Preventive Care and Screening: Cholesterol - Fasting Low Density Lipoprotein (LDL-C) Test Performed

Last updated: May 4, 2017

CMS Measure ID: CMS61v4
Version: 4
NQF Number: None
Measure Description:

Percentage of patients aged 20 through 79 years whose risk factors have been assessed and a fasting LDL-C test has been performed.

Initial Patient Population:

All patients 20 through 79 years of age before the beginning of the measurement period

Denominator Statement:

Denominator 1: (High Risk)
All patients aged 20 through 79 years who have CHD or CHD Risk Equivalent OR 10-Year Framingham Risk > 20%

Denominator 2: (Moderate Risk)
All patients aged 20 through 79 years who have 2 or more Major CHD Risk Factors OR 10-Year Framingham Risk 10-20%

Denominator 3: (Low Risk)
All patients aged 20 through 79 years who have 0 or 1 Major CHD Risk Factors OR 10-Year Framingham Risk <10%

** For Denominator 2 and Denominator 3, Fasting HDL-C > or equal to 60 mg/dL subtracts 1 risk from the above (This is a negative risk factor.)

Denominator Exclusions:

Patients who have an active diagnosis of pregnancy

OR

Patients who are receiving palliative care

When a fasting LDL-C test is not performed during the measurement period for a valid patient reason, the appropriate test that should have been performed should be submitted along with a negation code to indicate the reason the appropriate test was not performed

Numerator Statement:

Numerator 1: (High Risk)
Patients who had a fasting LDL-C test performed or a calculated LDL-C during the measurement period

Numerator 2: (Moderate Risk)
Patients who had a fasting LDL-C test performed or a calculated LDL-C during the measurement period

Numerator 3: (Low Risk)
Patients who had a fasting LDL-C test performed or a calculated LDL-C during the measurement period or up to four (4) years prior to the current measurement period

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

Patient Reason(s):

Patient Refusal

When a fasting LDL-C test is not performed during the measurement period for a valid patient reason, the appropriate test that should have been performed should be submitted along with a negation code to indicate the reason the appropriate test was not performed

Measure Steward: Centers for Medicare & Medicaid Services
Domain: Effective Clinical Care
Next Version: Preventive Care and Screening: Cholesterol - Fasting Low Density Lipoprotein (LDL-C) Test Performed
Measure Score: Proportion
Score Type: Process
Improvement Notation:

Higher score indicates better quality.

Guidance:

This is part of a two-part measure which is paired with CMS 64 Preventive Care and Screening: Cholesterol – Risk-Stratified Fasting LDL-C. If the fasting LDL-C test is performed, measure CMS 64 should also be reported.

To be eligible for performance calculations, patients must have at least one face-to-face visit with the eligible professional during the measurement period. To meet the numerator criteria for this measure, the patient will have one fasting LDL-C performed during the same measurement period with the exception of patients with 0 or 1 risk factors who may have a fasting LDL-C performed up to four (4) years prior to the current measurement period

Specifications

External Resources