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Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Compare Versions of: "Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture"

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Table Options
Measure Information 2022 Performance Period 2023 Performance Period 2024 Performance Period 2025 Performance Period
Title Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
CMS eCQM ID CMS249v4 CMS249v5 CMS249v6 CMS249v7
CBE ID* 3475e 3475e 3475e 3475e
MIPS Quality ID 472 472 472 472
Measure Steward Centers for Medicare & Medicaid Services (CMS) Centers for Medicare & Medicaid Services (CMS) Centers for Medicare & Medicaid Services (CMS) Centers for Medicare & Medicaid Services (CMS)
Description

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Measure Scoring Proportion measure Proportion measure Proportion measure Proportion measure
Measure Type Process Process Process Process
Stratification *See CMS249v4.html *See CMS249v5.html

None

None

Risk Adjustment *See CMS249v4.html *See CMS249v5.html

None

None

Rationale *See CMS249v4.html *See CMS249v5.html

This measure is expected to increase recording of patient risk for fracture data and decrease the amount of inappropriate DXA scans. Current osteoporosis guidelines recommend using bone measurement testing to assess osteoporosis risk in women 65 years and older. In postmenopausal women younger than age 65, guidelines recommend using a formal clinical risk assessment tool to establish a patient's risk for osteoporosis, in order to determine whether to screen a patient for osteoporosis using bone measurement testing. Clinical information, such as age, body mass index (BMI), parental hip fracture history, and alcohol use, can be used to determine a woman's fracture risk (U.S. Preventive Services Task Force [USPSTF], 2018). Additionally, there are potentially avoidable harms associated with screening for osteoporosis in general, including exposure to radiation, false positive exams, and resulting side effects from unnecessary osteoporosis medications, which add costs to an already burdened health care system (Lim, Hoeksema, & Sherin, 2009).

This measure is expected to increase recording of patient risk for fracture data and decrease the amount of inappropriate DXA scans. Current osteoporosis guidelines recommend using bone measurement testing to assess osteoporosis risk in women 65 years and older. In postmenopausal women younger than age 65, guidelines recommend using a formal clinical risk assessment tool to establish a patient's risk for osteoporosis, in order to determine whether to screen a patient for osteoporosis using bone measurement testing. Clinical information, such as age, body mass index (BMI), parental hip fracture history, and alcohol use, can be used to determine a woman's fracture risk (U.S. Preventive Services Task Force [USPSTF], 2018). Additionally, there are potentially avoidable harms associated with screening for osteoporosis in general, including exposure to radiation, false positive exams, and resulting side effects from unnecessary osteoporosis medications, which add costs to an already burdened health care system (Lim, Hoeksema, & Sherin, 2009).

Clinical Recommendation Statement *See CMS249v4.html *See CMS249v5.html

USPSTF:

"The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older." This is a B recommendation.

"The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis to prevent osteoporotic fractures in men." This is an I statement.

"The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool." This is a B recommendation.

"For postmenopausal women younger than 65 years who have at least 1 risk factor, a reasonable approach to determine who should be screened with bone measurement testing is to use a clinical risk assessment tool."

"Several tools are available to assess osteoporosis risk: the Simple Calculated Osteoporosis Risk Estimate (SCORE; Merck), Osteoporosis Risk Assessment Instrument (ORAI), Osteoporosis Index of Risk (OSIRIS), and the Osteoporosis Self-Assessment Tool (OST). These tools seem to perform similarly and are moderately accurate at predicting osteoporosis. The Fracture Risk Assessment (FRAX) tool (University of Sheffield), which assesses a person's 10-year risk of fracture, is also a commonly used tool."

"Because the benefits of treatment are greater in persons at higher risk of fracture, one approach is to perform bone measurement testing in postmenopausal women younger than 65 years who have a 10-year FRAX risk of major osteoporotic fracture (MOF) (without DXA) greater than that of a 65-year-old white woman without major risk factors. For example, in the United States, a 65-year-old white woman of mean height and weight without major risk factors has a 10-year FRAX risk of MOF of 8.4%."

USPSTF 2018:

"The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older." This is a B recommendation.

"The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis to prevent osteoporotic fractures in men." This is an I statement.

"The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool." This is a B recommendation.

"For postmenopausal women younger than 65 years who have at least 1 risk factor, a reasonable approach to determine who should be screened with bone measurement testing is to use a clinical risk assessment tool."

"Several tools are available to assess osteoporosis risk: the Simple Calculated Osteoporosis Risk Estimate (SCORE; Merck), Osteoporosis Risk Assessment Instrument (ORAI), Osteoporosis Index of Risk (OSIRIS), and the Osteoporosis Self-Assessment Tool (OST). These tools seem to perform similarly and are moderately accurate at predicting osteoporosis. The Fracture Risk Assessment (FRAX) tool (University of Sheffield), which assesses a person's 10-year risk of fracture, is also a commonly used tool."

"Because the benefits of treatment are greater in persons at higher risk of fracture, one approach is to perform bone measurement testing in postmenopausal women younger than 65 years who have a 10-year FRAX risk of major osteoporotic fracture (MOF) (without DXA) greater than that of a 65-year-old white woman without major risk factors. For example, in the United States, a 65-year-old white woman of mean height and weight without major risk factors has a 10-year FRAX risk of MOF of 8.4%."

Improvement Notation

Lower score indicates better quality

Lower score indicates better quality

Lower score indicates better quality

Lower score indicates better quality

Definition *See CMS249v4.html *See CMS249v5.html

The measure allows for clinicians to use 4 tools to assess osteoporosis or osteoporotic fracture risk.

1. The Fracture Risk Assessment Tool (FRAX[R]) is used to calculate 10-year absolute fracture risk. The FRAX evaluates a patient's 10-year probability of hip fracture and major osteoporotic fracture (clinical spine, forearm, hip, or shoulder fracture). It is applicable to people aged 40-90 years.

2. The Osteoporosis Risk Assessment Instrument (ORAI) is used to calculate osteoporosis risk. It is applicable to women >=45 years.

3. The Osteoporosis Index of Risk (OSIRIS) is used to calculate osteoporosis risk. It is applicable to patients of any age.

4. The Osteoporosis Self-Assessment Tool (OST) is used to calculate osteoporosis risk. It is applicable to patients of any age.

The measure allows for clinicians to use 4 tools to assess osteoporosis or osteoporotic fracture risk.

1. The Fracture Risk Assessment Tool (FRAX[R]) is used to calculate 10-year absolute fracture risk. The FRAX evaluates a patient's 10-year probability of hip fracture and major osteoporotic fracture (clinical spine, forearm, hip, or shoulder fracture). It is applicable to people aged 40-90 years.

2. The Osteoporosis Risk Assessment Instrument (ORAI) is used to calculate osteoporosis risk. It is applicable to women >=45 years.

3. The Osteoporosis Index of Risk (OSIRIS) is used to calculate osteoporosis risk. It is applicable to patients of any age.

4. The Osteoporosis Self-Assessment Tool (OST) is used to calculate osteoporosis risk. It is applicable to patients of any age.

Guidance

There are two ways that a patient can be excluded from the measure:

1. The patient has a specific number of "combination" risk factors (the number of risk factors varies by age).

2. The patient has one or more of the "independent" risk factors, including a 10-year probability of major osteoporotic fracture of 8.4 percent or higher as determined by the FRAX.

This eCQM is a patient-based measure.

This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.

Patients are excluded from the measure if they have one or more risk factors for osteoporosis, including a result indicating that the patient should be considered for bone density testing on one of the following risk assessment instruments:

• 10-year probability of major osteoporotic fracture of 8.4 percent or higher as determined by the FRAX

• ORAI score of >=9

• OSIRIS score of <1

• OST score of <2

This eCQM is a patient-based measure.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

Patients are excluded from the measure if they have one or more risk factors for osteoporosis, including a result indicating that the patient should be considered for bone density testing on one of the following risk assessment instruments:

- 10-year probability of major osteoporotic fracture of 8.4 percent or higher as determined by the FRAX

- ORAI score of >=9

- OSIRIS score of <1

- OST score of <2

This eCQM is a patient-based measure.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

Patients are excluded from the measure if they have one or more risk factors for osteoporosis, including a result indicating that the patient should be considered for bone density testing on one of the following risk assessment instruments:

- 10-year probability of major osteoporotic fracture of 8.4 percent or higher as determined by the FRAX

- ORAI score of >=9

- OSIRIS score of <1

- OST score of <2

This eCQM is a patient-based measure.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

Initial Population

Female patients ages 50 to 64 years with an encounter during the measurement period

Female patients ages 50 to 63 years at the start of the measurement period with an encounter during the measurement period

Female patients ages 50 to 63 years at the start of the measurement period with an encounter during the measurement period

Female patients ages 50 to 63 years at the start of the measurement period with an encounter during the measurement period

Denominator

Equals Initial Population

Equals Initial Population

Equals Initial Population

Equals Initial Population

Denominator Exclusions

Exclude patients with a combination of risk factors (as determined by age) or one of the independent risk factors

Ages: 50-54 (>=4 combination risk factors) or 1 independent risk factor

Ages: 55-59 (>=3 combination risk factors) or 1 independent risk factor

Ages: 60-64 (>=2 combination risk factors) or 1 independent risk factor

COMBINATION RISK FACTORS [The following risk factors are all combination risk factors; they are grouped by when they occur in relation to the measurement period]:

The following risk factors may occur any time in the patient's history but must be active during the measurement period:

White (race)

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Smoker (current during the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factor may occur any time in the patient's history and must not start during the measurement period:

Osteopenia

The following risk factors may occur at any time in the patient's history or during the measurement period:

Rheumatoid arthritis

Hyperthyroidism

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic liver disease

Chronic malnutrition

Osteoporotic fracture

The following risk factors may occur any time in the patient's history prior to the start of the measurement period but do not need to be active at the start of the measurement period:

Documentation of history of hip fracture in parent

Glucocorticoids [cumulative medication duration >= 90 days]

INDEPENDENT RISK FACTORS (The following risk factors are all independent risk factors; they are grouped by when they occur in relation to the measurement period):

The following risk factors may occur at any time in the patient's history and must not start during the measurement period:

Osteoporosis

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period, but do not need to be active during the measurement period:

Gastric bypass

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent

Aromatase inhibitors

The following risk factors may occur at any time in the patient's history or during the measurement period:

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Exclude patients with one of the following risk factors.

Risk factors are grouped by when they occur in relation to the measurement period.

The following risk factors must be active during the measurement period:

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period:

Osteoporosis

Osteopenia

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period, but do not need to be active during the measurement period:

Gastric bypass

Aromatase inhibitors

Documentation of history of hip fracture in parent

The following risk factors may occur at any time in the patient's history or during the measurement period:

Glucocorticoids [cumulative medication duration >= 90 days]

Osteoporotic fracture

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic malnutrition

Chronic liver disease

Rheumatoid arthritis

Hyperthyroidism

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Chemotherapy

Multiple myeloma

Premature menopause

Double or bilateral oophorectomy

Eating disorder

Amenorrhea

Organ transplant

Exclude patients with one of the following risk factors.

Risk factors are grouped by when they occur in relation to the measurement period.

The following risk factors must be active during the measurement period:

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period:

Osteoporosis

Osteopenia

Gastric bypass

Aromatase inhibitors

Documentation of history of hip fracture in parent

The following risk factors may occur at any time in the patient's history or during the measurement period:

Glucocorticoids [cumulative medication duration >= 90 days]

Osteoporotic fracture

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic malnutrition

Chronic liver disease

Rheumatoid arthritis

Hyperthyroidism

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Chemotherapy

Multiple myeloma

Premature menopause

Double or bilateral oophorectomy

Eating disorder

Amenorrhea

Organ transplant

Exclude patients with one of the following risk factors.

Risk factors are grouped by when they occur in relation to the measurement period.

The following risk factors must be active during the measurement period:

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period:

Osteoporosis

Osteopenia

Gastric bypass

Aromatase inhibitors

Documentation of history of hip fracture in parent

The following risk factors may occur at any time in the patient's history or during the measurement period:

Glucocorticoids [cumulative medication duration >= 90 days]

Osteoporotic fracture

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic malnutrition

Chronic liver disease

Rheumatoid arthritis

Hyperthyroidism

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Chemotherapy

Multiple myeloma

Premature menopause

Double or bilateral oophorectomy

Eating disorder

Amenorrhea

Organ transplant

Numerator

Female patients who received an order for at least one DXA scan in the measurement period

Female patients who received an order for at least one DXA scan in the measurement period

Female patients who received an order for at least one DXA scan in the measurement period

Female patients who received an order for at least one DXA scan in the measurement period

Numerator Exclusions

Not Applicable

Exclude patients with a result on one of the following tools, which indicates the patient should be considered for bone density testing, anytime in the patient’s history prior to the time of the first DXA scan during the measurement period:

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent

ORAI score of >=9

OSIRIS score of <1

OST score of <2

Exclude patients with a result on one of the following tools, which indicates the patient should be considered for bone density testing, anytime in the patient’s history prior to the time of the first DXA scan during the measurement period:

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent

ORAI score of >=9

OSIRIS score of <1

OST score of <2

Exclude patients with a result on one of the following tools, which indicates the patient should be considered for bone density testing, anytime in the patient’s history prior to the time of the first DXA scan during the measurement period:

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent

ORAI score of >=9

OSIRIS score of <1

OST score of <2

Denominator Exceptions

None

None

None

None

Telehealth Eligible Yes Yes Yes Yes
Next Version No Version Available
Previous Version No Version Available

Header

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Removed National Institute for Health and Care Excellence (NICE) guidelines that are only applicable to the U.K. Population.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated version number of the Quality Data Model (QDM) used in the measure specification to v5.6.

    Measure Section: Guidance

    Source of Change: Standards/Technical Update

  • Added age anchor specification to the initial population description to clarify measure requirements.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Updated the grouping category of glucocorticoids risk factor to reflect the timing requirement to improve readability and provide clarity.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Added exclusion risk factors associated with increased risk for osteoporosis based on recent evidence and stakeholder support.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Revised the timing requirement to align the onset of osteoporosis and osteopenia to prior to the measurement period.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Added new osteoporosis risk assessment tools to identify patients with increased risk for osteoporosis to align with USPSTF clinical recommendations.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Removed patients with qualifying risk assessment scores from the numerator exclusions instead of from the denominator exclusions to align with the measure intent.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Removed age combination risk factors 'race' and 'smoking status' and retained all others as independent risk factors to simplify the measure specification per the addition of new risk assessment tools.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Logic

  • Updated glucocorticoid active medication duration calculation to accurately capture total days covered by the period instead of 24-hour durations.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Updated the timing precision in the definitions from datetime to date by adding 'day of', 'date from', and/or function 'ToDateInterval' to align with the measure intent.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Updated the grouping category of glucocorticoids risk factor to reflect the timing requirement to improve readability.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Revised the timing requirement to align the onset of osteoporosis and osteopenia to prior to the measurement period.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Replaced value set Preventive Care Services Other (2.16.840.1.113883.3.464.1003.101.12.1030) with direct reference code CPT code (99429).

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Added QDM datatypes 'Diagnosis' and 'Procedure, Performed' to capture additional exclusion risk factors associated with increased risk for osteoporosis based on recent evidence and stakeholder support.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v7.0.000.

    Measure Section: Multiple Sections

    Source of Change: Standards/Technical Update

  • Updated the timing precision in the definitions to align with the measure intent by replacing 'starts before' to 'starts on or before'.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Revised logic to remove patients with qualifying risk assessment scores from numerator exclusions instead of from denominator exclusions to align with revised narrative and clinical recommendations.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated the version of the Quality Data Model (QDM) to 5.6 and Clinical Quality Language (CQL) to 1.5.

    Measure Section: Multiple Sections

    Source of Change: Standards/Technical Update

  • Replaced the Global.CalendarAgeInYearsAt function with the native CQL function AgeInYearsAt to take advantage of existing CQL features and increase human readability. As a result of this change, the LOINC code 21112-8 is no longer required and has been removed from the Terminology section of the human readable specification.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Revised the age interval to use closed intervals within the logic to align with CQL style best practices.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Removed age combination risk factors logic and retained all as independent risk factors except for 'race' and 'smoking status' to reflect the revised narrative.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Added new 'Assessment, Performed' logic to account for new osteoporosis risk assessment tools to align with revised narrative and clinical recommendations.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Multiple Sections

    Source of Change: Standards/Technical Update

Value set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Value set Chronic Liver Disease (2.16.840.1.113883.3.464.1003.199.12.1035): Added 1 SNOMED CT code (1010616001) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 ICD-10-CM code (K74.0) based on validity of code during timing of look back period.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Osteoporosis (2.16.840.1.113883.3.464.1003.113.12.1038): Added 39 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Hyperparathyroidism (2.16.840.1.113883.3.464.1003.117.12.1016): Added 1 SNOMED CT code (190045361000119101) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Malabsorption Syndromes (2.16.840.1.113883.3.464.1003.199.12.1050): Added 5 SNOMED CT codes (453720571000119100, 721702009, 880001008, 966011731000119103, 969688801000119108) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 ICD-10-CM code (K90.4) based on validity of code during timing of look back period.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Marfan's Syndrome (2.16.840.1.113883.3.464.1003.113.12.1048): Added 1 SNOMED CT code (1003407000) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Osteogenesis Imperfecta (2.16.840.1.113883.3.464.1003.113.12.1044): Added 1 SNOMED CT code (1003379004) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Rheumatoid Arthritis (2.16.840.1.113883.3.464.1003.113.12.1005): Added 65 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added direct reference code SNOMED CT code (7771000) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Type 1 Diabetes (2.16.840.1.113883.3.464.1003.103.12.1020): Deleted 8 ICD-10-CM codes (E10.321, E10.329, E10.331, E10.339, E10.341, E10.349, E10.351, E10.359) based on validity of code during timing of look back period.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed direct reference code LOINC code (21112-8) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Female (2.16.840.1.113883.3.560.100.2) with direct reference code AdministrativeGender code (F) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added direct reference code LOINC code (98133-2) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added direct reference code LOINC code (98139-9) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set White (2.16.840.1.113883.3.464.1003.123.12.1007) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Ehlers Danlos Syndrome (2.16.840.1.113883.3.464.1003.113.12.1047): Deleted 1 ICD-10-CM code (Q79.6) based on validity of code during timing of look back period.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Current Tobacco Smoker (2.16.840.1.113883.3.600.2390) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Major Transplant (2.16.840.1.113883.3.464.1003.198.12.1075) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Chemotherapy (2.16.840.1.113883.3.526.3.485) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set BMI Ratio (2.16.840.1.113883.3.600.1.1490) with direct reference code LOINC code (39156-5) based on applicability of a single code to represent clinical data.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Average Number of Drinks per Drinking Day (2.16.840.1.113883.3.464.1003.106.12.1018) with direct reference code LOINC code (11287-0) based on applicability of a single code to represent clinical data.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Replaced value set Preventive Care Services Other (2.16.840.1.113883.3.464.1003.101.12.1030) with direct reference code CPT code (99429) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added direct reference code LOINC code (98146-4) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Amenorrhea (2.16.840.1.113883.3.464.1003.1022) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Bone Marrow Transplant (2.16.840.1.113883.3.666.5.336) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Evidence of Bilateral Oophorectomy (2.16.840.1.113883.3.464.1003.1048) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Unilateral Oophorectomy Left (2.16.840.1.113883.3.464.1003.1028) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Bilateral Oophorectomy (2.16.840.1.113883.3.526.3.471) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Kidney Transplant (2.16.840.1.113883.3.464.1003.109.12.1012) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Unilateral Oophorectomy Right (2.16.840.1.113883.3.464.1003.1032) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Multiple Myeloma (2.16.840.1.113883.3.464.1003.1011) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Unilateral Oophorectomy, Unspecified Laterality (2.16.840.1.113883.3.464.1003.1035) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Premature Menopause (2.16.840.1.113883.3.464.1003.1013) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set Eating Disorders (2.16.840.1.113883.3.464.1003.1039) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Removed value set Tobacco Use Screening (2.16.840.1.113883.3.526.3.1278) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added direct reference code SNOMED CT code (24028007) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: Sep 23, 2024