Preventive Care and Screening: Influenza Immunization

Last updated: March 22, 2017

CMS Measure ID: CMS147v6
Version: 6
NQF Number: 0041
Measure Description:

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

Initial Patient Population:

All patients aged 6 months and older seen for at least two visits or at least one preventive visit during the measurement period

Denominator Statement:

Equals Initial Population and seen for a visit between October 1 and March 31

Denominator Exclusions:

None

Numerator Statement:

Patients who received an influenza immunization OR who reported previous receipt of an influenza immunization

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

Documentation of medical reason(s) for not receiving influenza immunization (eg, patient allergy, other medical reasons)

Documentation of patient reason(s) for not receiving influenza immunization (eg, patient declined, other patient reasons)

Documentation of system reason(s) for not receiving influenza immunization (eg, vaccine not available, other system reasons)

Measure Steward: PCPI(R) Foundation (PCPI[R])
Domain: Community/Population Health
Previous Version: Preventive Care and Screening: Influenza Immunization
Improvement Notation:

Higher score indicates better quality

Guidance:

The timeframe for the visit during the Encounter, Performed: Encounter-Influenza or Procedure, Performed: Peritoneal Dialysis or Procedure, Performed: Hemodialysis in the Population Criteria-Denominator, refers to the influenza season defined by the measure: October through March (October 1 for the year prior to the start of the reporting period through March 31 during the reporting period). The Encounter-Influenza Grouping OID detailed in the data criteria section below is comprised of several individual OIDs of different encounter types. The individual OIDs are included in the value set and should be reviewed to determine that an applicable visit occurred during the timeframe for Encounter, Performed: Encounter-Influenza as specified in the denominator.

To enable reporting of this measure at the close of the reporting period, this measure will only assess the influenza season that ends in March of the reporting period. The subsequent influenza season (ending March of the following year) will be measured and reported in the following year.

To account for the majority of reporting years' appropriate flu season duration, the measure logic will look at the first 89 days of the measurement period for the appropriate criteria and actions to be present/performed (January 1 through March 31). The measure developer believes it is best to keep the logic as static as possible from one reporting year to the next. Therefore, during leap years, only encounters that occur through March 30 will be counted in the denominator.

Specifications

Release Notes

Header

  • Updated Clinical Recommendation Statement.

    Section: Clinical Recommendation Statement

    Source: Measure Lead

  • ‚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 Measure Developer.

    Section: Measure Developer

    Source: Measure Lead

  • Updated Measure Steward.

    Section: Measure Steward

    Source: Measure Lead

  • Updated Reference.

    Section: Reference

    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 Exceptions

    Source: QDM Standards

  • Replaced 'Medication' QDM category with 'Immunization' QDM category for instances associated with a vaccination/immunization value set (CVX) to conform to QDM 4.2 changes.

    Section: Denominator Exceptions

    Source: QDM Standards

  • Revised timing from 'starts before end of' to 'overlaps' for the following data elements:

    'Diagnosis: Allergy to Eggs', 'Diagnosis: Allergy to Influenza Vaccine', 'Diagnosis: Intolerance to Influenza Vaccine', 'Procedure, Intolerance: Influenza Vaccination', 'Immunization, Intolerance: Influenza Vaccine', 'Immunization, Allergy: Influenza Vaccine'.

    Section: Denominator Exceptions

    Source: Measure Lead

  • Replaced 'Medication' QDM category with 'Immunization' QDM category for instances associated with a vaccination/immunization value set (CVX) to conform to QDM 4.2 changes.

    Section: Numerator

    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

  • Replaced 'Medication' QDM category with 'Immunization' QDM category for instances associated with a vaccination/immunization value set (CVX) to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

Value Set

  • Value set Allergy to Eggs (2.16.840.1.113883.3.526.3.1253): Added ICD10CM extensional value set (2.16.840.1.113883.3.526.2.1760) including 4 codes.

    Section: None

    Source: None

  • Value set Allergy to Eggs (2.16.840.1.113883.3.526.3.1253): Added ICD9CM extensional value set (2.16.840.1.113883.3.526.2.1759) including 2 codes.

    Section: None

    Source: None

  • Value set Allergy to Influenza Vaccine (2.16.840.1.113883.3.526.3.1256): Deleted 1 SNOMEDCT code (315631004).

    Section: None

    Source: None

  • Value set Influenza Vaccination (2.16.840.1.113883.3.526.3.402): Added 1 CPT code (90654).

    Section: None

    Source: None

  • Value set Influenza Vaccination (2.16.840.1.113883.3.526.3.402): Added HCPCS extensional value set (2.16.840.1.113883.3.526.2.1761) including 7 codes.

    Section: None

    Source: None

  • Value set Influenza Vaccination (2.16.840.1.113883.3.526.3.402): Deleted 1 SNOMEDCT code (442333005).

    Section: None

    Source: None

  • Value set Influenza Vaccine (2.16.840.1.113883.3.526.3.1254): Added 2 CVX codes (151, 168).

    Section: None

    Source: None

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

    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