General eCQM Information
CMS Measure ID | CMS249v2 |
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NQF Number | Not Applicable |
Measure 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 |
Initial Population | Female patients ages 50 to 64 years with an encounter during the measurement period |
Denominator Statement |
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 The following risk factors may occur any time in the patient's history and do not need to be active at the start of the measurement period: Documentation of history of hip fracture in parent Osteoporotic fracture 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: 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 |
Numerator Statement |
Female patients who received an order for at least one DXA scan in the measurement period |
Numerator Exclusions |
Not Applicable |
Denominator Exceptions |
None |
Measure Steward | Centers for Medicare & Medicaid Services (CMS) |
Domain | Efficiency and Cost Reduction |
Measure Scoring | Proportion measure |
Measure Type | Process measure |
Improvement Notation |
Lower score indicates better quality |
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. |
Quality ID | 472 |
Meaningful Measure | Appropriate Use of Healthcare |
Telehealth Eligible | Yes |
Next Version | |
Previous Version |
Data Element Repository
Header
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Updated eCQM version number.
Measure Section: eCQM Version number
Source of Change: Measure Lead
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Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
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Updated rationale.
Measure Section: Rationale
Source of Change: Measure Lead
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Updated header statements for the FRAX 10-year probability of all major osteoporosis related fracture results from 9.3% to 8.4% based on updated clinical guidelines.
Measure Section: Clinical Recommendation Statement
Source of Change: Measure Lead
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Updated clinical recommendation statement.
Measure Section: Clinical Recommendation Statement
Source of Change: Measure Lead
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Updated references to align with American Psychological Association (APA) style.
Measure Section: Reference
Source of Change: Measure Lead
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Updated references.
Measure Section: Reference
Source of Change: Measure Lead
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Updated guidance statement with removal of cumulative medication duration as it was outdated.
Measure Section: Guidance
Source of Change: ONC Project Tracking System (JIRA): CQM-3153
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Updated header statements for the FRAX 10-year probability of all major osteoporosis related fracture results from 9.3% to 8.4% based on updated clinical guidelines.
Measure Section: Guidance
Source of Change: Measure Lead
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Updated header statements for the FRAX 10-year probability of all major osteoporosis related fracture results from 9.3% to 8.4% based on updated clinical guidelines.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
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Updated parenthetical citations to align with American Psychological Association (APA) style.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Logic
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Added logic for glucocorticoid average daily dosing to improve alignment with measure intent.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
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Added the unit 'drinks/day' to express the average number of drinks per day as a quantity rather than an integer for clarity and to improve alignment with measure intent.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
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Changed the probability assessment result from 9.3% to 8.4% in the 'Osteoporosis Fracture Probability Assessment' definition to align with updated clinical guidelines.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
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Changed definition name from 'Average of More Than Two Drinks Per Drinking Day' to 'First Average Number of Drinks Assessments Indicating More Than Two Per Day' to better align with the measure intent.
Measure Section: Definitions
Source of Change: Measure Lead
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Changed the probability assessment result from 9.3% to 8.4% in the 'Osteoporosis Fracture Probability Assessment' definition to align with updated clinical guidelines.
Measure Section: Definitions
Source of Change: Measure Lead
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Updated the names of Clinical Quality Language (CQL) definitions, functions, and/or aliases for clarification and to align with CQL Style Guide.
Measure Section: Definitions and Functions
Source of Change: Standards Update
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Added new CQL library for day and month timing (DayMonthTimings-1.2.000).
Measure Section: Multiple Sections
Source of Change: Measure Lead
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Updated Clinical Quality Language (CQL) expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 3 (CQL 1.3).
Measure Section: Multiple Sections
Source of Change: Standards Update
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Updated definitions and functions in the Measure Authoring Tool (MAT) Global Common Functions Library to align with standards changes, Clinical Quality Language (CQL) Style Guide, and to include two new functions related to calculating hospital stays.
Measure Section: Multiple Sections
Source of Change: Standards Update
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Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-4.0.000).
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.
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Value set Chronic Liver Disease (2.16.840.1.113883.3.464.1003.199.12.1035): Added 9 SNOMED CT codes (737202006, 767809001, 767810006, 768006009, 768125005, 768126006, 768127002, 768288001, 768289009).
Measure Section: Terminology
Source of Change: Annual Update
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Value set Glucocorticoids (oral only) (2.16.840.1.113883.3.464.1003.196.12.1266): Deleted 2 RxNorm codes (197543, 197545).
Measure Section: Terminology
Source of Change: Annual Update
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Value set Marfan's Syndrome (2.16.840.1.113883.3.464.1003.113.12.1048): Added 1 SNOMED CT code (763839005).
Measure Section: Terminology
Source of Change: Annual Update
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Value set Type 1 Diabetes (2.16.840.1.113883.3.464.1003.103.12.1020): Added 24 SNOMED CT codes.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Ten-year probability of all major osteoporosis related fracture (2.16.840.1.113883.3.464.1003.118.12.1081): Removed Ten-year probability of all major osteoporosis related fracture.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Osteoporosis (2.16.840.1.113883.3.464.1003.113.12.1038): Added 1 SNOMED CT code (203657009).
Measure Section: Terminology
Source of Change: Annual Update
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Replaced Ten year probability of hip fracture (2.16.840.1.113883.3.464.1003.118.11.1095) with direct reference code LOINC code (90265-0).
Measure Section: Terminology
Source of Change: Annual Update
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Direct reference code for Birth date (LOINC Code (21112-8)) now displayed in Human Readable.
Measure Section: Terminology
Source of Change: Annual Update
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Standardized purpose statement language in value sets across eCQMs. Value set purpose statements are visible in the Value Set Authority Center (VSAC) as well as the downloadable eCQM value set files.
Measure Section: Terminology
Source of Change: Measure Lead
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Replaced Ten year probability of hip fracture (2.16.840.1.113883.3.464.1003.118.11.1095) with direct reference code LOINC code (90265-0).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (307469008)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396140003)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396131002)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (225756002)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396143001)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (307468000)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396139000)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396126004)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (225754004)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396127008)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (307470009)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396125000)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (225752000)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (307439001)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (229797004)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396109005)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396108002)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396107007)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (229798009)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (229799001)).
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code (SNOMED CT code (396111001)).
Measure Section: Terminology
Source of Change: Measure Lead