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Preventive Care and Screening: Influenza Immunization

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eCQMs for 2019 Performance Period

CMS2v8
CMS22v7
CMS50v7
CMS52v7
CMS56v7
CMS66v7
CMS68v8
CMS69v7
CMS74v8
CMS75v7
CMS82v6
CMS90v8
CMS117v7
CMS122v7
CMS124v7
CMS125v7
CMS127v7
CMS128v7
CMS129v8
CMS130v7
CMS131v7
CMS132v7
CMS133v7
CMS134v7
CMS135v7
CMS136v8
CMS137v7
CMS138v7
CMS139v7
CMS142v7
CMS143v7
CMS144v7
CMS145v7
CMS146v7
CMS147v8
CMS149v7
CMS153v7
CMS154v7
CMS155v7
CMS156v7
CMS157v7
CMS159v7
CMS160v7
CMS161v7
CMS165v7
CMS177v7
CMS249v1
CMS347v2
CMS349v1
CMS645v2
CMS Measure ID
CMS147v8
Version
8
NQF Number
0041
Measure Description

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

Initial Population

All patients aged 6 months and older seen for a visit during the measurement period

Denominator Statement

Equals Initial Population and seen for a visit between October 1 and March 31

Denominator Exclusions

None

Numerator Statement

Patients who received an influenza immunization OR who reported previous receipt of an influenza immunization

Numerator Exclusions

Not Applicable

Denominator Exceptions

Documentation of medical reason(s) for not receiving influenza immunization (eg, patient allergy, other medical reasons).

Documentation of patient reason(s) for not receiving influenza immunization (eg, patient declined, other patient reasons).

Documentation of system reason(s) for not receiving influenza immunization (eg, vaccine not available, other system reasons).

Measure Steward
PCPI(R) Foundation (PCPI[R])
Domain
Community/Population Health
Previous Version
CMS147v7
Next Version
CMS147v9
Measure Scoring
Proportion
Measure Type
Process
Improvement Notation

Higher score indicates better quality

Guidance

The timeframe for the visit during the "Encounter, Performed": "Encounter-Influenza" or "Procedure, Performed": "Peritoneal Dialysis" or "Procedure, Performed": "Hemodialysis" in the Population Criteria-Denominator, refers to the influenza season defined by the measure: October through March (October 1 for the year prior to the start of the reporting period through March 31 during the reporting period). The "Encounter-Influenza" Grouping OID detailed in the data criteria section below is comprised of several individual OIDs of different encounter types. The individual OIDs are included in the value set and should be reviewed to determine that an applicable visit occurred during the timeframe for "Encounter, Performed": "Encounter-Influenza" as specified in the denominator.

To enable reporting of this measure at the close of the reporting period, this measure will only assess the influenza season that ends in March of the reporting period. The subsequent influenza season (ending March of the following year) will be measured and reported in the following year.

To account for the majority of reporting years' appropriate flu season duration, the measure logic will look at the first 89 days of the measurement period for the appropriate criteria and actions to be present/performed (January 1 through March 31). The measure developer believes it is best to keep the logic as static as possible from one reporting year to the next. Therefore, during leap years, only encounters that occur through March 30 will be counted in the denominator.

As a result of updated CDC/ACIP guidelines which include the interim recommendation that live attenuated influenza vaccine (LAIV) should not be used due to low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013-14 and 2015-16 seasons, the measure specifications have been updated and no longer include LAIV or intranasal flu vaccine as an option for numerator eligibility.

Quality ID
110
Meaningful Measure
Preventive Care

Specifications

Attachment Size
CMS147v8.html 75.06 KB
CMS147v8.zip 61.97 KB
CMS147v8_TRN.xlsx 19.57 KB

Data Element Repository

Release Notes

Header

  • Updated Version Number.

    Measure Section: eMeasure Version number

    Source of Change: Measure Lead

  • Updated Copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated Disclaimer.

    Measure Section: Disclaimer

    Source of Change: Measure Lead

  • Updated Clinical Recommendation Statement.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated Reference.

    Measure Section: Reference

    Source of Change: Measure Lead

Logic

  • Added 'AuthorDateTime' attribute to QDM datatypes that include negation rationale: ‘Diagnostic, Performed’, ‘Intervention Performed’, ‘Encounter, Performed’, ‘Laboratory Test, Performed’, ‘Medication, Administered’, ‘Physical Exam, Performed’, ‘Procedure, Performed’, ‘Substance Administered’ to conform with QDM 5.3 changes.

    Measure Section: Denominator Exceptions

    Source of Change: Standards Update

  • Replaced 'Allergy, Intolerance' datatypes with 'Allergy/Intolerance' category to conform with QDM 5.3 changes.

    Measure Section: Denominator Exceptions

    Source of Change: Standards Update

  • Added supplemental timing attributes to most datatypes in QDM 5.3 to facilitate accurate retrieval of time related information within CQL logic. Timing attributes now include a time interval, such as prevalence period or relevant period, and/or actual time of documentation with Author Datetime. Relevant period is the general method to describe start and stop times for datatypes. Prevalence period is used for some datatypes to more accurately define onset and abatement times.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Assigned cardinality to each attribute to be more explicit in guiding specification and implementation of QDM data elements. Cardinality refers to the number of instances of the attribute that can be included in the measure description. Cardinality for most attributes is 0.. 1 (i.e., can occur up to 1 time), but some attributes have a cardinality of 0.. * (i.e., can occur multiple times).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • CQL libraries contain sets of CQL definitions, or CQL expression statements. A context statement, patient or population, can now be used in a CQL library to clearly establish how the subsequent list of CQL expressions will be interpreted. A 'Population' context will interpret the CQL expression with reference to the entire population of the item being counted, patients or encounters. A 'Patient' context will interpret the CQL expression with reference to a single patient. Context statements are not required, but one or more context statements may be used within a library to help clarify how the CQL expressions will be interpreted. Patient context is the default if none is specified.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Removed the 'Face-To-Face Interaction' data element and added relevant SNOMED codes to the Encounter Grouping value sets to better align between the SNOMED and CPT encounter codes.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Replaced measure-defined definitions with similar definitions and functions from CQL shared libraries for consistency across measures.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated measure logic from Quality Data Model (QDM)-based logic to Clinical Quality Language (CQL)-based logic. Information on CQL can be found at the eCQI Resource center (https://ecqi.healthit.gov/cql). Information about specific versions of the new standards in use for CMS reporting periods can be found at the eCQI Resource Center (https://ecqi.healthit.gov/ecqm-tools-key-resources). Switching from QDM to CQL brings with it many changes, as well as enhanced expression capability, but only those changes with significant impact will be outlined in technical release notes. For example, in the case of timing operators, changes may only be summarized if those changes impact the measure calculation.

    Measure Section: Multiple Sections

    Source of Change: Standards 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 Patient Reason (2.16.840.1.113883.3.526.3.1008): Deleted 1 SNOMEDCT code (385648002).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Encounter-Influenza (2.16.840.1.113883.3.526.3.1252): Removed SNOMED extensional Face-to-Face Interaction (2.16.840.1.113883.3.464.1003.101.11.1216). Added Office Visit SNOMED extensional (2.16.840.1.113883.3.464.1003.101.11.1264), Outpatient Consultation SNOMED extensional (2.16.840.1.113883.3.464.1003.101.11.1266), Nursing Facility Visit SNOMED extensional (2.16.840.1.113883.3.464.1003.101.11.1261), Care Services in Long-Term Residential Facility SNOMED extensional (2.16.840.1.113883.3.464.1003.101.11.1262), and Home Healthcare Services SNOMED extensional (2.16.840.1.113883.3.464.1003.101.11.1265).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Influenza Vaccine (2.16.840.1.113883.3.526.3.1254): Added 1 CVX code (186) and deleted 1 CVX code (153).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Influenza Vaccination (2.16.840.1.113883.3.526.3.402): Added 1 CPT code (90756).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1264) including 7 codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1266) including 3 codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Nursing Facility Visit (2.16.840.1.113883.3.464.1003.101.12.1012): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1261) including 2 codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Care Services in Long-Term Residential Facility (2.16.840.1.113883.3.464.1003.101.12.1014): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1262) including 2 codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Home Healthcare Services (2.16.840.1.113883.3.464.1003.101.12.1016): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1265) including 11 codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Payer (2.16.840.1.114222.4.11.3591): Added 11 SOP codes (299, 32127, 32128, 391, 517, 524, 614, 621, 622, 623, 629) and deleted 3 SOP codes (63, 64, 69).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Face-to-Face Interaction (2.16.840.1.113883.3.464.1003.101.12.1048): Removed Face-to-Face Interaction.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Payer (2.16.840.1.114222.4.11.3591): Deleted 1 SOP code (24).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

External Resources

United States Health Information Knowledgebase
NLM Value Set Authority Center (VSAC)
Last Updated: Oct 10, 2019