Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%)

Last updated: February 1, 2017

CMS Measure ID: CMS145v5
Version: 5
NQF Number: None
Measure Description:

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12 month period who also have a prior MI or a current or prior LVEF <40% who were prescribed beta-blocker therapy

Initial Patient Population:

All patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12 month period

Denominator Statement:

Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <40%

Denominator Exclusions:

None

Numerator Statement:

Patients who were prescribed beta-blocker therapy

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, allergy, intolerance, other medical reasons)

Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons)

Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the health care system)

Measure Steward: PCPI(R) Foundation (PCPI[R])
Domain: Effective Clinical Care
Previous Version: Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%)
Improvement Notation:

Higher score indicates better quality

Guidance:

Beta-blocker therapy:

  • For patients with prior MI, beta-blocker therapy includes any agent within the beta-blocker drug class. As of 2015, no recommendations or evidence are cited in current stable ischemic heart disease guidelines for preferential use of specific agents
  • For patients with prior LVEF <40%, beta-blocker therapy includes the following: bisoprolol, carvedilol, or sustained release metoprolol succinate

    The requirement of Count >=2 of Encounter, Performed is to establish that the eligible professional has an existing relationship with the patient.

Specifications

Release Notes

Header

  • ‚ÄčUpdated Copyright.

    Section: Copyright

    Source: Annual Update

  • Updated Disclaimer.

    Section: Disclaimer

    Source: Measure Lead

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • Updated Endorsed By to 'None'. As of February 2016, this measure is not endorsed by NQF as an eMeasure. The former NQF Number of 0070 is now a reference to the registry modality endorsement of this measure.

    Section: Endorsed By

    Source: Measure Lead

  • Updated Guidance to confirm currency of no recommendations or evidence.

    Section: Guidance

    Source: Measure Lead

  • Updated Measure Developer.

    Section: Measure Developer

    Source: Measure Lead

  • Updated Measure Steward.

    Section: Measure Steward

    Source: Measure Lead

  • Updated NQF Number to 'Not Applicable'. As of February 2016, this measure is not endorsed by NQF as an eMeasure. The former NQF Number of 0070 is now a reference to the registry modality endorsement of this measure.

    Section: NQF Number

    Source: Measure Lead

Logic

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Denominator

    Source: QDM Standards

  • Revised timing in Population Criteria 2, Denominator for 'Diagnosis: Myocardial Infarction' from 'starts before end of' to 'ends before start of' Occurrence A of $CADEncounters145 as a result of the QDM update.

    Section: Denominator

    Source: Measure Lead

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Denominator Exceptions

    Source: QDM Standards

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Initial Population

    Source: QDM Standards

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

Value Set

  • Value set Allergy to Beta Blocker Therapy (2.16.840.1.113883.3.526.3.1177): Deleted 1 SNOMEDCT code (407577009).

    Section: None

    Source: None

  • Value set Asthma (2.16.840.1.113883.3.526.3.362): Added 9 SNOMEDCT codes (707445000, 707446004, 707447008, 708038006, 708090002, 708093000, 708094006, 708095007, 708096008) and deleted 7 SNOMEDCT codes (233681001, 233685005, 266364000, 427354000, 57546000, 59327009, 91340006).

    Section: None

    Source: None

  • Value set Beta Blocker Therapy (2.16.840.1.113883.3.526.3.1174): Added 16 RXNORM codes and deleted 4 RXNORM codes (856412, 896974, 896975, 896976).

    Section: None

    Source: None

  • Value set Beta Blocker Therapy Ingredient (2.16.840.1.113883.3.526.3.1493): Deleted 1 RXNORM code (689716).

    Section: None

    Source: None

  • Value set Coronary Artery Disease No MI (2.16.840.1.113883.3.526.3.369): Added 1 SNOMEDCT code (443502000).

    Section: None

    Source: JIRA (CQM-1854)

  • Value set Medical Reason (2.16.840.1.113883.3.526.3.1007): Deleted 1 SNOMEDCT code (161590003).

    Section: None

    Source: None

  • Value set Myocardial Infarction (2.16.840.1.113883.3.526.3.403): Deleted 1 SNOMEDCT code (194798004).

    Section: None

    Source: None

  • Value set Patient Reason (2.16.840.1.113883.3.526.3.1008): Deleted 1 SNOMEDCT code (5015009).

    Section: None

    Source: None

External Resources