 667.12, 667.14, 668.00, 668.01, 668.02, 668.03, 668.04, 668.10, 668.11, 668.12, 668.13, 668.14, 668.20, 668.21, 668.22, 668.23, 668.24, 668.80, 668.81, 668.82, 668.83, 668.84, 668.90, 668.91, 668.92, 668.93, 668.94, 669.00, 669.01, 669.02, 669.03, 669.04, 669.10, 669.11, 669.12, 669.13, 669.14, 669.20, 669.21, 669.22, 669.23, 669.24, 669.30, 669.32, 669.34, 669.40, 669.41, 669.42, 669.43, 669.44, 669.50, 669.51, 669.60, 669.61, 669.70, 669.71, 669.80, 669.81, 669.82, 669.83, 669.84, 669.90, 669.91, 669.92, 669.93, 669.94, 670.00, 670.02, 670.04, 670.10, 670.12, 670.14, 670.20, 670.22, 670.24, 670.30, 670.32, 670.34, 670.80, 670.82, 670.84, 671.00, 671.01, 671.02, 671.03, 671.04, 671.10, 671.11, 671.12, 671.13, 671.14, 671.20, 671.21, 671.22, 671.23, 671.24, 671.30, 671.31, 671.33, 671.40, 671.42, 671.44, 671.50, 671.51, 671.52, 671.53, 671.54, 671.80, 671.81, 671.82, 671.83, 671.84, 671.90, 671.91, 671.92, 671.93, 671.94, 672.00, 672.02, 673.01, 673.02, 673.03, 673.04, 673.10, 673.11, 673.12, 673.13, 673.14, 673.20, 673.21, 673.22, 673.23, 673.24, 673.30, 673.31, 673.32, 673.33, 673.34, 673.80, 673.81, 673.82, 673.83, 673.84, 674.00, 674.01,674.02, 674.03, 674.04, 674.10, 674.12, 674.14, 674.20, 674.22, 674.24,



674.30, 674.32, 674.34, 674.40, 674.42, 674.44, 674.50, 674.51, 674.52, 674.53, 674.54, 674.80, 674.82, 674.84, 674.90, 674.92, 674.94, 675.00, 675.01, 675.02, 675.03, 675.04, 675.10, 675.11, 675.12, 675.13, 675.14, 675.20, 675.21, 675.22, 675.23, 675.24, 675.80, 675.81, 675.82, 675.83, 675.84, 675.90, 675.91, 675.92, 675.93, 675.94, 676.00, 676.01, 676.02, 676.03, 676.04, 676.10, 676.11, 676.12, 676.13, 676.14, 676.20, 676.21, 676.22, 676.23, 676.24, 676.30, 676.31, 676.32, 676.33, 676.34, 676.40, 676.41, 676.42, 676.43, 676.50, 676.51, 676.52, 676.53, 676.54, 676.60, 676.61, 676.62, 676.63, 676.64, 676.80, 676.81, 676.82, 676.83, 676.84, 676.90, 676.91, 676.92, 676.93, 676.94, 678.01, 678.13, 679.01, 679.02, 679.03, 679.11, 679.12, 679.13, V22.0, V22.1, V22.2, V23.0, V23.1, V23.2, V23.3, V23.41, V23.49, V23.5, V23.7, V23.81, V23.82, V23.83, V23.84, V23.85, V23.86, V23.9, V28.0, V28.1, V28.2, V28.3, V28.4, V28.5, V28.6, V28.81, V28.82, V28.89, V28.9



Diagnosis, Active:

Pregnancy: ICD10

A34, O00.0, O00.1, O00.2, O00.8, O00.9, O01.9, O02.0, O02.1, O02.8, O03.0, O03.1, O03.2, O03.30, O03.31, O03.32, O03.33, O03.34, O03.37, O03.39, O03.4, O03.5, O03.6, O03.7, O03.80, O03.81, O03.82, O03.83, O03.84, O03.85, O03.86, O03.87, O03.88, O03.89, O03.9, O04.5, O04.6, O04.7, O04.80, O04.81, O04.82, O04.83, O04.84, O04.85, O04.86, O04.87, O04.88, O04.89, O07.0, O07.1, O07.2, O07.30, O07.31, O07.32, O07.33, O07.34, O07.35, O07.36, O07.37, O07.38, O07.39, O07.4, O08.0, O08.1, O08.2, O08.3, O08.4, O08.5, O08.6, O08.7, O08.81, O08.82, O08.83, O08.89, O08.9, O09.00, O09.10, O09.211, O09.291, O09.30, O09.40, O09.41, O09.42, O09.43, O09.511, O09.512, O09.513, O09.519, O09.521, O09.522, O09.523, O09.529, O09.611, O09.621, O09.819, O09.821, O09.822, O09.823, O09.829, O09.891, O09.892, O09.893, O09.899, O09.90, O09.91, O09.92, O09.93, O10.011, O10.012, O10.013, O10.019, O10.03, O10.111, O10.112, O10.113, O10.119, O10.12, O10.13, O10.211, O10.212, O10.213, O10.219, O10.22, O10.23, O10.311, O10.312, O10.313, O10.319, O10.32, O10.33, O10.411, O10.412, O10.413, O10.419, O10.42, O10.43, O10.911, O10.912, O10.913, O10.919, O10.92, O10.93, O11.1, O11.2, O11.3, O11.9, O12.00, O12.01, O12.02, O12.03, O12.20, O12.21, O12.22, O12.23, O13.1, O13.2, O13.3, O13.9, O14.00, O14.02, O14.03, O14.10, O14.12, O14.13, O14.20, O14.22, O14.23, O14.90, O14.92, O14.93, O15.02, O15.03, O15.1, O15.2, O16.1, O16.2, O16.3, O16.9, O20.0, O20.8, O20.9, O21.0, O21.2, O21.8, O21.9, O22.00, O22.01, O22.02, O22.03, O22.10, O22.11, O22.12, O22.13, O22.20, O22.21, O22.22, O22.23, O22.30, O22.31, O22.32, O22.33, O22.40, O22.41, O22.42, O22.43, O22.50, O22.51, O22.52, O22.53, O22.90, O22.91, O22.92, O22.93, O23.00, O23.10, O23.20, O23.30, O23.40, O23.41, O23.42, O23.43, O23.519, O23.529, O23.599, O23.90, O23.91, O23.92, O23.93, O24.319, O24.32, O24.419, O24.429, O24.439, O24.911, O24.912, O24.913, O24.92, O24.93, O25.10, O25.11, O25.12, O25.13, O25.2, O25.3, O26.00, O26.01, O26.02, O26.03, O26.11, O26.12, O26.13, O26.20, O26.21, O26.22, O26.23, O26.41, O26.42, O26.43, O26.50, O26.51, O26.52, O26.53, O26.611, O26.612, O26.613, O26.619, O26.62, O26.811, O26.812, O26.813, O26.819, O26.821, O26.822, O26.823, O26.829, O26.831, O26.832, O26.833, O26.839, O26.841, O26.842, O26.843, O26.849, O26.851, O26.852, O26.853, O26.859, O26.872, O26.873, O26.879, O26.891, O26.892, O26.893, O26.899, O26.90, O30.001, O30.002, O30.003, O30.009, O30.021, O30.022, O30.023, O30.029, O30.03, O30.101, O30.102, O30.103, O30.109, O30.201, O30.202, O30.203, O30.209, O30.801, O30.802, O30.803, O30.809, O30.90, O30.91, O30.92, O30.93, O33.0, O33.1, O33.2, O33.7, O33.8, O33.9, O34.00, O34.01, O34.02, O34.03, O34.10, O34.11, O34.12, O34.13, O34.21, O34.29, O34.30, O34.31, O34.32, O34.33, O34.40, O34.41, O34.42, O34.43, O34.511, O34.512, O34.513, O34.519, O34.521, O34.522, O34.523, O34.529, O34.531, O34.532, O34.533, O34.539, O34.591, O34.592, O34.593, O34.599, O34.60, O34.61, O34.62, O34.63, O34.70, O34.71, O34.72, O34.73, O34.80, O34.81, O34.82, O34.83, O34.90, O34.91, O34.92, O34.93, O35.7XX0, O35.7XX1, O35.7XX2, O35.7XX3, O35.7XX4, O35.7XX5, O35.7XX9, O35.8XX0, O35.8XX1, O35.8XX2, O35.8XX3, O35.8XX4, O35.8XX5, O35.8XX9, O36.0110, O36.0120, O36.0130, O36.0190, O36.0910, O36.0920, O36.0930, O36.0990, O36.1110, O36.1120, O36.1130, O36.1190, O36.1910, O36.1920, O36.1930, O36.1990, O36.5110, O36.5120, O36.5130, O36.5190, O36.5910, O36.5920, O36.5930, O36.5990, O36.8120, O36.8130, O36.8190, O36.8210, O36.8220, O36.8230, O36.8290, O36.8910, O36.8920, O36.8930, O36.8990, O41.1010, O41.1020, O41.1030, O41.1090, O41.1210, O41.1220, O41.1230, O41.1290, O41.1410, O41.1420, O41.1430, O41.1490, O42.00, O42.011, O42.012, O42.013, O42.02, O42.10, O42.111, O42.112, O42.113, O42.12, O43.011, O43.019, O43.101, O43.102, O43.103, O43.199, O43.211, O43.212, O43.213, O43.221, O43.222, O43.223, O43.231, O43.232,



O43.233, O43.239, O43.811, O43.812, O43.813, O43.819, O43.91, O43.92, O43.93, O44.00, O44.01, O44.02, O44.03, O44.10, O44.11, O44.12, O44.13, O45.001, O45.002, O45.003, O45.011, O45.012, O45.013, O45.021, O45.022, O45.023, O45.091, O45.092, O45.093, O45.91, O45.92, O45.93, O46.001, O46.002, O46.003, O46.009, O46.011, O46.012, O46.013, O46.019, O46.021, O46.022, O46.023, O46.029, O46.091, O46.092, O46.093, O46.099, O46.90, O46.91, O46.92, O46.93, O47.00, O47.02, O47.03, O47.1, O47.9, O48.0, O48.1, O60.00, O60.02, O60.03, O61.0, O61.1, O61.9, O62.0, O62.1, O62.2, O62.3, O62.4, O62.9, O63.0, O63.1, O63.2, O63.9, O65.4, O65.5, O65.9, O66.0, O66.1, O66.40, O66.5, O66.8, O66.9, O67.0, O67.8, O67.9, O68, O70.0, O70.1, O70.2, O70.3, O70.4, O70.9, O71.00, O71.02, O71.03, O71.1, O71.2, O71.3, O71.4, O71.5, O71.6, O71.7, O71.82, O71.89, O71.9, O72.0, O72.1, O72.2, O72.3, O73.0, O73.1, O74.1, O74.2, O74.3, O74.8, O74.9, O75.0, O75.1, O75.2, O75.3, O75.4, O75.5, O75.81, O75.89, O75.9, O76, O77.0, O80, O82, O85, O86.0, O86.11, O86.12, O86.13, O86.19, O86.20, O86.21, O86.22, O86.29, O86.4, O86.81, O86.89, O87.0, O87.1, O87.2, O87.3, O87.4, O87.8, O87.9, O88.011, O88.012, O88.013, O88.019, O88.02, O88.03, O88.111, O88.112, O88.113, O88.119, O88.12, O88.13, O88.211, O88.212, O88.213, O88.219, O88.22, O88.23, O88.311, O88.312, O88.313, O88.319, O88.32, O88.33, O88.811, O88.812, O88.813, O88.819, O88.82, O88.83, O89.09, O89.1, O89.2, O89.8, O89.9, O90.0, O90.1, O90.2, O90.3, O90.4, O90.5, O90.6, O90.81, O90.89, O90.9, O91.011, O91.012, O91.013, O91.019, O91.02, O91.111, O91.112, O91.113, O91.119, O91.12, O91.211, O91.212, O91.213, O91.219, O91.22, O91.23, O92.011, O92.012, O92.013, O92.019, O92.03, O92.111, O92.112, O92.113, O92.119, O92.13, O92.20, O92.29, O92.3, O92.5, O92.6, O92.70, O92.79, O94, O98.011, O98.012, O98.013, O98.019, O98.02, O98.03, O98.111, O98.112, O98.113, O98.119, O98.12, O98.13, O98.211, O98.212, O98.213, O98.219, O98.22, O98.23, O98.3, O98.311, O98.312, O98.313, O98.319, O98.32, O98.33, O98.42, O98.43, O98.511, O98.512, O98.513, O98.519, O98.52, O98.53, O98.611, O98.612, O98.613, O98.619, O98.62, O98.63, O98.811, O98.812, O98.813, O98.819, O98.82, O98.83, O98.911, O98.912, O98.913, O98.919, O98.92, O98.93, O99.011, O99.012, O99.013, O99.019, O99.02, O99.03, O99.111, O99.112, O99.113, O99.119, O99.12, O99.13, O99.210, O99.211, O99.212, O99.213, O99.214, O99.215, O99.280, O99.281, O99.282, O99.283, O99.284, O99.285, O99.320, O99.321, O99.322, O99.323, O99.324, O99.325, O99.330, O99.331, O99.332, O99.333, O99.334, O99.335, O99.340, O99.341, O99.342, O99.343, O99.344, O99.345, O99.350, O99.351, O99.352, O99.353, O99.354, O99.355, O99.411, O99.412, O99.413, O99.419, O99.42, O99.43, O99.810, O99.814, O99.815, O99.834, O99.835, O99.840, O99.841, O99.842, O99.843, O99.844, O99.845, O99.89, Z33.1, Z33.2, Z34.00, Z34.80, Z34.90, Z36

Diagnosis, Active:

Pregnancy: SNOMED

102872000, 102873005, 102875003, 127363001, 14418008, 16356006, 169560008, 169561007, 169562000, 169563005, 169564004, 169565003, 169566002, 169567006, 169568001, 198624007, 198626009, 198627000, 198881004, 199715003, 237233002, 237238006, 237239003, 237240001, 237241002, 237242009, 237244005, 239101008, 248985009, 281307002, 289908002, 29399001, 314204000, 31601007, 34801009, 386322007, 38720006, 41587001, 41991004, 43990006, 442478007, 44782008, 45307008, 47200007, 57630001, 58532003, 59466002, 60000008, 60810003, 64254006, 65147003, 65727000, 69532007, 72892002, 77386006, 79290002, 79586000, 80997009, 82661006, 83074005, 87605005, 90968009, 9279009, 9899009




BMI Encounter Code Set:HCPCS

G0101, G0108, G0270, G0271, G0402, G0438, G0439, G0447


BMI Encounter Code Set: CPT

90791, 90792, 90832, 90834, 90837, 90839, 96150, 96151, 96152, 97001, 97003, 97802, 97803, 98960, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215


BMI Encounter Code Set:SNOMED

10197000, 108220007, 108221006, 108224003, 108311000, 13607009, 14736009, 165171009, 18512000, 185349003, 185463005, 185465003, 225967005, 270427003, 270430005, 30346009, 308335008, 32537008, 35025007, 37894004, 386372009, 390906007, 406547006, 410155007, 410157004, 410158009, 410160006, 410170008, 410172000, 46662001, 55162003, 68381003, 78318003, 83607001, 8411005, 86013001, 90526000


BMI Encounter Code Set: CDT

D7140, D7210

Intervention, Order:

Above Normal Follow‐up: ICD9

V65.3, V65.41


Above Normal Follow‐up:ICD10

Z71.3


Above Normal Follow‐up: SNOMED

304549008, 307818003, 361231003, 370847001, 386291006, 386292004, 386373004, 386463000, 386464006, 410177006, 413315001, 418995006, 424753004, 443288003




Above Normal Follow‐up: HCPCS

G8417, S9449, S9451, S9452, S9470


Above Normal Follow‐up: CPT

43644, 43645, 43770, 43771, 43772, 43773, 43774, 43842, 43843, 43845, 43846, 43847, 43848, 97804, 98960, 99078


Below Normal Follow up: ICD9

V65.3


Below Normal Follow up: ICD10

Z71.3


Below Normal Follow up: SNOMED

386464006, 410177006, 413315001, 418995006, 424753004, 429095004, 443288003


Below Normal Follow up:HCPCS

G8418, S9449, S9452, S9470


Referrals where weight assessment may occur: SNOMED

103698003, 103699006, 183515008, 183524004, 183583007, 185359002, 305922005, 306136006, 306163007, 306164001, 306165000, 306166004, 306167008, 306168003, 306226009, 306227000, 306252003, 306344004, 306353006, 306354000, 308459004, 308470006, 308477009, 390864007, 390866009, 390893007, 408289007, 410160006, 416790000, 424203006, 91251008



Physical Exam, Finding:

BMI LOINC Value: LOINC

39156‐5

Physical Exam, Performed not done:

Medical or Other reason not done: SNOMED

183932001, 397745006, 407563006

Physical Exam, Performed not done:

Patient Reason Refused: SNOMED

105480006, 183944003, 183945002, 413310006, 413311005, 413312003

Physical Exam, Performed:

BMI LOINC Value

39156‐5

Attribute: Reason:

Overweight: SNOMED

238131007

Attribute: Reason:

Underweight:SNOMED

248342006



Line 14a – Tobacco Use Screening and Cessation

Name Details

Description: Percentage of patients aged 18 years and older (seen after their 18th birthday) who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user.

This is related to Clinical Quality Measure NQF 0028 but does have some differences (for example, the UDS version does not have exclusions)

Denominator: **Patients in Age Range > = 18 years (checked before the start of the measurement period)

AND:

***Who have had at least 1 Encounter of Preventive Care Services ‐ Group Counseling or Preventive Care Services – Other or Preventive Care Services‐Initial Office Visit, 18 and Up or Preventive Care Services ‐ Established Office Visit, 18 and Up or Preventive Care Services‐Individual Counseling or Face‐to‐Face Interaction or Annual Wellness Visit during the Measurement period

OR

***Who have had At least 2 Encounters of Psych Visit ‐ Diagnostic Evaluation or Health and Behavior Assessment – Initial or Health & Behavioral Assessment – Individual or Occupational Therapy Evaluation or Office Visit or Psych Visit – Psychotherapy or Psychoanalysis or Ophthalmological Services during the Measurement period

Encounters with Encounter Level Specified (CPT codes and HCPCS codes)

NOTE | Reporting will look at Encounter Plan ‐‐Procedure Orders for Face to Face Interaction (SNOMED codes).


Numerator: (14a) Patient asked for Smoking status at last visit (or in last 2 years)

AND

* Patient has not been identified as a tobacco user in the past 2 years [Patient DOESN’T Fit 15a] OR

** (15a) Patient identified as a tobacco user in the past 2 years

AND

** (15b) Tobacco use intervention at last visit (or in last 2 years)





14a


“The patient was queried about any and all forms of tobacco use at their most recent visit, or within the past 24 months.”

**Patients have had their Tobacco User or Tobacco Non‐User status documented (see code list for SNOMED codes)

**And it has been reviewed <= 24 months before end of the measurement period

MedInfo > Histories > Habits

15a


“The Patient has been identified as a tobacco user sometime in the past 24 months (including both smoked and smokeless tobacco).”

**Patients have had their Tobacco User status documented (see code list for SNOMED codes)

**Date Range: Has been reviewed <= 24 months before end of the measurement Period

MedInfo > Histories > Habits

15b


“There is documentation that within the past 24 months, the patient had received tobacco use cessation counseling OR received a prescription or recommendation to purchase a smoking cessation medication. This medication may be prescription or OTC.”

*** Patients who had an Intervention Performed of Tobacco Use Cessation Counseling (see code list for CPT and SNOMED codes)

** Date Range: <= 24 months before end of the Measurement Period


Encounter Plan – Instructions

OR

***who were prescribed Tobacco Use Cessation Pharmacotherapy medications (see medication names in code list)

** Date Range: <= 24 months before end of the Measurement Period

MedInfo > Medical > Medications


Annual Wellness Visit:

HCPCS

G0438, G0439


Face‐to‐Face Interaction:

SNOMED

12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 4525004, 87790002, 90526000


Health & Behavioral

Assessment – Individual:

CPT

96152




Health and Behavioral

Assessment ‐ Initial:

CPT

96150


Occupational Therapy Evaluation:

CPT

97003, 97004


Office Visit:

CPT

99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215


Ophthalmological Services:

CPT

92002, 92004, 92012, 92014


Preventive Care Services ‐ Established Office Visit, 18 and Up:

CPT

99395, 99396, 99397


Preventive Care Services ‐ Group Counseling:

CPT

99411, 99412


Preventive Care Services ‐ Other:

CPT

99420, 99429


Preventive Care Services‐ Individual Counseling:

CPT

99401, 99402, 99403, 99404


Preventive Care Services‐ Initial Office Visit, 18 and Up:

CPT

99385, 99386, 99387


Psych Visit ‐ Diagnostic Evaluation:

CPT

90791, 90792


Psych Visit ‐ Psychotherapy:

CPT

90832, 90834, 90837




Psychoanalysis: CPT

90845


Tobacco Use Cessation Counseling:

CPT

99406, 99407


Tobacco Use Cessation Counseling:

SNOMED

171055003, 185792005, 185793000, 185794006, 185795007, 185796008, 225323000, 225324006, 310429001, 315232003, 384742004

Medication, Active:

OR

Medication, Order:

Tobacco Use Cessation Pharmacotherapy:

RXNORM

24 HR Nicotine 0.313 MG/HR Transdermal Patch, 24 HR Nicotine 0.938 MG/HR Transdermal Patch, topiramate 50 MG Oral Tablet, 24 HR Nicotine 0.583 MG/HR Transdermal Patch, 24 HR Nicotine 0.875 MG/HR Transdermal Patch, 24 HR Nicotine 0.292 MG/HR Transdermal Patch, Nortriptyline 10 MG Oral Capsule, Nortriptyline 50 MG Oral Capsule, Nortriptyline 75 MG Oral Capsule, topiramate 25 MG Oral Tablet, topiramate 100 MG Oral Tablet, topiramate 200 MG Oral Tablet, topiramate 25 MG Oral Capsule, topiramate 15 MG Oral Capsule, Nicotine 4 MG/ACTUAT Inhalant Solution, 24 HR Nicotine 0.458 MG/HR Transdermal Patch, 24 HR Nicotine 0.917 MG/HR Transdermal Patch, Nicotine 4 MG Chewing Gum, Nortriptyline 2 MG/ML Oral Solution, Nicotine 2 MG Chewing Gum, Nortriptyline 25 MG Oral Capsule, Nicotine 2 MG Lozenge, Nicotine 4 MG Lozenge, 24 HR Nicotine 0.625 MG/HR Transdermal Patch, varenicline 0.5 MG Oral Tablet, varenicline 1 MG Oral Tablet, {11 (varenicline 0.5 MG Oral Tablet) / 42 (varenicline 1 MG Oral Tablet) } Pack, {56 (varenicline 1 MG Oral Tablet) } Pack, {14 (24 HR Nicotine 0.292 MG/HR Transdermal Patch) / 14 (24 HR Nicotine 0.583 MG/HR Transdermal Patch) / 28 (24 HR Nicotine 0.875 MG/HR Transdermal Patch) } Pack, 200 ACTUAT Nicotine 0.5 MG/ACTUAT Nasal Inhaler, 12 HR Bupropion Hydrochloride 100 MG Extended Release Tablet, 12 HR Bupropion Hydrochloride 150 MG Extended Release Tablet, 12 HR Bupropion Hydrochloride 200 MG Extended Release Tablet, 24 HR Bupropion Hydrochloride 150 MG Extended Release Tablet, 24 HR Bupropion hydrobromide 174 MG Extended Release Tablet, 24 HR Bupropion Hydrochloride 300 MG Extended Release Tablet, 24 HR Bupropion hydrobromide 348 MG Extended Release Tablet, 24 HR Bupropion hydrobromide 522 MG Extended Release Tablet, 168 HR Clonidine 0.00417 MG/HR Transdermal Patch, 168 HR Clonidine 0.00833 MG/HR Transdermal Patch, 168 HR Clonidine 0.0125 MG/HR Transdermal Patch



Patient Characteristic:

Tobacco Non‐User:

SNOMED

105539002, 105540000, 105541001, 160618006, 160620009, 160621008, 228501004, 228502006, 228503001, 228512004, 266919005, 266921000, 266922007, 266923002, 266924008, 266925009, 266928006, 281018007, 360890004, 360900008, 360918006, 360929005, 405746006, 53896009, 8392000, 8517006, 87739003

Patient Characteristic:

Tobacco User:

SNOMED

428041000124106, 428061000124105, 428071000124103,160603005, 160604004, 160605003, 160606002, 160619003, 228494002, 228504007, 228514003, 228515002, 228516001, 228517005, 228518000, 230059006, 230060001, 230062009, 230063004, 230064005, 230065006, 266920004, 449868002, 65568007, 77176002, 81703003, 82302008

Risk Category Assessment:

Tobacco Use Screening:

LOINC

11366‐2, 68535‐4, 68536‐2



Line 16 – Asthma Pharmacologic Therapy

Name Details

Description: The performance measure is “Percentage of patients aged 5 through 40 with a diagnosis of mild, moderate, or severe persistent asthma who received or were prescribed accepted pharmacologic therapy.”

This is partially related to Clinical Quality Measure NQF 0036 (but with some major differences)

Denominator: Number of patients who were 5 through 40 years of age at some point during the measurement year, who have been seen at least twice in the practice and who had at least one medical visit during the reporting year.

AND

(16a) The patient was seen during the measurement year and had an active diagnosis of persistent asthma at the time of the visit.


Numerator: (16b) There is documentation that the patient received, was prescribed, or used an inhaled corticosteroid or an acceptable pharmacological agent.

Exclusion: (16c) Patient is allergic to asthma medications, or has had an adverse reaction to asthma medications


16a

(used to determine denominator)

“The patient was seen during the measurement year and had an active diagnosis of persistent asthma at the time of the visit.”

**Patients in Age Range: >= 5 years and <= 41 years (checked on the last day of the measurement period) [everyone who turns 5 during the year to everyone who turns 41 during the year]

AND

** Patient has diagnosis of Persistent Asthma (see code list for ICD and SNOMED codes)

** Date Range: Beginning date between one year prior to start of the measurement period and end of the measurement period.










16b

(used to determine numerator)

“There is documentation that the patient received, was prescribed, or used an inhaled corticosteroid or an acceptable pharmacological agent.”

**Patients who were dispensed at least one prescription for a Preferred Asthma Therapy (see medication names in code list)

**Date Range: during the measurement period.


16c

(used to determine exclusion)

“Patient is allergic to asthma medications, or has had an adverse reaction to asthma medications.”

**Patients who were allergic to or had an adverse reaction to Preferred Asthma Therapy (see medication names in code list)

**Date Range: prior to the end of the measurement period

MedInfo > Medical > Allergies

MedInfo > Medical > Medications (medication terminated because of adverse reaction)

Diagnosis, Active: Persistent

Asthma: ICD‐9

493.00, 493.01, 493.02, 493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.81, 493.82, 493.90, 493.91, 493.92

Diagnosis, Active: Persistent

Asthma: SNOMED

426656000, 426979002, 427295004



Medication, Dispensed:

Preferred Asthma Therapy:

RXNORM

240 ACTUAT Triamcinolone Acetonide 0.075 MG/ACTUAT Metered Dose Inhaler, Fluticasone propionate 0.22 MG/ACTUAT Inhalant Powder, 60 ACTUAT flunisolide 0.078 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT flunisolide 0.078 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Budesonide 0.08 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Budesonide 0.08 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler, Aminophylline 250 MG Rectal Suppository, Dyphylline 200 MG Oral Tablet, Dyphylline 400 MG Oral Tablet, Dyphylline 200 MG / Guaifenesin 200 MG Oral Tablet, Theophylline 100 MG Oral Capsule, Theophylline 125 MG Extended Release Capsule, Theophylline 125 MG Oral Tablet, Theophylline 250 MG Oral Tablet, Theophylline 300 MG Oral Tablet, Theophylline 400 MG Extended Release Capsule, Guaifenesin 180 MG / Theophylline 300 MG Oral Capsule, Budesonide 0.032 MG/ACTUAT Inhalant Powder, Theophylline 50 MG Oral Tablet, zafirlukast 20 MG Oral Tablet, zileuton 600 MG Oral Tablet, montelukast 10 MG Oral Tablet, Theophylline 100 MG Extended Release Tablet, Dyphylline 6.67 MG/ML / Guaifenesin 6.67 MG/ML Oral Solution, montelukast 5 MG Chewable Tablet, Guaifenesin 6.67 MG/ML / Theophylline 20 MG/ML Oral Solution, Guaifenesin 20 MG/ML / Theophylline 20 MG/ML Oral Solution, Budesonide 0.2 MG/ACTUAT Inhalant Powder, Dyphylline 6.67 MG/ML Oral Solution, Aminophylline 250 MG/ML Injectable Solution, Budesonide 0.5 MG/ML Inhalant Solution, Aminophylline 100 MG Enteric Coated Tablet, Aminophylline 21 MG/ML Oral Solution, Aminophylline 130 MG / Guaifenesin 100 MG / Phenobarbital 8 MG Oral Tablet, Aminophylline 130 MG / Potassium Iodide 195 MG Oral Tablet, Aminophylline 200 MG Enteric Coated Tablet, Aminophylline 225 MG Extended Release Tablet, Aminophylline 200 MG Oral Tablet, Aminophylline 25 MG/ML Injectable Solution, Dyphylline 20 MG/ML / Guaifenesin 20 MG/ML Oral Solution, Guaifenesin 6.67 MG/ML / Theophylline 6.67 MG/ML Oral Solution, Guaifenesin 100 MG / Theophylline 125 MG Oral Tablet, Guaifenesin 6 MG/ML / Theophylline 10 MG/ML Oral Solution, montelukast 4 MG Chewable Tablet, Theophylline 0.8 MG/ML Injectable Solution, Theophylline 1.6 MG/ML Injectable Solution, Theophylline 10.7 MG/ML Oral Solution, Theophylline 200 MG Extended Release Capsule, Theophylline 250 MG Oral Capsule, Theophylline 2 MG/ML Injectable Solution, Theophylline 3.2 MG/ML Injectable Solution,Theophylline 400 MG Extended Release Tablet,



Theophylline 4 MG/ML Injectable Solution, Theophylline 500 MG Extended Release Tablet, Theophylline 65 MG Extended Release Capsule, Theophylline 75 MG Extended Release Capsule, Theophylline 5.33 MG/ML Oral Solution, Theophylline 300 MG Extended Release Capsule, zafirlukast 10 MG Oral Tablet, Aminophylline 100 MG Oral Tablet, Theophylline 250 MG Extended Release Tablet, Theophylline 450 MG Extended Release Tablet, Guaifenesin 200 MG / Theophylline 250 MG Oral Tablet, Theophylline 300 MG Extended Release Tablet, Theophylline 130 MG Extended Release Capsule, Theophylline 200 MG Extended Release Tablet, Theophylline 600 MG Extended Release Tablet, Budesonide 0.125 MG/ML Inhalant Solution, Dyphylline 200 MG / Guaifenesin 300 MG Oral Tablet, Budesonide 0.25 MG/ML Inhalant Solution, montelukast 4 MG Granules, Dyphylline 200 MG / Guaifenesin 400 MG Oral Tablet, omalizumab 125 MG/ML Injectable Solution, Budesonide 0.08 MG/ACTUAT / formoterol 0.0045 MG/ACTUAT Inhalant Powder, Theophylline 50 MG Oral Capsule, Theophylline 20 MG/ML Oral Suspension, Aminophylline 60 MG/ML Enema, Theophylline 10 MG/ML Oral Solution, Aminophylline 130 MG / Guaifenesin 100 MG Oral Tablet, Guaifenesin 100 MG / Theophylline 137 MG Oral Tablet, Theophylline 330 MG Oral Tablet, Noscapine 30 MG / Theophylline 200 MG Extended Release Tablet, Aminophylline 300 MG Extended Release Tablet, 12 HR Aminophylline 225 MG Extended Release Tablet, Aminophylline 111 MG / Guaifenesin 100 MG Oral Tablet, Budesonide 0.16 MG/ACTUAT / formoterol 0.0045 MG/ACTUAT Inhalant Powder, mometasone furoate 0.2 MG/ACTUAT Inhalant Powder, Budesonide 0.18 MG/ACTUAT Inhalant Powder, Budesonide 0.09 MG/ACTUAT Inhalant Powder, Theophylline 100 MG Extended Release Capsule, Theophylline 50 MG Extended Release Capsule, 12 HR zileuton 600 MG Extended Release Tablet, 120 ACTUAT mometasone furoate 0.2 MG/ACTUAT Dry Powder Inhaler, 14 ACTUAT mometasone furoate 0.2 MG/ACTUAT Dry Powder Inhaler, 30 ACTUAT mometasone furoate 0.2 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT mometasone furoate 0.2 MG/ACTUAT Dry Powder Inhaler, 120 ACTUAT Budesonide 0.032 MG/ACTUAT Nasal Inhaler, 200 ACTUAT Budesonide 0.032 MG/ACTUAT Nasal Inhaler, 200 ACTUAT flunisolide 0.029 MG/ACTUAT Nasal Inhaler, Dyphylline 20 MG/ML / Guaifenesin 10 MG/ML Oral Solution, Dyphylline 20 MG/ML / Guaifenesin 40 MG/ML Oral Solution, Dyphylline 40 MG/ML / Guaifenesin 20 MG/ML Oral Solution, Aminophylline 16.7 MG/ML Oral Solution, Guaifenesin 10 MG/ML / Pseudoephedrine 2 MG/ML / Theophylline 10 MG/ML Oral Solution, Theophylline 22 MG/ML Oral Solution, Theophylline 7.5 MG/ML Oral Solution,



ACTUAT mometasone furoate 0.1 MG/ACTUAT Dry Powder Inhaler, 30 ACTUAT mometasone furoate 0.1 MG/ACTUAT Dry Powder Inhaler, 100 ACTUAT flunisolide 0.25 MG/ACTUAT Metered Dose Inhaler, Cromolyn Sodium 10 MG/ML Inhalant Solution, Cromolyn Sodium 0.8 MG/ACTUAT Inhalant Powder, Cromolyn Sodium 20 MG/ML Oral Solution, Cromolyn Sodium 100 MG Oral Capsule, 120 ACTUAT Fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.11 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.22 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT Dry Powder Inhaler, 28 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler, 28 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT Dry Powder Inhaler, 14 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 14 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 28 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 14 ACTUAT Fluticasone propionate 0.5 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.5 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Fluticasone propionate 0.045 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.045 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Fluticasone propionate 0.115 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.115 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 60 ACTUAT Fluticasone propionate 0.23 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Fluticasone propionate 0.23 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler, Fluticasone propionate 0.25 MG/ML Inhalant Solution, 104 ACTUAT Nedocromil Sodium 1.75 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Budesonide 0.16 MG/ACTUAT Dry Powder Inhaler, 200 ACTUAT Budesonide 0.16 MG/ACTUAT Dry Powder Inhaler, 60 ACTUAT Budesonide 0.08 MG/ACTUAT Dry Powder Inhaler,



Line 17 – Coronary Artery Disease: Lipid‐Lowering Therapy

100 ACTUAT Beclomethasone Dipropionate 0.04 MG/ACTUAT Metered Dose Inhaler, 100 ACTUAT Beclomethasone Dipropionate 0.08 MG/ACTUAT Metered Dose Inhaler, 200 ACTUAT Beclomethasone Dipropionate 0.042 MG/ACTUAT Metered Dose Inhaler, 200 ACTUAT Beclomethasone Dipropionate 0.084 MG/ACTUAT Metered Dose Inhaler, 80 ACTUAT Beclomethasone Dipropionate 0.042 MG/ACTUAT Metered Dose Inhaler, 120 ACTUAT Beclomethasone Dipropionate 0.084 MG/ACTUAT Metered Dose Inhaler.

Name Details

Description: The performance measure is “Percentage of patients aged 18 years and older with a diagnosis of CAD who were prescribed a lipid‐lowering therapy.”

This is related to Pre‐2014 Clinical Quality Measure NQF 0074 – No equivalent measure exists in the 2014 CQMs

Denominator: Number of patients who were seen during the measurement year after their 18th birthday, who had at least one medical visit during the reporting year, with at least two medical visits ever.

AND

(17a) Patient has an active diagnosis of CAD (Coronary Artery Disease) including MI (Myocardial Infarction) or has had cardiac surgery


Numerator: (17b) Documentation exists that Patient was prescribed (or was already taking) a lipid‐lowering therapy during the measurement year.

Exclusion: (17c) Patient is allergic to lipid lowering medications, or has had an adverse reaction to lipid lowering medications




17a


“Patient has an active diagnosis of CAD (Coronary Artery Disease) including MI (Myocardial Infarction) or has had cardiac surgery.”

**Patients in Age Range: >= 18 years (by the end of the measurement period)

AND

***Who have had at least 1 Encounter with Encounter Levels Outpatient or Nursing Facility (see code list)

**Date Range: During the measurement period

Encounters with Encounter Level Specified (CPT codes and HCPCS codes)

NOTE | Reporting will look at Encounter Plan ‐‐Procedure Orders for Face to Face Interaction (SNOMED codes)

AND

***who have condition of Coronary Artery Disease includes MI recorded in their chart (see code list)

***Date Range: prior to the encounter date


Encounter Assessment

OR

***who have had Cardiac Surgery (see code list)

***Date Range: Prior to the encounter

Encounter Plan (performed)



MedInfo > Orders > Orders (completed)

NOTE | Reporting will look at the CPT codes or Procedure names related to the surgery.

17b


“Documentation exists that Patient was prescribed (or was already taking) a lipid‐lowering therapy during the measurement year.”

**Patients who were prescribed Lipid Lowering Therapy (see code list)

**Date Range: Prior to the end of the reporting period


17c

(used to determine exclusion)

“Patient is allergic to lipid lowering medications, or has had an adverse reaction to lipid lowering medications.”

**Patients who were allergic to or had an adverse reaction to Lipid Lowering Medications (see medication names in code list)

MedInfo > Medical > Allergies

MedInfo > Medical > Medications (medication terminated because of adverse reaction)





Outpatient:

CPT

99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350


Nursing Facility:

CPT

99304, 99305, 99306, 99307, 99308, 99309, 99310

Diagnosis, Active:

Coronary Artery Disease ‐ includes MI

ICD9

410.00, 410.01, 410.02, 410.10, 410.11, 410.12, 410.20, 410.21, 410.22, 410.30, 410.31, 410.32, 410.40, 410.41, 410.42, 410.50, 410.51, 410.52, 410.60, 410.61, 410.62, 410.70, 410.71, 410.72, 410.80, 410.81, 410.82, 410.90, 410.91, 410.92, 411.0, 411.1, 411.81, 411.89, 412, 413.0, 413.1, 413.9, 414.00, 414.01, 414.02, 414.03, 414.04, 414.05, 414.06, 414.07, 414.8


Cardiac Surgery:

CPT

33140, 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536, 92980, 92981, 92982, 92984, 92995, 92996


Cardiac Surgery:

Procedure Name

Coronary Artery Bypass Graft (CABG)

Medication, Dispensed:

Lipid Lowering Therapy:RXNORM

Advicor 1,000 mg‐20 mg 24 hr Tab, Advicor 500 mg‐20 mg 24 hr Tab, Advicor 750 mg‐20 mg 24 hr Tab, Altocor 10 mg 24 hr Tab, Altocor 20 mg 24 hr Tab, Altocor 40 mg 24 hr Tab, Altocor 60 mg 24 hr Tab, Altoprev 10 mg 24 hr Tab, Altoprev 20 mg 24 hr Tab, Altoprev 40 mg 24 hr Tab, Altoprev 60 mg 24 hr Tab, amlodipine‐atorvastatin 10 mg‐10 mg Tab, amlodipine‐atorvastatin 10 mg‐20 mg Tab, amlodipine‐atorvastatin 10 mg‐40 mg Tab, amlodipine‐atorvastatin 10 mg‐ 80 mg Tab, amlodipine‐atorvastatin 2.5 mg‐10 mg Tab, amlodipine‐atorvastatin 2.5 mg‐20 mg Tab, amlodipine‐atorvastatin 2.5 mg‐40 mg Tab, amlodipine‐atorvastatin 5 mg‐10 mg Tab, amlodipine‐atorvastatin 5 mg‐20 mg Tab, amlodipine‐atorvastatin 5 mg‐40 mg Tab, amlodipine‐atorvastatin 5 mg‐80 mg Tab, Antara 130 mg Cap, Antara 43 mg Cap, atorvastatin 10 mg Tab, atorvastatin 20 mg Tab, atorvastatin 40 mg Tab, atorvastatin 80 mg Tab, Atromid‐S 500 mg Cap, B‐3 Niacin 100 mg Tab, B‐3 Niacin ER 500 mg Tab, B‐3‐50 50 mg Tab, B3‐500‐GR 500 mg Tab, Caduet 10 mg‐10 mg Tab, Caduet 10 mg‐20 mg Tab, Caduet 10 mg‐40 mg Tab, Caduet 10 mg‐80 mg Tab, Caduet 2.5 mg‐10 mg Tab, Caduet 2.5 mg‐ 20 mg Tab, Caduet 2.5 mg‐40 mg Tab, Caduet 5 mg‐10 mg Tab, Caduet 5 mg‐20 mg Tab, Caduet 5 mg‐40 mg Tab, Caduet 5 mg‐80 mg Tab, Cholestyramine Light 4 gram Oral Powder, Cholestyramine Light 4 gram Packet,



Cholestyramine Susp Light 4 gram Packet, cholestyramineaspartame 4 gram Oral Powder, cholestyramine‐aspartame 4 gram Packet, cholestyramine‐sucrose 4 gram Oral Powder, cholestyramine‐sucrose 4 gram Packet, clofibrate 500 mg Cap, colesevelam 625 mg Tab, Crestor 10 mg Tab, Crestor 20 mg Tab, Crestor 40 mg Tab, Crestor 5 mg Tab, Endur‐Acin 500 mg Tab, ezetimibe 10 mg Tab, ezetimibe‐simvastatin 10 mg‐10 mg Tab, ezetimibe‐simvastatin 10 mg‐20 mg Tab, ezetimibe‐simvastatin 10 mg‐40 mg Tab, ezetimibe‐simvastatin 10 mg‐80 mg Tab, fenofibrate 160 mg Tab, fenofibrate 54 mg Tab, fenofibrate micronized 130 mg Cap, fenofibrate micronized 134 mg Cap, fenofibrate micronized 160 mg Tab, fenofibrate micronized 200 mg Cap, fenofibrate micronized 43 mg Cap, fenofibrate micronized 67 mg Cap, fenofibrate nanocrystallized 145 mg Tab, fenofibrate nanocrystallized 160 mg Tab, fenofibrate nanocrystallized 48 mg Tab, fenofibrate nanocrystallized 50 mg Tab, fluvastatin 20 mg Cap, fluvastatin 40 mg Cap, fluvastatin ER 80 mg 24 hr Tab, Gemcor 600 mg Tab, gemfibrozil 600 mg Tab, inositol niacinate 500 mg Cap, Lescol 20 mg Cap, Lescol 40 mg Cap, Lescol XL 80 mg 24 hr Tab, Lipitor 10 mg Tab, Lipitor 20 mg Tab, Lipitor 40 mg Tab, Lipitor 80 mg Tab, LoCholest 4 gram Oral Packet, LoCholest 4 gram Oral Powder, LoCholest Light 4 gram Oral Packet, Lofibra 134 mg Cap, Lofibra 160 mg Tab, Lofibra 200 mg Cap, Lofibra 54 mg Tab, Lofibra 67 mg Cap, Lopid 600 mg Tab, lovastatin 10 mg Tab, lovastatin 20 mg Tab, lovastatin 40 mg Tab, lovastatin ER 10 mg 24 hr Tab, lovastatin ER 20 mg 24 hr Tab, lovastatin ER 40 mg 24 hr Tab, lovastatin ER 60 mg 24 hr Tab, Mevacor 10 mg Tab, Mevacor 20 mg Tab, Mevacor 40 mg Tab, Na‐500 500 mg Cap, Nb3 500 mg Tab, Nia‐Bid 400 mg Cap, Niac 400 mg Cap, Niacels 400 mg Cap, niacin 100 mg Tab, niacin 250 mg Tab, niacin 50 mg Tab, niacin 500 mg Tab, niacin ER 1,000 mg Tab, niacin ER 125 mg Cap, niacin ER 250 mg Cap, niacin ER 400 mg Cap, niacin ER 500 mg Cap, niacin ER 500 mg Tab, niacin ER 750 mg Tab, niacin‐lovastatin ER 1,000 mg‐20 mg multiphase 24 hr Tab, niacin‐lovastatin ER 500 mg‐20 mg multiphase 24 hr Tab, niacin‐lovastatin ER 750 mg‐20 mg multiphase 24 hr Tab, Niacin‐Time 500 mg Tab, Niacinol 500 mg Cap, Niacor 500 mg Tab, Niacor B3 500 mg Tab, NiaDelay 500 mg Tab, Niaplus 400 mg Cap, Niatab 500 mg, Nico‐400 400 mg Cap, Nico‐Span 400 mg Cap, Nicobid 125 mg Cap, Nicobid 250 mg Cap, Nicobid 500 mg Cap, Nicocap 400 mg, Nicolar 500 mg Tab, Nicotinic Acid 100 mg Tab, Nicotinic Acid 250 mg Cap, Nicotinic Acid 500 mg Cap, Nicotym 400 mg Cap, Pravachol 10 mg Tab, Pravachol 20 mg Tab, Pravachol 40 mg Tab, Pravachol 80 mg Tab, pravastatin 10 mg Tab, pravastatin 20 mg Tab, pravastatin 40 mg Tab, pravastatin 80 mg Tab, Prevalite 4 gram Oral Packet,



Line 18 – Ischemic Vascular Disease (IVD): Aspirin or Antithrombotic Therapy

Prevalite 4 gram Oral Powder, Questran 4 gram Oral Powder, Questran 4 gram Packet, Questran Light 4 gram Oral Powder, Questran Light 4 gram Packet, Ridicin 100 mg Tab, Ridicin 50 mg Tab, rosuvastatin 10 mg Tab, rosuvastatin 20 mg Tab, rosuvastatin 40 mg Tab, rosuvastatin 5 mg Tab, simvastatin 10 mg Tab, simvastatin 20 mg Tab, simvastatin 40 mg Tab, simvastatin 5 mg Tab, simvastatin 80 mg Tab, Slo‐Niacin 500 mg Tab, Slo‐Niacin 750 mg Tab, Tega Span‐125 125 mg Cap, Tega Span‐250 250 mg Cap, Tega Span‐400 400 mg Cap, Tega‐Span 400 mg Cap, Tricor 134 mg Cap, Tricor 145 mg Tab, Tricor 160 mg Tab, Tricor 200 mg Cap, Tricor 48 mg Tab, Tricor 67 mg Cap, Triglide 160 mg Tab, Triglide 50 mg Tab, Vytorin 10‐10 10 mg‐10 mg Tab, Vytorin 10‐20 10 mg‐20 mg Tab, Vytorin 10‐40 10 mg‐40 mg Tab, Vytorin 10‐80 10 mg‐80 mg Tab, WelChol 625 mg Tab, Zetia 10 mg Tab, Zocor 10 mg Tab, Zocor 20 mg Tab, Zocor 40 mg Tab, Zocor 5 mg Tab, Zocor 80 mg Tab.

Name Details

Description: Number of patients who were aged 18 and older at some point during the measurement year, who had at least one medical visit during the reporting year, who had an active diagnosis of ischemic vascular disease (IVD) during the current or prior year OR had been discharged alive after AMI, CABG or PTCA between January 1 and November 1 of the year prior to the measurement year, who had documentation of use of aspirin or another antithrombotic


Denominator: **Patients in Age Range > = 18 years (by the end of the measurement period)

AND

** (18a) Documentation exists that Patient was discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from Jan. 1 to Nov. 1 of the year prior to the measurement year OR patient had a diagnosis of ischemic vascular disease (IVD) during the measurement year or one year prior


Numerator: ** (18b) Documentation exists that Patient was prescribed (or was already taking) aspirin or another antithrombotic therapy during the measurement year.




18a


“Documentation exists that Patient was discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous transluminal coronary angioplasty (PTCA) from Jan. 1 to Nov. 1 of the year prior to the measurement year OR patient had a diagnosis of ischemic vascular disease (IVD) during the measurement year or one year prior.”

**Patients in Age Range: >= 18 years (by the end of the measurement period)

AND

***who have condition of Acute Myocardial Infarction recorded in their chart (see code list for ICD and SNOMED codes)

***Date Range: Beginning date between 12 months and 2 months before the start of the measurement Period.

MedInfo > Medical > Problem List


MedInfo > Histories > Medical History

OR

***who have condition of Ischemic Vascular Disease recorded in their chart (see code list for ICD and SNOMED codes)

***Date Range: Beginning date after 12 months prior to the start Measurement period and prior to the end of the Measurement Period

MedInfo > Medical > Problem List


MedInfo > Histories > Medical History

OR

***Patient has had Percutaneous Coronary Interventions or a Coronary Artery Bypass Graft (see code list for CPT, HCPCS and SNOMED codes)

***Date Range: Between 12 months and 2 months before the start of the Measurement Period.





18b


“Documentation exists that Patient was prescribed (or was already taking) aspirin or another antithrombotic therapy during the measurement year.”

**Patients who were prescribed Aspirin and Other Anti‐thrombotics medications (see medication names in code list)

**Date Range: Beginning date prior to end of the measurement period and end date (if exists) after the start of the measurement period.





Diagnosis, Active:

Acute Myocardial Infarction:

ICD9

410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81,

410.91

Diagnosis, Active:


ICD10

I21.01, I21.02, I21.09, I21.11, I21.19, I21.21, I21.29, I21.3, I21.4

Diagnosis, Active:


SNOMED

10273003, 15990001, 194798004, 194802003, 194809007, 233825009, 233826005, 233827001, 233828006, 233829003, 233830008, 233831007, 233832000, 233833005, 233834004, 233835003, 233836002, 233837006, 233838001, 282006, 30277009, 304914007, 307140009, 401303003, 401314000, 52035003, 54329005, 57054005, 58612006, 59063002, 62695002, 64627002, 65547006, 70211005, 70422006, 70998009, 73795002, 76593002, 79009004

Diagnosis, Active:

Ischemic Vascular Disease:

ICD9

411.0, 411.1, 411.81, 411.89, 413.0, 413.1, 413.9, 414.00, 414.01, 414.02, 414.03, 414.04, 414.05, 414.06, 414.07, 414.2, 414.8, 414.9, 429.2, 433.00, 433.01, 433.10, 433.11, 433.20, 433.21, 433.30, 433.31, 433.80, 433.81, 433.90, 433.91, 434.00, 434.01, 434.10, 434.11, 434.90, 434.91, 440.1, 440.20, 440.21, 440.22, 440.23, 440.24, 440.29, 440.4, 444.0, 444.1, 444.21, 444.22, 444.81, 444.89, 444.9, 445.01, 445.02, 445.81, 445.89



Diagnosis, Active:


ICD10

I20.0, I20.1, I20.8, I20.9, I24.0, I24.1, I24.8, I24.9, I25.10, I25.110, I25.111, I25.118, I25.119, I25.5, I25.6, I25.700, I25.701, I25.708, I25.709, I25.710, I25.711, I25.718, I25.719, I25.720, I25.721, I25.728, I25.729, I25.730, I25.731, I25.738, I25.739, I25.750, I25.751, I25.758, I25.759, I25.760, I25.761, I25.768, I25.769, I25.790, I25.791, I25.798, I25.799, I25.810, I25.811, I25.812, I25.82, I25.89, I25.9, I63.00, I63.011, I63.012, I63.019, I63.02, I63.031, I63.032, I63.039, I63.09, I63.10, I63.111, I63.112, I63.119, I63.12, I63.131, I63.132, I63.139, I63.19, I63.20, I63.211, I63.212, I63.219, I63.22, I63.231, I63.232, I63.239, I63.29, I63.30, I63.311, I63.312, I63.319, I63.321, I63.322, I63.329, I63.331, I63.332, I63.339, I63.341, I63.342, I63.349, I63.39, I63.40, I63.411, I63.412, I63.419, I63.421, I63.422, I63.429, I63.431, I63.432, I63.439, I63.441, I63.442, I63.449, I63.49, I63.50, I63.511, I63.512, I63.519, I63.521, I63.522, I63.529, I63.531, I63.532, I63.539, I63.541, I63.542, I63.549, I63.59, I63.6, I63.8, I63.9, I65.01, I65.02, I65.03, I65.09, I65.1, I65.21, I65.22, I65.23, I65.29, I65.8, I65.9, I66.01, I66.02, I66.03, I66.09, I66.11, I66.12, I66.13, I66.19, I66.21, I66.22, I66.23, I66.29, I66.3, I66.8, I66.9, I70.1, I70.201, I70.202, I70.203, I70.208, I70.209, I70.211, I70.212, I70.213, I70.218, I70.219, I70.221, I70.222, I70.223, I70.228, I70.229, I70.231, I70.232, I70.233, I70.234, I70.235, I70.238, I70.239, I70.241, I70.242, I70.243, I70.244, I70.245, I70.248, I70.249, I70.25, I70.261, I70.262, I70.263, I70.268, I70.269, I70.291, I70.292, I70.293, I70.298, I70.299, I70.92, I74.01, I74.09, I74.10, I74.11, I74.19, I74.2, I74.3, I74.4, I74.5, I74.8, I74.9, I75.011, I75.012, I75.013, I75.019, I75.021, I75.022, I75.023, I75.029, I75.81, I75.89



Diagnosis, Active:


SNOMED

1055001, 109381003, 111291001, 111296006, 111298007, 111299004, 123641001, 123642008, 129573006, 14977000, 19057007, 194823009, 194828000, 194842008, 194843003, 194849004, 195182007, 195183002, 195185009, 195186005, 195189003, 195190007, 195200006, 195206000, 195230003, 195231004, 195232006, 195233001, 195234007, 195235008, 195236009, 195254008, 195317001, 195318006, 195319003, 195320009, 195321008, 195323006, 195324000, 195325004, 195326003, 195327007, 195335005, 195336006, 195337002, 195340002, 195341003, 195342005, 195343000, 20059004, 21470009, 225566008, 230692004, 230693009, 230694003, 230695002, 230698000, 230699008, 230700009, 230701008, 230702001, 230703006, 230704000, 230706003, 230707007, 230708002, 233817007, 233819005, 233821000, 233823002, 233844002, 233955003, 233956002, 233958001, 233959009, 233960004, 233961000, 233962007, 233964008, 233970002, 233972005, 233973000, 233974006, 236120009, 23687008, 251024009, 25106000, 266253001, 266254007, 266262004, 266263009, 26900001, 274101000, 276219001, 280871000, 281091000, 287731003, 28790007, 297136002, 297138001, 297141005, 29899005, 300917007, 300920004, 300995000, 301755001, 302728008, 302904002, 302910002, 302930003, 307363008, 307406004, 307407008, 307408003, 307409006, 307766002, 307767006, 312375001, 312378004, 312822006, 314116003, 315025001, 315348000, 35928006, 361132001, 361133006, 363340006, 371039008, 371803003, 371804009, 371805005, 371806006, 371807002, 371808007, 371809004, 371810009, 371811008, 371812001, 394659003, 39823006, 402861007, 408546009, 408665008, 413102000, 41334000, 413439005, 413444003, 413552002, 413838009, 413844008, 414545008, 414795007, 420006002, 425527003, 426107000, 426651005, 427296003, 427567003, 428196007, 428507003, 429245005, 429559004, 429673002, 431466007, 432083006, 432504007, 441574008, 442224005, 442240008, 442421004, 442439008, 442693003, 442701004, 442735001, 443502000, 443971004, 444855007, 444856008, 446712002, 45281005, 4557003, 48601002, 49176002, 50808002, 51274000, 51677000, 52674009, 53741008, 54519002, 54687002, 5534004, 55382008, 57357009, 59021001, 59062007, 60989005, 61490001, 63739005, 64586002, 64775002, 65084004, 65198009, 66189004, 67682002, 67992007, 69742007, 71444005, 72092001, 73192008, 75543006, 81817003, 85284003, 87343002, 88174006, 89323001, 90520006, 92517006, 95458005, 95459002, 95580006



Medication, Active:

Aspirin and Other Antithrombotics:

RXNORM

Aspirin 800 MG Extended Release Tablet, Aspirin 325 MG Oral Capsule, Aspirin 325 MG Enteric Coated Tablet, Aspirin 500 MG Oral Tablet, Aspirin 650 MG Oral Tablet, Aspirin 162 MG Enteric Coated Tablet, Aspirin 300 MG Oral Capsule, Aspirin 325 MG Oral Tablet, Aspirin 65 MG Oral Tablet, Aspirin 81 MG Oral Tablet, Aspirin 500 MG Oral Capsule, Aspirin 80 MG Enteric Coated Tablet, Aspirin 25 MG / Dipyridamole 200 MG Oral Capsule, Aspirin 500 MG Enteric Coated Tablet, Aspirin 650 MG Enteric Coated Tablet, Aspirin 75 MG Chewable Tablet, Aspirin 81 MG Enteric Coated Tablet, Aspirin 975 MG Enteric Coated Tablet, clopidogrel 75 MG Oral Tablet, Ticlopidine 250 MG Oral Tablet, Aspirin 81 MG Chewable Tablet, Aspirin 81 MG Enteric Coated Capsule, Aspirin 80 MG Oral Tablet, Aspirin 488 MG Oral Tablet, Aspirin 500 MG Enteric Coated Capsule, Aspirin 81 MG Disintegrating Tablet, clopidogrel 300 MG Oral Tablet, Aspirin 228 MG Chewing Gum, prasugrel 10 MG Oral Tablet, prasugrel 5 MG Oral Tablet


Coronary Artery Bypass Graft:

HCPCS

S2205, S2206, S2207, S2208, S2209



CPT

33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536





SNOMED

10326007, 119564002, 119565001, 175007008, 175008003, 175009006, 175011002, 175021005, 175022003, 175024002, 175025001, 175026000, 175029007, 175030002, 175031003, 175032005, 175033000, 175045009, 175047001, 175048006, 175050003, 232717009, 232719007, 232720001, 232721002, 232722009, 232723004, 232724005, 265481001, 275215001, 275216000, 275252001, 275253006, 30670000, 309814006, 3546002, 359597003, 359601003, 39202005, 39724006, 414088005, 418551006, 419132001, 48431000, 74371005, 82247006

Coronary artery bypass with autogenous graft, three grafts (procedure), Internal mammary‐coronary artery bypass graft (procedure), Coronary artery bypass graft, anastomosis of artery of thorax to coronary artery (procedure), Saphenous vein graft replacement of one coronary artery (procedure), Saphenous vein graft replacement of two coronary arteries (procedure), Saphenous vein graft replacement of three coronary arteries (procedure), Saphenous vein graft replacement of four or more coronary arteries (procedure), Allograft bypass of coronary artery (procedure), Allograft replacement of one coronary artery (procedure), Allograft replacement of two coronary arteries (procedure), Allograft replacement of three coronary arteries (procedure), Allograft replacement of four or more coronary arteries (procedure), Prosthetic bypass of coronary artery (procedure), Prosthetic replacement of one coronary artery (procedure), Prosthetic replacement of two coronary arteries (procedure), Prosthetic replacement of three coronary arteries (procedure), Prosthetic replacement of four or more coronary arteries (procedure), Connection of mammary artery to coronary artery (procedure), Double implantation of mammary arteries into coronary arteries (procedure), Single anastomosis of mammary artery to left anterior descending coronary artery (procedure), Single implantation of mammary artery into coronary artery (procedure), Coronary artery bypass grafting (procedure), Coronary artery bypass graft x 1 (procedure), Coronary artery bypass grafts x 2 (procedure), Coronary artery bypass grafts x 3 (procedure), Coronary artery bypass grafts x 4 (procedure), Coronary artery bypass grafts x 5 (procedure), Coronary artery bypass grafts greater than 5 (procedure), Double anastomosis of mammary arteries to coronary arteries (procedure), Left internal mammary artery single anastomosis (procedure), Right internal mammary artery single anastomosis (procedure),



Left internal mammary artery sequential anastomosis (procedure), Right internal mammary artery sequential anastomosis (procedure), Anastomosis of thoracic artery to coronary artery, double (procedure), Aortocoronary bypass grafting (procedure), Aortocoronary artery bypass graft with saphenous vein graft (procedure), Single internal mammary‐coronary artery bypass (procedure), Coronary artery bypass with autogenous graft of internal mammary artery, single graft (procedure), Coronary artery bypass with autogenous graft, four grafts (procedure), Anastomosis of internal mammary artery to coronary artery, double vessel (procedure), Emergency coronary artery bypass graft (procedure), Robot assisted coronary artery bypass (procedure), Minimally invasive direct coronary artery bypass (procedure), Anastomosis of thoracic artery to coronary artery, single (procedure), Coronary artery bypass with autogenous graft, two grafts (procedure), Coronary artery bypass with autogenous graft, five grafts (procedure)


Percutaneous Coronary Interventions:

HCPCS

G0290



CPT

92920, 92924, 92928, 92933, 92937, 92941, 92943, 92980, 92982, 92995





SNOMED

11101003, 15256002, 175066001, 232727003, 232728008, 232729000, 397193006, 397431004, 414089002, 414509005, 415070008, 428488008, 429499003, 429639007, 431759005, 75761004, 80762004, 85053006, 91338001

Percutaneous transluminal coronary angioplasty (procedure), Transmyocardial revascularization by laser technique (procedure), Percutaneous transluminal balloon angioplasty of bypass graft of coronary artery (procedure), Percutaneous directional coronary atherectomy (procedure), Percutaneous low speed rotational coronary atherectomy (procedure), Percutaneous high speed rotational coronary atherectomy (procedure), Percutaneous transluminal coronary angioplasty by rotoablation (procedure), Percutaneous transluminal coronary angioplasty with rotoablation, single vessel (procedure), Emergency percutaneous coronary intervention (procedure), Insertion of drug coated stent (procedure), Percutaneous coronary intervention (procedure), Placement of stent in anterior descending branch of left coronary artery (procedure), Placement of stent in circumflex branch of left coronary artery (procedure), Percutaneous transluminal balloon angioplasty with insertion of stent into coronary artery (procedure), Percutaneous transluminal atherectomy using fluoroscopic guidance (procedure), Infusion of intra‐arterial thrombolytic agent with percutaneous transluminal coronary angioplasty (procedure), Infusion of intraarterial thrombolytic agent with percutaneous transluminal coronary angioplasty, multiple vessels (procedure), Percutaneous transluminal coronary angioplasty, multiple vessels (procedure), Infusion of intra‐arterial thrombolytic agent with percutaneous transluminal coronary angioplasty, single vessel (procedure)



Line 19 – Colorectal Cancer Screening

Name Details

Description: The performance measure is “Percentage of patients aged 50 to 75 who had appropriate screening for colorectal cancer.”

This closely related to Clinical Quality Measure NQF 0034

Denominator: Adults 50 to 75 years of age (51 through 75 during the measurement year)

A patient turning 50 has until a year after they turn 50 to become compliant, same for a patient turning 74, hence the 51‐75 at the end of the year)


Numerator: (19a) There is documentation that the patient had a Colonoscopy performed during the reporting period or in the nine years prior to the reporting period.

OR

(19b) There is documentation that the patient had a Flexible sigmoidoscopy performed during the reporting period or in the four years prior to the reporting period.

OR

(19c) There is documentation that the patient had a Fecal Occult Blood Test (FOBT) performed During the reporting period.

Exclusion: (19d) Patient has ever been diagnosed with Colorectal cancer


19a


“There is documentation that the patient had a Colonoscopy performed during the reporting period or in the nine years prior to the reporting period.”

** Patient is between 51 and 75 years old (checked at the end of the measurement year)

AND

**Patient has had screening performed ‐‐ Colonoscopy (see code list for CPT, HCPCS and SNOMED codes)

**Date Range: up to 9 years prior to the end of the measurement period




MedInfo > Medical > Diagnostic Test








19b


“There is documentation that the patient had a Flexible sigmoidoscopy performed during the reporting period, or in the four years prior to the reporting period.”

**Patient has had screening performed ‐‐ Flexible Sigmoidoscopy (see code list for CPT, HCPCS and SNOMED codes )

**Date Range: up to 4 years prior to the end of the measurement period









19c


“There is documentation that the patient had a Fecal Occult Blood Test (FOBT) performed During the reporting period.”

**Patient has had Fecal Occult Blood Testing (FOBT) (see code list for LOINC codes)

**Date Range Within the measurement period


19d

[Determine Exclusion]

“Patient has ever been diagnosed with Colorectal cancer”

**Patient has diagnosis of Malignant Neoplasm of Colon (see code list for ICD and SNOMED codes)

**Date Range: Prior to the end of the measurement period



Diagnosis, Active:

Malignant Neoplasm of Colon: ICD9

153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154.0, 154.1, 197.5

Diagnosis, Active:

Malignant Neoplasm of Colon:

SNOMED

187758006, 109838007, 187757001, 269533000, 269544008, 285312008, 285611007, 301756000, 312111009, 312112002, 312114001, 312115000, 314965007, 315058005, 363406005, 363407001, 363408006, 363409003, 363410008, 363412000, 363413005, 363414004, 363510005, 425178004, 429699009, 93683002, 93761005, 93771007, 93826009, 94006002, 94072004, 94105000, 94179005, 94260004, 94271003, 94328005, 94509004, 94538001, 94604000, 94643001



Diagnosis, Inactive:


ICD9

153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154.0, 154.1, 197.5

Diagnosis, Inactive:


SNOMED

187758006, 109838007, 187757001, 269533000, 269544008, 285312008, 285611007, 301756000, 312111009, 312112002, 312114001, 312115000, 314965007, 315058005, 363406005, 363407001, 363408006, 363409003, 363410008, 363412000, 363413005, 363414004, 363510005, 425178004, 429699009, 93683002, 93761005, 93771007, 93826009, 94006002, 94072004, 94105000, 94179005, 94260004, 94271003, 94328005, 94509004, 94538001, 94604000, 94643001

Diagnosis, Resolved:


ICD9

53.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154.0, 154.1, 197.5

Diagnosis, Resolved:


SNOMED

187758006, 109838007, 187757001, 269533000, 269544008, 285312008, 285611007, 301756000, 312111009, 312112002, 312114001, 312115000, 314965007, 315058005, 363406005, 363407001, 363408006, 363409003, 363410008, 363412000, 363413005, 363414004, 363510005, 425178004, 429699009, 93683002, 93761005, 93771007, 93826009, 94006002, 94072004, 94105000, 94179005, 94260004, 94271003, 94328005, 94509004, 94538001, 94604000, 94643001


Fecal Occult Blood Test (FOBT):

LOINC

12503‐9, 12504‐7, 14563‐1, 14564‐9, 14565‐6, 2335‐8, 27396‐1, 27401‐9, 27925‐7, 27926‐5, 29771‐3, 56490‐6, 56491‐4, 57905‐2, 58453‐2


Colonoscopy:

HCPCS

G0105, G0121


Colonoscopy:

CPT

44388, 44389, 44390, 44391, 44392, 44393, 44394, 44397, 45355, 45378, 45379, 45380, 45381, 45382, 45383, 45384, 45385, 45386, 45387, 45391, 45392




Colonoscopy:

SNOMED

12350003, 174158000, 174184006, 235150006, 235151005, 25732003, 303587008, 310634005, 34264006, 367535003, 418714002, 427459009, 443998000, 444783004, 446521004, 446745002, 447021001, 73761001, 8180007

Colonoscopy with rigid sigmoidoscope through colotomy (procedure), Open colonoscopy (procedure), Diagnostic endoscopic examination on colon (procedure), Total colonoscopy (procedure), Limited colonoscopy (procedure), Fiberoptic colonoscopy with biopsy (procedure), Therapeutic colonoscopy (procedure), Check colonoscopy (procedure), Intraoperative colonoscopy (procedure), Fiberoptic colonoscopy (procedure), Virtual computed tomography colonoscopy (procedure), Diagnostic endoscopic examination of colonic pouch and biopsy of colonic pouch using colonoscope (procedure), Colonoscopy through colostomy with endoscopic biopsy of colon (procedure), Screening colonoscopy (procedure), Colonoscopy and excision of mucosa of colon (procedure), Colonoscopy and biopsy of colon (procedure), Colonoscopy and tattooing (procedure), Colonoscopy (procedure), Fiberoptic colonoscopy through colostomy (procedure)


Flexible Sigmoidoscopy:

HCPCS

G0104



CPT

45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45339, 45340, 45341, 45342, 45345



SNOMED

112870002, 396226005, 425634007, 44441009

Flexible fiberoptic sigmoidoscopy for removal of foreign body (procedure), Flexible fiberoptic sigmoidoscopy with biopsy (procedure), Diagnostic endoscopic examination of lower bowel and sampling for bacterial overgrowth using fiberoptic sigmoidoscope (procedure), Flexible fiberoptic sigmoidoscopy (procedure)



Line 20 – Newly Identified HIV Cases with Timely follow-Up

Name Details

Description: Patients whose first ever HIV diagnosis was made by health center staff between October 1 of the prior year and September 30 of the reporting year and who were seen for follow up within 90 days of that first ever diagnosis

This is similar to NQF 0403 only in regards to what codes are used. There are no equivalent CQMs that check for first ever HIV diagnosis.

Denominator: (20a) The Patient’s first ever HIV diagnosis was made by health center staff

between October 1st of the year prior to the reporting period and September

30th of the reporting year.


Numerator: (20b) The patient was seen for a follow‐up visit within 90 days of their first ever HIV diagnosis.





20a

[Used to calculate Denominator]

“The Patient’s first ever HIV diagnosis was made by health center staff between

October 1st of the prior year and September 30th of the reporting year.”

** Patient diagnosed with HIV (see code list)

**Date Range: between October 1st of the prior year and September 30th of the reporting year







AND

**The patient has had NO prior diagnoses of HIV prior to October 1st of the previous year







20b


“The patient was seen for a follow‐up visit within 90 days of their first ever HIV diagnosis.”

**Patients Who have had a follow‐up Encounter of HIV Visit (see code list)

**Date Range: Between 1 day and 90 days after their first ever HIV diagnosis (as recorded in 20a)

Encounters with Encounter Level Specified (CPT Codes)

Encounter Plan > Procedure Orders (SNOMED codes)

Diagnosis, Active:

HIV:

ICD9

042, V08

Diagnosis, Active:

HIV:

ICD10

B20, Z21



Diagnosis, Active:

HIV:

SNOMED

111880001, 186706006, 186707002, 186708007, 186709004, 186717007, 186718002, 186719005, 186721000, 186723002, 186725009, 186726005, 230180003, 230201009, 230598008, 235009000, 235726002, 240103002, 276666007, 315019000, 359791000, 397763006, 398329009, 402915006, 402916007, 40780007, 48794007, 52079000, 5810003, 62246005, 62479008, 77070006, 79019005, 86406008, 87117006, 91947003


HIV Visit:

CPT

99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397


HIV Visit:

SNOMED

12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 270427003, 270430005, 308335008, 390906007, 406547006, 439708006, 4525004, 87790002, 90526000



Line 21 – Depression Screening and Follow-Up

Name Details

Description: Percentage of patients aged 12 years and older screened for clinical depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow‐up plan is documented on the date of the positive screen.

This closely related to Clinical Quality Measure NQF 0418

Denominator: Patients 12 or older during measurement year with an encounter during the reporting period.


Numerator: (21a) Patient was screened by a normalized and validated depression screening tool developed for the patient population in which it is being utilized

AND

(21b does NOT apply to patient) The patient tested negative for depression on an age‐appropriate standardized screening tool

OR

* (21b) The patient tested positive for depression on an age‐appropriate standardized screening tool

AND

* (21c) Following a positive depression screening, there is documentation of follow‐up which include one or more of the following: additional evaluation for depression, suicide risk assessment, referral to a practitioner who is qualified to diagnose and treat depression, pharmacological interventions, other interventions or follow‐up for the diagnosis or treatment of depression.

Exclusion: (21d) Patient has an active diagnosis of Depression or Bipolar Disorder

that existed prior to the Depression Screening.

OR

(21e) Depression Screening was not done because the patient refused to participate, because of medical reasons, or because the patient's functional capacity or motivation to improve may impact the accuracy of results




21a


“Patient was screened by a normalized and validated depression screening tool developed for the patient population in which it is being utilized”

**Patients Who have had at least 1 Depression Screening Encounter (See Codes for Encounter of Depression Screening Denominator Encounter Codes New)


Encounters with Encounter Level Specified (CPT and HCPCS codes)

Encounter Plan > Procedure Orders (CPT, HCPCS and SNOMED codes)

AND

[ADOLESCENT PATIENTS]

**Patients in Age Range: < 18 years (checked at Start of Risk Category Assessment of Adolescent Depression Screening)

AND

**Patients who had Risk Category Assessment of Adolescent Depression Screening (see LOINC codes for Assessment of Adolescent Depression Screening)




OR

[ADULT PATIENTS]

** Patients in Age Range: >= 18 years (checked at Start of Risk Category Assessment of Adult Depression Screening)

AND

**Patients who had Risk Category Assessment of Adult Depression Screening (see LOINC codes for Assessment of Adult Depression Screening)




NOTE | Most recent Screening result During the measurement period will be used



21b


“The patient tested positive for depression on an age‐appropriate standardized screening tool.”


** Patients in Age Range: < 18 years (checked at Start of Risk Category Assessment of Adolescent Depression Screening)

AND

** Patients who had Risk Category Assessment of Adolescent Depression Screening with Result Flag or Result Status as ‘Positive’ (see LOINC codes for Assessment of Adolescent Depression Screening)


MedInfo > Medical > Diagnostic Test (uses Result Flag)

MedInfo > Health Maintenance > Screening and Prevention (uses Result Status)

OR

[ADULT PATIENTS]

** Patients in Age Range: >= 18 years (checked at Start of Risk Category Assessment of Adult Depression Screening)

AND

** Patients who had Risk Category Assessment of Adult Depression Screening with Result Flag or Result Status as ‘Positive’ (see LOINC codes for Assessment of Adult Depression Screening)






21c


“Following a positive depression screening, there is documentation of follow‐up which include one or more of the following: additional evaluation for depression, suicide risk assessment, referral to a practitioner who is qualified to diagnose and treat depression, pharmacological interventions, other interventions or follow‐up for the diagnosis or treatment of depression.”


** Patients in Age Range: < 18 years (checked at Start of Risk Category Assessment of Adolescent Depression Screening)

AND

****Patients who had Risk Category Assessment of Adolescent Depression Screening with Result Flag or Result Status as ‘Positive’ (see LOINC codes for Assessment of Adolescent Depression Screening)




AND

*** Patients who had an Intervention done for Additional evaluation for depression – adolescent or Referral for Depression Adolescent or Follow‐up for depression – adolescent

***Date Range: Within one day after the start of Risk Category Assessment of Adolescent Depression Screening with Result Flag or Result Status as ‘Positive’


OR

*** Patients who had a Referral order created of Referral for Depression Adolescent



OR



*** Patients who were prescribed Depression medications ‐ adolescent (see medication names in code list)



OR

***Patient had a Suicide Risk Assessment Procedure performed (see code list for SNOMED codes)






Encounter Plan > Nursing Orders

MedInfo > Orders > Nursing Care Orders (Performed)





OR

[ADULT PATIENTS]

**Patients in Age Range: >= 18 years (checked at Start of Risk Category Assessment of Adult Depression Screening with result value as 'Depression Screening Result' )

AND

**Patients who had Risk Category Assessment of Adult Depression Screening with Result Flag or Result Status as ‘Positive’ (see LOINC codes for Assessment of Adult Depression Screening)






AND

*** Patients who had an Intervention done for Additional evaluation for depression – Adult or Referral for Depression Adult or Follow‐up for depression ‐ Adult

***Date Range: Within one day after the start of Risk Category Assessment of Adult Depression Screening with Result Flag or Result Status as ‘Positive’


OR

*** Patients who had a Referral order created of Referral for Depression Adult



OR

*** Patients who were prescribed Depression medications ‐ Adult (see medication names in code list)

*** Date Range: Within one day after the start of Risk Category Assessment of Adult Depression Screening with Result Flag or Result Status as ‘Positive’


OR

***Patient had a Suicide Risk Assessment Procedure performed (see code list for SNOMED codes)






Encounter Plan > Nursing Orders

MedInfo > Orders > Nursing Care Orders (Performed)







21d

[Exclusion Criteria]

“Patient has an active diagnosis for Depression of Bipolar Disorder that existed prior to the Depression Screening.”


** Patients who had Risk Category Assessment of Adolescent Depression Screening (see LOINC codes for Assessment of Adolescent Depression Screening)




NOTE | Most recent Screening result During the measurement period will be used

AND

**With an Active diagnosis of Depression diagnosis OR Bipolar diagnosis recorded in their chart.(see code list for ICD and SNOMED codes)

**Date Range: Begin Date before the start of Risk Category Assessment of Adolescent Depression Screening and End Date (if exists) after the start of Risk Category Assessment of Adolescent Depression Screening



MedInfo > Histories > Hospitalization History Diagnosis codes)




OR

[ADULT PATIENTS]

** Patients who had Risk Category Assessment of Adult Depression Screening (see LOINC codes for Assessment of Adult Depression Screening)

**Date Range : During the measurement period



NOTE | Most recent Screening result During the measurement period will be used.




AND

**With an Active diagnosis of Depression diagnosis OR Bipolar Diagnosis recorded in their chart.(see code list for ICD and SNOMED codes)

**Date Range: Begin Date before the start of Risk Category Assessment of Adult Depression Screening and End Date (if exists) after the start of Risk Category Assessment of Adult Depression Screening





MedInfo > Histories>Surgical Procedures > Medical Details (Diagnosis codes in before or after operation fields)

MedInfo > Orders > Laboratory Orders (Diagnosis codes

21e

[Exclusion Criteria]

“Depression Screening was not done because the patient refused to participate, because of medical reasons, or because the patient's functional capacity or motivation to improve may impact the accuracy of results.”

** Documentation of medical reasons for not doing Risk Category Assessment of Adolescent or Adult Depression Screening (see code list for LOINC codes for Assessment of Adolescent and Adult

Depression Screening and SNOMED codes of Medical Reason contraindicated and Patient Refusal Reasons)





Diagnosis, Active:

Bipolar Diagnosis:

ICD9

296.40, 296.41, 296.42, 296.43, 296.44, 296.45, 296.46, 296.80

Diagnosis, Active:

Bipolar Diagnosis:

ICD10

F31.1, F31.11, F31.12, F31.13, F31.2, F31.73, F31.74, F31.9



Diagnosis, Active:

Bipolar Diagnosis:

SNOMED

10875004, 10981006, 111485001, 1196001, 13313007, 13581000, 13746004, 14495005, 1499003, 162004, 16295005, 16506000, 17782008, 191618007, 191620005, 191621009, 191623007, 191625000, 191627008, 191629006, 191630001, 191632009, 191634005, 191636007, 191638008, 191639000, 191641004, 191643001, 192362008, 19300006, 20960007, 21900002, 22121000, 22407005, 231444002, 26203008, 26530004, 28663008, 28884001, 29929003, 30520009, 30687003, 30935000, 31446002, 33380008, 34315001, 3530005, 35481005, 35846004, 36583000, 371596008, 371599001, 371600003, 371604007, 38368003, 40926005, 41552001, 41832009, 41836007, 43568002, 43769008, 4441000, 45479006, 46229002, 48937005, 49468007, 49512000, 51637008, 53049002, 53607008, 54761006, 55516002, 5703000, 59617007, 61403008, 63249007, 64731001, 65042007, 66631006, 68569003, 70546001, 71294008, 71984005, 73471000, 74686005, 75360000, 75752004, 78269000, 78640000, 79584002, 81319007, 82998009, 83225003, 85248005, 86058007, 87203005, 87950005, 9340000

Diagnosis, Active:

Depression diagnosis:

ICD9

290.13, 290.21, 290.43, 296.2, 296.21, 296.22, 296.23, 296.24, 296.25, 296.26, 296.3, 296.31, 296.32, 296.33, 296.34, 296.36, 296.82, 298.0, 300.4, 301.12, 309.0, 309.1, 309.28, 311

Diagnosis, Active:


ICD10

F01.51, F03, F32.0, F32.1, F32.2, F32.3, F32.4, F32.5, F32.8, F32.9, F33.0, F33.1, F33.2, F33.3, F33.42, F33.9, F34.1, F43.21, F43.23

Diagnosis, Active:


SNOMED

14183003, 15193003, 15639000, 18818009, 191610000, 191611001, 191613003, 191616006, 191659001, 192080009, 19527009, 19694002, 20250007, 231504006, 231542000, 2506003, 25922000, 2618002, 268621008, 28475009, 3109008, 319768000, 320751009, 33078009, 35489007, 36170009, 36474008, 36923009, 370143000, 38451003, 38694004, 39809009, 40379007, 40568001, 42925002, 430852001, 442057004, 48589009, 63778009, 66344007, 67711008, 69392006, 71336009, 73867007, 75084000, 75837004, 76441001, 77486005, 77911002, 78667006, 79298009, 81319007, 83176005, 832007, 84760002, 85080004, 87512008


Depression Screening

Denominator Encounter

Codes New:

HCPC

G0101, G0402, G0438, G0439, G0444




Codes New:

CPT

90791, 90792, 90832, 90834, 90837, 90839, 92557, 92567, 92568, 92625, 92626, 96116, 96118, 96150, 96151, 97003, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215






Codes New:

SNOMED

10197000, 108220007, 108221006, 108224003, 108250004, 108311000, 13607009, 14736009, 165171009, 171207006, 18512000, 185349003, 185463005, 185465003, 252592009, 252603000, 270427003, 270430005, 274803000, 277404009, 302440009, 30346009, 308335008, 32537008, 35025007, 370803007, 37894004, 390906007, 406547006, 410155007, 410157004, 43362002, 46662001, 48423005, 53555003, 67533008, 78318003, 83607001, 8411005, 86013001, 90526000, 91573000


Referral for Depression Adolescent:

SNOMED

183524004, 183583007, 183851006, 183866009, 305922005, 306136006, 306137002, 306226009, 306227000, 306252003, 306291008, 306294000, 308459004, 308477009, 309627007, 390866009, 401174001, 429387009, 61801003


Referral for Depression Adult:

SNOMED

14129001, 183524004, 183528001, 183583007, 183866009, 305922005, 306136006, 306137002, 306138007, 306204008, 306226009, 306227000, 306252003, 306294000, 308459004, 308477009, 390866009, 401174001, 408293001, 429387009, 61801003


Additional evaluation for

depression – adolescent:

SNOMED

10197000, 10997001, 165171009, 165190001, 370803007, 38756009, 45392008, 79094001, 90407005


Additional evaluation for

depression – adult:

SNOMED

10197000, 10997001, 165171009, 165190001, 370803007, 38756009, 45392008, 79094001, 90407005


Follow‐up for depression –

adolescent:

SNOMED

372067001, 385721005, 385724002, 385725001, 385726000, 385727009, 385887004, 385889001, 385890005, 401277000, 410223002, 410224008, 410225009, 410226005, 410227001, 410228006, 410229003, 410230008, 410231007, 410232000, 410233005, 410234004, 425604002, 439141002, 5694008, 88848003, 91310009


Follow‐up for depression –

adult:

SNOMED

372067001, 385721005, 385724002, 385725001, 385726000, 385727009, 385887004, 385889001, 385890005, 401277000, 410223002, 410224008, 410225009, 410226005, 410227001, 410228006, 410229003, 410230008, 410231007, 410232000, 410233005, 410234004, 425604002, 439141002, 5694008, 88848003, 91310009

Medication, Order:

Depression medications –

adolescent:

RXNORM

Fluoxetine 60 MG Oral Tablet, Fluoxetine 20 MG Oral Tablet, Fluoxetine 10 MG Oral Capsule, Fluoxetine 20 MG Oral Capsule, Fluoxetine 4 MG/ML Oral Solution, Fluoxetine 40 MG Oral Capsule, Fluoxetine 10 MG Oral Tablet, Fluoxetine 90 MG Enteric Coated Capsule, Fluoxetine 15 MG Oral Tablet.



Medication, Order:

Depression medications – adult:

RXNORM

Doxepin Hydrochloride 10 MG Oral Capsule, Doxepin Hydrochloride 10 MG/ML Oral Solution, Doxepin Hydrochloride 100 MG Oral Capsule, Doxepin Hydrochloride 150 MG Oral Capsule, Doxepin Hydrochloride 25 MG Oral Capsule, Doxepin Hydrochloride 50 MG Oral Capsule, Doxepin Hydrochloride 50 MG/ML Topical Cream, Doxepin Hydrochloride 75 MG Oral Capsule, Omega‐3 Acid Ethyl Esters (USP) 1400 MG Oral Capsule, Folic Acid 0.4 MG Oral Capsule, vilazodone hydrochloride 10 MG Oral Tablet, vilazodone hydrochloride 20 MG Oral Tablet, vilazodone hydrochloride 40 MG Oral Tablet, {7 (vilazodone hydrochloride 10 MG Oral Tablet) / 7 (vilazodone hydrochloride 20 MG Oral Tablet) / 16 (vilazodone hydrochloride 40 MG Oral Tablet) } Pack, Omega‐3 Acid Ethyl Esters (USP)

1000 MG Enteric Coated Capsule, Nefazodone hydrochloride 100 MG Oral Tablet, Nefazodone hydrochloride 150 MG Oral Tablet, Nefazodone hydrochloride 200 MG Oral Tablet, Nefazodone hydrochloride 250 MG Oral Tablet, Nefazodone hydrochloride 50 MG Oral Tablet, Nefazodone hydrochloride 300 MG Oral Tablet, Desipramine Hydrochloride 10 MG Oral Tablet, Desipramine Hydrochloride 100 MG Oral Tablet, Desipramine

Hydrochloride 150 MG Oral Tablet, Desipramine Hydrochloride 25 MG Oral Tablet, Desipramine Hydrochloride 50 MG Oral Tablet, Desipramine Hydrochloride 75 MG Oral Tablet, Omega‐3 Acid Ethyl Esters (USP) 875 MG Chewable Tablet, Omega‐3 Acid Ethyl Esters (USP) 840 MG Enteric Coated Capsule, Fluoxetine 60 MG Oral Tablet, 24 HR Bupropion Hydrochloride 450 MG Extended Release Tablet, Omega‐3 Acid Ethyl Esters

(USP) 333 MG Enteric Coated Capsule, Omega‐3 Acid Ethyl Esters (USP) 875 MG Oral Capsule, Maprotiline Hydrochloride 25 MG Oral Tablet, Maprotiline Hydrochloride 50 MG Oral Tablet, Maprotiline Hydrochloride 75 MG Oral Tablet, Omega‐3 Acid Ethyl Esters (USP) 1400 MG Enteric Coated Capsule, Omega‐3 Acid Ethyl Esters (USP) 600 MG Enteric Coated Capsule, Amoxapine 100 MG Oral Tablet, Amoxapine 150 MG Oral Tablet,

Amoxapine 25 MG Oral Tablet, Amoxapine 50 MG Oral Tablet, Nortriptyline 10 MG Oral Capsule, Nortriptyline 50 MG Oral Capsule, Nortriptyline 75 MG Oral Capsule, Folic Acid 0.4 MG Oral Tablet, Folic Acid 0.8 MG Oral Tablet, Nortriptyline 10 MG Oral Tablet, Folic Acid 5 MG Oral Tablet, Folic Acid 0.5 MG Oral Tablet, Trimipramine 25 MG Oral Tablet, ST. JOHN'S WORT EXTRACT 300 MG Oral Capsule, ST. JOHN'S WORT EXTRACT 510 MG Oral Capsule, Citalopram 20 MG Oral Tablet, Folic Acid 5 MG/ML Injectable Solution, ST. JOHN'S WORT EXTRACT 225 MG Oral Capsule, ST. JOHN'S WORT EXTRACT 25 MG/ML Oral Solution, ST. JOHN'S WORT EXTRACT 600 MG Oral Capsule, Trimipramine 50 MG Oral Tablet, Folic Acid 25 MG Oral Tablet, Fluoxetine 20 MG Oral Tablet, Sertraline 200 MG Oral Tablet,



Folic Acid 0.8 MG Oral Capsule, ST. JOHN'S WORT EXTRACT 150 MG Oral Tablet, ST. JOHN'S WORT EXTRACT 300 MG Oral Tablet, ST. JOHN'S WORT EXTRACT 450 MG Extended Release Tablet, ST. JOHN'S WORT EXTRACT 400 MG Oral Capsule, ST. JOHN'S WORT EXTRACT 375 MG Oral Capsule, ST. JOHN'S WORT EXTRACT 500 MG/ML

Oral Solution, Folic Acid 5 MG Oral Capsule, Folic Acid 20 MG Oral Capsule, ST. JOHN'S WORT EXTRACT 250 MG Oral Capsule, Mirtazapine 15 MG Disintegrating Tablet, Mirtazapine 30 MG Disintegrating Tablet, Mirtazapine 45 MG Disintegrating Tablet, Citalopram 10 MG Oral Tablet, ST. JOHN'S WORT EXTRACT 1000 MG Oral Capsule, Citalopram 2 MG/ML Oral Solution, Citalopram 40 MG Oral Tablet, Desipramine 25 MG Oral Capsule, Desipramine 50 MG Oral Capsule, Fluoxetine 10 MG Oral Capsule, Fluoxetine 20 MG Oral Capsule, Fluoxetine 4 MG/ML Oral Solution, Folic Acid 1 MG Oral Tablet, Mirtazapine 15 MG Oral Tablet, Mirtazapine 45 MG Oral Tablet, Nortriptyline 2 MG/ML Oral Solution, Paroxetine 10 MG Oral Tablet, Paroxetine 2 MG/ML Oral Suspension, Paroxetine 30 MG Oral Tablet, Paroxetine 40 MG Oral Tablet, Phenelzine

15 MG Oral Tablet, Sertraline 100 MG Oral Tablet, Sertraline 25 MG Oral Tablet, Sertraline 50 MG Oral Tablet, Tranylcypromine 10 MG Oral Tablet, Trimipramine 100 MG Oral Capsule, Trimipramine 100 MG Oral Tablet, Trimipramine 25 MG Oral Capsule, Trimipramine 50 MG Oral Capsule, venlafaxine 100 MG Oral Tablet, 24 HR venlafaxine 150 MG Extended Release Capsule, venlafaxine 25 MG Oral Tablet, 24 HR venlafaxine 37.5

MG Extended Release Capsule, venlafaxine 37.5 MG Oral Tablet, 24 HR venlafaxine 75 MG Extended Release Capsule, venlafaxine 75 MG Oral Tablet, Fluoxetine 40 MG Oral Capsule, Fluoxetine 10 MG Oral Tablet, Fluoxetine 90 MG Enteric Coated Capsule, Mirtazapine 30 MG Oral Tablet, Paroxetine 20 MG Oral Tablet, venlafaxine 50 MG Oral Tablet, Nortriptyline 25 MG Oral Capsule, Escitalopram 10 MG Oral Tablet, atomoxetine 10 MG Oral Capsule, atomoxetine 18 MG Oral Capsule, atomoxetine 25 MG Oral Capsule, atomoxetine 40 MG Oral Capsule, atomoxetine 60 MG Oral Capsule, Escitalopram 5 MG Oral Tablet, Escitalopram 20 MG Oral Tablet, Escitalopram 1 MG/ML Oral Solution, atomoxetine 5 MG Oral Capsule, 5‐Hydroxytryptophan 100 MG Oral Capsule, Folic Acid 15 MG Oral Tablet, Mirtazapine 7.5 MG Oral Tablet, 5‐Hydroxytryptophan 50 MG Oral Capsule, Paroxetine 12.5 MG Extended Release Tablet, Paroxetine 25 MG Extended Release Tablet, Paroxetine 37.5 MG Extended Release Tablet, Omega‐3 Acid Ethyl Esters (USP) 1000 MG Oral Capsule, duloxetine 20 MG Enteric Coated Capsule, duloxetine 30 MG Enteric Coated Capsule, duloxetine 60 MG Enteric Coated Capsule, atomoxetine 100 MG Oral Capsule, atomoxetine 80 MG Oral Capsule, Folic Acid 0.2 MG Oral Tablet, Citalopram 10 MG Oral Capsule, Citalopram 20 MG Oral Capsule, Citalopram 40 MG Oral Capsule, 24 HR Desvenlafaxine 100 MG Extended Release Tablet, 24 HR Desvenlafaxine 50 MG Extended Release Tablet, Sertraline 150 MG Oral Tablet,



Fluoxetine 15 MG Oral Tablet, 24 HR venlafaxine 150 MG Extended Release Tablet, 24 HR venlafaxine 225 MG Extended Release Tablet, 24 HR venlafaxine 37.5 MG Extended Release Tablet, 24 HR venlafaxine 75 MG Extended Release Tablet, Imipramine Hydrochloride 25 MG Oral Tablet, Imipramine Hydrochloride 50 MG Oral Tablet, Imipramine pamoate 75 MG Oral Capsule, Imipramine pamoate 150 MG Oral Capsule, Imipramine Hydrochloride 12.5 MG/ML Injectable Solution, Imipramine pamoate 125 MG Oral Capsule, Imipramine pamoate 100 MG Oral Capsule, Imipramine Hydrochloride 10 MG Oral Tablet, Trazodone Hydrochloride 150 MG Oral Tablet, Trazodone Hydrochloride 300 MG Oral Tablet, Trazodone Hydrochloride 100 MG Oral Tablet, Trazodone Hydrochloride 50 MG Oral Tablet, Amitriptyline Hydrochloride 10 MG / Perphenazine 2 MG Oral Tablet, Amitriptyline Hydrochloride 10 MG / Perphenazine 4 MG Oral Tablet, Amitriptyline Hydrochloride 100 MG Oral Tablet, Amitriptyline Hydrochloride 12.5 MG / Chlordiazepoxide 5 MG Oral Tablet, Amitriptyline Hydrochloride 150 MG Oral Tablet, Amitriptyline Hydrochloride 10 MG Oral Tablet, Amitriptyline Hydrochloride 25 MG / Chlordiazepoxide 10 MG Oral Tablet, Amitriptyline Hydrochloride 25 MG / Perphenazine 2 MG Oral Tablet, Amitriptyline Hydrochloride 25 MG / Perphenazine 4 MG Oral Tablet, Amitriptyline Hydrochloride 25 MG Oral Tablet, Amitriptyline Hydrochloride 50 MG / Perphenazine 4 MG Oral Tablet, Amitriptyline Hydrochloride 50 MG Oral Tablet, Amitriptyline Hydrochloride 75 MG Oral Tablet, Clomipramine Hydrochloride 10 MG Oral Tablet, Clomipramine Hydrochloride 25 MG Oral Tablet, Clomipramine Hydrochloride 25 MG Oral Capsule, Clomipramine Hydrochloride 50 MG Oral Capsule, Clomipramine Hydrochloride 75 MG Oral Capsule, Clomipramine Hydrochloride 50 MG Oral Tablet, selegiline hydrochloride 5 MG Oral Capsule, selegiline hydrochloride 1.25 MG Disintegrating Tablet, selegiline hydrochloride 5 MG Oral Tablet, Sertraline 20 MG/ML Oral Solution, 24 HR selegiline hydrochloride 0.25 MG/HR Transdermal Patch, 24 HR selegiline hydrochloride 0.375 MG/HR Transdermal Patch, 24 HR selegiline hydrochloride 0.5 MG/HR Transdermal Patch, Omega‐3 Acid Ethyl Esters (USP) 1050 MG Oral Capsule, Omega‐3 Acid Ethyl Esters (USP) 725 MG Oral Capsule, Omega‐3 Acid Ethyl Esters (USP) 952 MG Oral Capsule, Omega‐3 Acid Ethyl Esters (USP) 340 MG Enteric Coated Capsule, {5 (atomoxetine 10 MG Oral Capsule) / 5 (atomoxetine 18 MG Oral Capsule) / 5 (atomoxetine 25 MG Oral Capsule) / 15 (atomoxetine 40 MG Oral Capsule) } Pack, {5 (atomoxetine 18 MG Oral Capsule) / 5 (atomoxetine 25 MG Oral Capsule) / 5 (atomoxetine 40 MG Oral Capsule) / 15 (atomoxetine 60 MG Oral Capsule) } Pack, {5 (atomoxetine 25 MG Oral Capsule) / 5 (atomoxetine 40 MG Oral Capsule) / 5 (atomoxetine 60 MG Oral Capsule) / 15 (atomoxetine 80 MG Oral Capsule)} Pack, 24 HR Trazodone Hydrochloride 150 MG Extended Release Tablet, 24 HR Trazodone Hydrochloride 300 MG Extended Release Tablet, Omega‐3 Acid Ethyl Esters (USP) 880 MG Oral Capsule, 24 HR Fluvoxamine Maleate 100 MG Extended Release Capsule, 24 HR Fluvoxamine Maleate 150 MG Extended Release Capsule,



Fluvoxamine Maleate 100 MG Oral Tablet, Fluvoxamine Maleate 25 MG Oral Tablet, Fluvoxamine Maleate 50 MG Oral Tablet, Protriptyline Hydrochloride 10 MG Oral Tablet, Protriptyline Hydrochloride 5 MG Oral Tablet, Doxepin 3 MG Oral Tablet, Doxepin 6 MG Oral Tablet, Folic Acid 7.5 MG Oral Tablet, 12 HR Bupropion Hydrochloride 100 MG Extended Release Tablet, 12 HR Bupropion Hydrochloride 150 MG Extended Release Tablet, 12 HR Bupropion Hydrochloride 200 MG Extended Release Tablet, 24 HR Bupropion Hydrochloride 150 MG Extended Release Tablet, 24 HR Bupropion hydrobromide 174 MG Extended Release Tablet, 24 HR Bupropion Hydrochloride 300 MG Extended Release Tablet, 24 HR Bupropion hydrobromide 348 MG Extended Release Tablet, 24 HR Bupropion hydrobromide 522 MG Extended Release Tablet, Bupropion Hydrochloride 100 MG Oral Tablet, Bupropion Hydrochloride 75 MG Oral Tablet, Omega‐3 Acid Ethyl Esters (USP) 100 MG Chewable Tablet.


Suicide Risk Assessment:

SNOMED

Suicide risk assessment (procedure)

225337009

Risk Category Assessment

not done:

Medical reason contraindicated:

SNOMED

183932001, 397745006, 407563006

Risk Category Assessment

not done:

Patient Reason refused: SNOMED

105480006, 183944003, 183945002, 413310006, 413311005, 413312003


Adolescent Depression

Screening:

SNOMED

73831‐0


Adult Depression Screening:

LOINC

73832‐8

Attribute: Result:

Depression Screening Result:

SNOMED

428171000124102, 428181000124104

Attribute: Result:

Negative Depression Screening:

SNOMED

428171000124102



Attribute: Result:

Positive Depression Screening:

SNOMED

428181000124104



TABLE 7 – HEALTH OUTCOMES AND DISPARITIES – UNIVERSALLine # DescriptionAll(Sec A‐C)

Race and ethnicity need to be populated on the Patient Detail screen, along with items from

the Patient Profile Detail screen.

Must be a qualified visit during the reporting period.

Race and ethnicity are pulled from Patient Detail.

If a Patient has multiple races selected, they will be counted as “More than One Race”

A Patient is counted as Hispanic if ethnicity is set to “Hispanic”

A Patient is counted as Non‐Hispanic if ethnicity is set to “All others” or “Non‐Hispanic” OR

ethnicity is set to “Declined to Specify” and race is NOT set to “Declined to Specify”

A Patient is only counted in the “Declined to Specify” section if BOTH race and ethnicity are

set as “Declined to Specify”

Must have a qualified visit in the reporting period. If a patient doesn’t show up on table 3a,

they won’t be counted anywhere else in the UDS Reports

A 0‐2i TABLE 7 ‐ HEALTH OUTCOMES AND DISPARITIES ‐ UNIVERSALSection A: Deliveries and Birth Weight by Race and Hispanic/Latino Ethnicity.

Pregnancy data is listed in the Pregnancy History section of the Patient Profile Detail tab of

Patient Detail. This section will be hidden unless Prenatal User is checked.

This section shows pregnancy information entered in PM, as well as those entered into

Pregnancy History in the EMR. Entering a pregnancy into this section in the PM will create a

new Pregnancy History record in the EMR.

A 0

HIV Positive Pregnant Women

Prenatal User must be checked on the Patient Profile Detail tab of Patient Detail

“Patient is Pregnant and HIV Positive” must be checked on a pregnancy where EITHER the

first care date OR the delivery date is within the service date range of the report.

A 2

Deliveries performed by Health Center’s Providers

Prenatal User must be checked on the Patient Profile Detail tab of Patient Detail



Table 7 – Health Outcomes and Disparities – Universal106


TABLE 7 (CONTINUED)A 1a‐2i

Line#

Race and Ethnicity

Prenatal Care Patients Who

Delivered During the Year(1a)

Live Births:<1500 grams

(1b)

Live Births:1500‐2499 grams(1c)

Live Births:=>2500 grams(1d)

Hispanic / Latino

1a Asian 0 0 0 0

1b1 Native Hawaiian 0 0 0 0

1b2 Pacific Islander 0 0 0 0

1c Black / African American 0 0 0 0

1d American Indian / Alaska Native 0 0 0 0

1e White 0 0 0 0

1f More than One Race 0 0 0 0

1g Unreported / Refused to Report Race 0 0 0 0

Subtotal Hispanic/Latino 0 0 0 0

Non‐Hispanic Latino

2a Asian 0 0 0 0





2e White 0 0 0 0



Subtotal Non‐Hispanic/Latino 0 0 0 0

Unreported / Refused to Report Ethnicity

h Unreported / Refused to Report Race and Ethnicity 0 0 0 0

i Total 0 0 0 0

Deliveries by Birth Weight and Race

Prenatal User must be checked on the Patient Profile Detail tab of Patient Detail. Delivery date must be during the


The total count of columns 1b, 1c and 1d will NOT necessarily match the count in 1a because of these things:

Columns 1b – 1d only look at deliveries where the Pregnancy Description is set as “Full‐term” or “Pre‐term” while

column 1a also includes those with a pregnancy description of “Stillbirth”.

If birth weight is not filled in, the pregnancy will NOT be counted in 1b – 1d, but will still be counted in 1a.

If a patient has delivered multiple children from a single pregnancy they will only be counted once in 1a, but may be

counted multiple times in columns 1b – 1d.

If a patient has delivered children from multiple pregnancies in a single year they will be counted multiple times in both

1a and 1b – 1d.



TABLE 7 (CONTINUED)

New info for Hypertension and Diabetes sections (sections B and C of the report):

New Functionality has been added to make populating this table easier for practices that are also using

MicroMD EMR. Beginning in version 11.0.2 a nightly database job will update the Patient information

related to diabetes and hypertension.

[Patient Profile Detail tab of Patient Detail]

It will search encounters and problem list to find patients who have been diagnosed with diabetes

during or before the measurement year and patients who have been diagnosed with hypertension

before June 30th of the measurement year.

“Adequate blood pressure” and “blood pressure measured” are updated based on the most recent

(during the measurement year) blood pressure data from Vital Signs.

“HbA1c Level” and “HbA1c Measured” are updated based on the most recent hba1c lab tests (during

the measurement year) that include discrete results.

If a practice does not have MicroMD EMR then they will need to continue selecting these checkboxes

and drop down selectors for each relevant patient.

Table 7 (continued)108


TABLE 7 (CONTINUED)Line # DescriptionB 1a‐2i TABLE 7 ‐ HEALTH OUTCOMES AND DISPARITIES ‐ UNIVERSAL

Section B: Hypertension by Race and Hispanic/Latino ethnicity

# Race and EthnicityTotal Hypertensive

Patients(2a)

Charts Sampled or EHR Total

(2b)

Patients with HTN Controlled

(2c)

Hispanic/Latino1a Asian 0 0 0

1b1 Native Hawaiian 0 0 0

1b2 Pacific Islander 0 0 0

1c Black / African American 41 41 25

1d American Indian / Alaska Native 0 0 0

1e White 118 118 77

1f More than One Race 4 4 4

1g Unreported / Refused to Report Race 3 3 1

Subtotal Hispanic/Latino 166 166 107

Non‐Hispanic/Latino2a Asian 15 15 8

2b1 Native Hawaiian 0 0 0

2b2 Pacific Islander 1 1 1

2c Black / African American 58 58 38

2d American Indian / Alaska Native 4 4 2

2e White 993 993 652

2f More than One Race 7 7 5

2g Unreported / Refused to Report Race 6 6 4

Subtotal Non‐Hispanic/Latino 1084 1084 710

Unreported / Refused to Report Ethnicityh Unreported / Refused to Report Race and Ethnicity 1 1 1

i Total 1251 1251 818

To show on this report, the patient must have at least two qualified visits during the reporting year.

To be counted as a hypertensive patient “Hypertension User” must be checked on the Patient Profile Detail tab of

Patient Detail.

Whether or not Hypertension is considered controlled or not is based on data entered into the Patient Profile Detail

Tab of Patient Detail.

The patient will be counted in the 3f column of the report if Adequate Blood Pressure is not entered or the Blood

Pressure Measured date field is blank or has a date outside of the reporting period.

Criteria for practices using MicroMD EMR:

“Hypertension User” will be checked for a patient when they meet the following criteria:

An active diagnosis of hypertension that began before June 30th of the reporting year (or in previous years).

ICD‐9: 401.x – 405.x, ICD‐10: I10.x – I15.x

The patient must NOT have an active diagnosis of Pregnancy or End Stage Renal Disease anytime during the reporting

year. [these patients are excluded from this report]

“Adequate Blood Pressure” and “Date Blood Pressure Measured” will be updated based on the following information:

The most recent entry from vital signs that includes blood pressure data will be used. Data will only be used if both

systolic and diastolic blood pressures have been entered and there is a valid date.



TABLE 7 (CONTINUED)

PM‐Only Practices:

The “Hypertension User”, “Adequate Blood Pressure”, and “Date Blood Pressure Measured” fields will need to be

completed manually, as in the past, based on the information in this

manual and in the official UDS Manual.

C 1a‐2i TABLE 7 ‐ HEALTH OUTCOMES AND DISPARITIES ‐ UNIVERSAL

Section B: Hypertension by Race and Hispanic/Latino ethnicity

# Race and EthnicityTotal Patients with

Diabetes(3a)

Charts Sampled or EHR total

(3b)

Patients with Hba1c <8%

(3d1)

Patients with Hba1c >9% or

No Test During Year

(3f)

Hispanic/Latino1a Asian 0 0 0 0





1e White 70 70 17 49



Subtotal Hispanic/Latino 95 95 20 70

Non‐Hispanic/Latino2a Asian 11 11 1 9





2e White 353 353 49 290



Subtotal Non‐Hispanic/Latino 401 401 56 329

Unreported / Refused to Report Ethnicityh Unreported / Refused to Report Race 2 2 1 1

i Total 498 498 77 400

To show on this report, the patient must have at least two qualified visits during the

reporting year. To be counted as a diabetic patient “Diabetes User” must be checked on the

Patient Profile Detail tab of Patient Detail.

HbA1c level is based on data entered into the Patient Profile Detail Tab of Patient Detail. The

patient will be counted in the 3f column of the report if “HbA1c level” is not entered or the

“Date Hba1c measured” field is blank or has a date outside of the reporting period.

Criteria for practices using MicroMD EMR:

“Diabetic User” will be checked for a patient when they meet the following criteria:

An active diagnosis of hypertension that began before the end of the reporting year (or in

previous years).

ICD‐9: 250.x, 648.0

ICD‐10: E10.x, E11.x, O24.x

Table 7 (continued)110


TABLE 7 (CONTINUED)C 1a‐2i The patient must NOT have any of the following diagnoses during the measurement year:

Polycystic Ovaries, Gestational Diabetes, or Steroid‐induced Diabetes [these patients are

excluded from this report]

ICD‐9: 249.x, 251.8, 256.4, 648.8, 926.0ICD‐10: E16.4, E16.8, E28.2, O99.81

“HbA1c Level “and “Date HbA1c Measured” will be updated based on the following

information:

The most recent HbA1c lab result with a numeric result that has one of the following codes:

Panel: 83036

LOINC: 4548‐4, 4549‐2, 17856‐6

PM‐Only Practices:

The “Diabetic User”, “HbA1c Level”, and “Date HbA1c Measured” fields will need to be

completed manually, as in the past, based on the information in this manual and in theofficial UDS Manual.



TABLE 9 – PATIENT RELATED REVENUELine

#Description

All

(1‐14)

TABLE 9 ‐ PATIENT RELATED REVENUE

PAYOR CATEGORY FULL CHARGES THIS

PERIOD (a)

AMOUNT

COLLECTED THIS PERIOD

(b)

ALLOWANCES

(d)

SLIDING

DISCOUNTS (e)

BAD DEBT WRITE‐

OFF (f)

1.Medicaid Non‐Managed

Care10,385.00 (1,308.70) (691.42)

2a.Medicaid Managed Care (capitated)

269.00 0.00 0.00

2b.Medicaid Managed Care

(fee for service)799.00 (41951.77) (100.15)

3.TOTAL MEDICAID

(LINES1+2a+2b)11,453 (42,900) (802)

4.Medicare Non‐Managed Care

11,332.50 (13,220.90) (2,346.17)

5a.Medicare Managed Care

(capitated)0.00 0.00 0.00

5b.Medicaid Managed Care

(fee for service)0.00 0.00 0.00

6.TOTAL MEDICAID

(LINES1+2a+2b)

7.Other Public including Non‐Medicaid CHP (Non‐

Managed Care)

0.00 0.00 0.00

8a.

Other Public including

Non‐Medicaid CHP (Managed Care Capitated)

0.00 0.00 0.00

8b.

Other Public including

Non‐Medicaid CHP

(Managed Care fee for service)

0.00 0.00 0.00

9.TOTAL OTHER PUBLIC

(LINES 7+8A+8B)0 0 0

10.Private Non‐Managed

Care209,987.10 (197,032.17) (62,045.37)

11a.Private Managed Care (capitated)

0.00 0.00 0.00

11b.Private Managed Care

(fee for service)6,943.00 (410.00) (182.00)

12.TOTAL PRIVATE

(LINES 10+11A+11B)210,930 (197,442) (62,227)

13. Self Pay 15,521.83 (12,225.43) (1,519.49) 0.00

14.TOTAL

(lINES 3+6+9+12+13)249,237 (265,789) (65,375) (1,519) 0

Patient Related Revenue.

Uses the CHC Payor Category on plan.

Data is pulled from transactions made during the reporting period and the plans that are tied to them. Pulls all

charges, payments, write‐offs and sliding‐fee bad debt from the Practice

Setup. Must have service date in date range specified.

Table 9 – Patient Related Revenue112


How Table 9 is calculated in MicroMD PM:

This report looks at transaction lines where the service dates are during the report period. The sequence number for the transaction must be 1 or higher.

For Rows other than SELF‐PAY:

The row that the transaction is counted in is based on the CHC Payor Category set on the plan.

Column A includes:

Transaction lines where the POS is NOT one of these: 'P1,PO,R1,RO,W1,PR,WR,PI,RR,BI,BR'AND bill flag for the transaction line is not set to “N” (and the plan’s CHC Payor Category is not set to “Self Pay”)

Column B Includes:

Transaction lines where the POS is ‘P1’ or ‘PO’AND bill flag for the transaction line is not set to “N” (and the plan’s CHC Payor Category is not set to “Self Pay”)

Column D Includes:

Transaction lines where the POS is “WR” or “W1”AND TOS for the procedure is set to “II”AND the “allowances” checkbox is checked for the procedure AND bill flag for the transaction line is not set to “N” (and the plan’s CHC Payor Category is not set to “Self Pay”)

For the SELF‐PAY row (Line 13):

Column A includes:

Transaction lines where the POS is NOT one of these: 'P1,PO,R1,RO,W1,PR,WR,PI,RR,BI,BR'AND the plan’s CHC Payor Category is set to “Self Pay” and the bill flag is not set to “N”

OR the bill flag is set to “N”

Column B Includes:

Transaction lines where the POS is ‘P1’ or ‘PO’AND the plan’s CHC Payor Category is set to “Self Pay” and the bill flag is not set to “N”


The last two colums involve the “Bad Debt Writeoff Code” that is set on the Practice Setup tab of the MicroMD CHC Practice Setup window.(Aux ‐> MicroMD CHC ‐> Setup ‐> Practice)

Column E Includes:

The Transaction line’s procedure code does NOT match the code selected as the “Bad debt writeoff code”AND the POS is “W1” or “WR”AND the plan’s CHC Payor Category is set to “Self Pay” and the bill flag is not set to “N”


Column F Includes:

Transaction line’s procedure code matches the code selected as the “bad debt writeoff code”

Table 9 – Patient Related Revenue 113

Henry Schein MicroMD760 Boardman-Canfield RoadBoardman, OH 44512

www.micromd.com

330-758-8832

uds reporting guide - micromd · uds reporting guide overview this document contains a basic...

Documents