| eCQM Title | Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists |
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| eCQM Identifier (Measure Authoring Tool) | 74 | eCQM Version Number | 10.2.000 |
| NQF Number | Not Applicable | GUID | 0b81b6ba-3b30-41bf-a2f3-95bdc9f558f2 |
| Measurement Period | January 1, 20XX through December 31, 20XX | ||
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) | ||
| Measure Developer | National Committee for Quality Assurance | ||
| Endorsed By | None | ||
| Description |
Percentage of children, 6 months - 20 years of age, who received a fluoride varnish application during the measurement period |
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| Copyright |
This Physician Performance Measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & Medicaid Services (CMS). CMS contracted (Contract HHSP23320095627WC; HHSP23337008T) with the National Committee for Quality Assurance (NCQA) to develop this electronic measure. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third party codes contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2019 American Medical Association. LOINC(R) copyright 2004-2019 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2019 International Health Terminology Standards Development Organisation. ICD-10 copyright 2019 World Health Organization. All Rights Reserved. |
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| Disclaimer |
The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]. |
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| Measure Scoring | Proportion | ||
| Measure Type | Process | ||
| Stratification |
Population 1: age 6 months - 5 years Population 2: age 6-12 Population 3: age 13-20 |
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| Risk Adjustment |
None |
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| Rate Aggregation |
None |
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| Rationale |
The literature reflects that fluoride varnish, when applied to the teeth of high-risk children, reduces, in conjunction with anticipatory guidance provided to the caregiver, the risk of the child developing caries (Weintraub et al., 2006). |
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| Clinical Recommendation Statement |
ADA clinical recommendations for use of professionally applied or prescription-strength, home-use topical fluorides for caries prevention in patients at elevated risk of developing caries: - Younger Than 6 Years - 2.26 percent fluoride varnish at least every three to six months - 6-18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF*) gel for four minutes at least every three to six months - Older Than 18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months (Weyant et al., 2013) The USPSTF [US Preventive Services Task Force] recommends that primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary tooth eruption. (B recommendation) |
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| Improvement Notation |
A higher score indicates better quality |
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| Reference |
Weintraub, J. A., Ramos-Gomez, F., Jue, B., et al. (2006). Fluoride varnish efficacy in preventing early childhood caries. Journal of Dental Research, 85(2), 172-176. |
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| Reference |
Weyant, R. J., Tracy, S. L., Anselmo, T. T., et al. (2013). Topical fluoride for caries prevention: Executive summary of the updated clinical recommendations and supporting systematic review. Journal of the American Dental Association, 144(11), 1279-1291. doi: 10.14219/jada.archive.2013.0057 |
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| Reference |
Moyer, V.A. on behalf of the US Preventive Services Task Force. (2014). Prevention of dental caries in children from birth through age 5 years: US Preventive Services Task Force recommendation statement. Pediatrics, 133(6), 1102-1111. |
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| Definition |
None |
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| Guidance |
This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM. |
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| Transmission Format |
TBD |
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| Initial Population |
Children, 6 months - 20 years of age, with a visit during the measurement period |
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| Denominator |
Equals Initial Population |
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| Denominator Exclusions |
Exclude patients whose hospice care overlaps the measurement period |
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| Numerator |
Children who receive a fluoride varnish application during the measurement period |
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| Numerator Exclusions |
Not Applicable |
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| Denominator Exceptions |
None |
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| Supplemental Data Elements |
For every patient evaluated by this measure also identify payer, race, ethnicity and sex |
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exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) < 20
)
and exists ( "Qualifying Encounters" )
"Initial Population"
Hospice."Has Hospice"
exists ( ["Procedure, Performed": "Fluoride Varnish Application for Children"] FluorideApplication
where FluorideApplication.relevantPeriod during "Measurement Period"
)
None
None
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) <= 4
)
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[5, 11]
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[12, 20 )
"Initial Population"
Hospice."Has Hospice"
exists ( ["Encounter, Performed": "Encounter Inpatient"] DischargeHospice
where ( DischargeHospice.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or DischargeHospice.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and DischargeHospice.relevantPeriod ends during "Measurement Period"
)
or exists ( ["Intervention, Order": "Hospice care ambulatory"] HospiceOrder
where HospiceOrder.authorDatetime during "Measurement Period"
)
or exists ( ["Intervention, Performed": "Hospice care ambulatory"] HospicePerformed
where HospicePerformed.relevantPeriod overlaps "Measurement Period"
)
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) < 20
)
and exists ( "Qualifying Encounters" )
exists ( ["Procedure, Performed": "Fluoride Varnish Application for Children"] FluorideApplication
where FluorideApplication.relevantPeriod during "Measurement Period"
)
( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Preventive Care - Established Office Visit, 0 to 17"] union ["Encounter, Performed": "Preventive Care- Initial Office Visit, 0 to 17"] union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"] union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"] union ["Encounter, Performed": "Clinical Oral Evaluation"] ) ValidEncounter where ValidEncounter.relevantPeriod during "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
exists ( ["Patient Characteristic Birthdate": "Birth date"] BirthDate
where Global."CalendarAgeInMonthsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) >= 6
and Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) <= 4
)
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[5, 11]
exists ["Patient Characteristic Birthdate": "Birth date"] BirthDate where Global."CalendarAgeInYearsAt" ( BirthDate.birthDatetime, start of "Measurement Period" ) in Interval[12, 20 )
months between ToDate(BirthDateTime)and ToDate(AsOf)
years between ToDate(BirthDateTime)and ToDate(AsOf)
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezoneoffset from Value)
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
| Measure Set |
Not Applicable |
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