General eCQM Information
|CMS Measure ID||CMS249v1|
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.
|Initial Population||Female patients ages 50 to 64 years with an encounter during the measurement period|
Equals Initial Population
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:
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:
The following risk factors may occur at any time in the patient's history or during the measurement period:
Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption
Chronic liver disease
Documentation of history of hip fracture in parent
Glucocorticoids (>= 5 mg/per day) [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:
The following risk factors may occur at any time in the patient's history:
FRAX[R] ten-year probability of all major osteoporosis related fracture >= 9.3 percent
Type I Diabetes
End stage renal disease
Female patients who received an order for at least one DXA scan in the measurement period
|Measure Steward||Centers for Medicare & Medicaid Services (CMS)|
|Domain||Efficiency and Cost Reduction|
|Measure Scoring||Proportion measure|
|Measure Type||Process measure|
Lower score indicates better quality
CUMULATIVE MEDICATION DURATION is an individual's total number of medication days over a specific period; the period counts multiple prescriptions with gaps in between, but does not count the gaps during which a medication was not dispensed.
To determine the cumulative medication duration, determine first the number of the Medication Days for each prescription in the period: the number of doses divided by the dose frequency per day. Then add the Medication Days for each prescription without counting any days between the prescriptions.
For example, there is an original prescription for 30 days with 2 refills for thirty days each. After a gap of 3 months, the medication was prescribed again for 60 days with 1 refill for 60 days. The cumulative medication duration is (30 x 3) + (60 x 2) = 210 days over the 10 month period.
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 9.3 percent or higher as determined by the FRAX.
|Meaningful Measure||Appropriate Use of Healthcare|