General eCQM Information
| CMS Measure ID | CMS144v9 |
|---|---|
| NQF Number | 0083e |
| Measure Description |
Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
| Initial Population | All patients aged 18 years and older with a diagnosis of heart failure |
| Denominator Statement |
Equals Initial Population with a current or prior LVEF < 40% |
| Denominator Exclusions |
None |
| Numerator Statement |
Patients who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
| Numerator Exclusions |
Not Applicable |
| Denominator Exceptions |
Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons). Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the healthcare system). |
| Measure Steward | PCPI(R) Foundation (PCPI[R]) |
| Domain | Effective Clinical Care |
| Measure Scoring | Proportion measure |
| Measure Type | Process measure |
| Improvement Notation |
Higher score indicates better quality |
| Guidance |
This eCQM is to be reported as patient-based or episode-based, depending on the clinical setting. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period if seen in the outpatient setting. If the patient has an eligible inpatient discharge during the measurement period, as defined in the measure logic, it is expected to be reported at each hospital discharge. A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than 40% threshold noted in the denominator logic. A range that is inclusive of or greater than 40% would not meet the measure requirement. Beta-blocker therapy: -For patients with prior LVEF < 40%, beta-blocker therapy should include bisoprolol, carvedilol, or sustained release metoprolol succinate. The requirement of two or more visits used in Population Criteria 1 is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM. |
| Quality ID | 8 |
| Meaningful Measure | Management of Chronic Conditions |
| Telehealth Eligible | Yes |
| Previous Version |
Data Element Repository
Header
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Updated eCQM Version Number.
Measure Section: eCQM Version Number
Source of Change: Standards Update
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Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
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Updated disclaimer.
Measure Section: Disclaimer
Source of Change: Standards Update
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Updated reference to align with American Psychological Association (APA) formatting.
Measure Section: Reference
Source of Change: Measure Lead
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Added text to identify the Quality Data Model (QDM) version used in the measure specification.
Measure Section: Guidance
Source of Change: Standards Update
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Added text to indicate whether the measure is patient-based or episode-based.
Measure Section: Guidance
Source of Change: Standards Update
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Updated guidance statement related to the two visit requirement to specify its applicability to population criteria 1.
Measure Section: Guidance
Source of Change: Measure Lead
Logic
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Added a new data element using the Allergy/Intolerance QDM category and datatype to capture the substance related to beta blocker as a potential allergen to align with measure intent and interoperability standards.
Measure Section: Denominator Exceptions
Source of Change: Measure Lead
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QDM v5.5 standards update: Added 'relevantDatetime' attribute to QDM datatypes. 'RelevantDatetime' indicates when the action occurred whereas 'authorDatetime' indicates when the action was recorded.
Measure Section: Multiple Sections
Source of Change: Standards Update
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Revised Clinical Quality Language (CQL) definition construction to reduce the overall complexity of the measure logic without changing the intent and/or application of data element. These revisions were intended to make the definition logic less complex, easier to understand, and more meaningful.
Measure Section: Multiple Sections
Source of Change: Measure Lead
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Updated CQL expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).
Measure Section: Multiple Sections
Source of Change: Standards Update
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Updated CQL definition names and aliases used to more closely align with clinical concept intent or create consistency of naming across measures.
Measure Section: Multiple Sections
Source of Change: Measure Lead
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Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-5.0.000). Updated definitions and functions in the MAT Global Common Functions Library to align with standards changes, CQL Style Guide, and to include one new function related to calculating length of hospital stays with observation stays.
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 Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008): Deleted 1 SNOMED CT code (17436001) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Nursing Facility Visit (2.16.840.1.113883.3.464.1003.101.12.1012): Added 3 CPT codes (99315, 99316, 99318) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Medical Reason (2.16.840.1.113883.3.526.3.1007): Deleted 5 SNOMED CT codes (216952002, 274512008, 371133007, 416406003, 445528004) based on expert review and/or public feedback. Removed codes due to intent of concepts which do not indicate a medical contraindication, but rather a provider decision to discontinue something or change a course of treatment.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Patient Provider Interaction (2.16.840.1.113883.3.526.3.1012): Deleted 1 SNOMED CT code (11797002) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Intolerance to Beta Blocker Therapy (2.16.840.1.113883.3.526.3.1178): Deleted 1 SNOMED CT code (292429003) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Asthma (2.16.840.1.113883.3.526.3.362): Deleted 14 ICD-9-CM codes. Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant. Added 1 SNOMED CT code (782520007) and deleted 1 SNOMED CT code (30352005) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Arrhythmia (2.16.840.1.113883.3.526.3.366): Deleted 2 ICD-9-CM codes (427.89, 427.9). Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Atrioventricular Block (2.16.840.1.113883.3.526.3.367): Deleted 3 ICD-9-CM codes (426.0, 426.12, 426.13). Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Cardiac Pacer in Situ (2.16.840.1.113883.3.526.3.368): Deleted 1 ICD-9-CM code (V45.01). Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Hypotension (2.16.840.1.113883.3.526.3.370): Deleted 6 ICD-9-CM codes (458.0, 458.1, 458.21, 458.29, 458.8, 458.9). Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Heart Failure (2.16.840.1.113883.3.526.3.376): Deleted 24 ICD-9-CM codes.Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Bradycardia (2.16.840.1.113883.3.526.3.412): Deleted 2 ICD-9-CM codes (427.81, 427.89). Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant.
Measure Section: Terminology
Source of Change: Annual Update
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Removed ICD-9-CM extensional value sets from applicable Groupings due to ICD-9-CM no longer being maintained and the measure not requiring historical lookback period.
Measure Section: Terminology
Source of Change: Measure Lead
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Added direct reference code SNOMED CT Code (373254001) based on expert review and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead