Dementia: Cognitive Assessment | eCQI Resource Center

Measure Information	2021 Performance Period
CMS Measure ID	CMS149v9
NQF Number	2872e
Measure Description	Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period
Initial Population	All patients, regardless of age, with a diagnosis of dementia
Denominator Statement	Equals Initial Population
Denominator Exclusions	None
Numerator Statement	Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period
Numerator Exclusions	Not Applicable
Denominator Exceptions	Documentation of patient reason(s) for not assessing cognition
Measure Steward	PCPI(R) Foundation (PCPI[R])
Quality Domain	Effective Clinical Care
Measure Scoring	Proportion measure
Measure Type	Process measure
Improvement Notation	Higher score indicates better quality
Guidance	Use of a standardized tool or instrument to assess cognition other than those listed will meet numerator performance. Standardized tools can be mapped to the concept "Intervention, Performed": "Cognitive Assessment" included in the numerator logic below. The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. In recognition of the growing use of integrated and team-based care, the diagnosis of dementia and the assessment of cognitive function need not be performed by the same provider or clinician. The DSM-5 has replaced the term dementia with major neurocognitive disorder and mild neurocognitive disorder. For the purposes of this measure, the terms are equivalent. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
MIPS Quality ID	281
Meaningful Measure	Prevention, Treatment, and Management of Mental Health
Telehealth Eligible	Yes
Next Version	CMS149v10
Previous Version	No Version Available

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Measure Information	2021 Performance Period	2022 Performance Period	2023 Performance Period
CMS Measure ID	CMS149v9	CMS149v10	CMS149v11
NQF Number	2872e	2872e	2872e
Measure Description	Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period	Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period	Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period
Initial Population	All patients, regardless of age, with a diagnosis of dementia	All patients, regardless of age, with a diagnosis of dementia	All patients, regardless of age, with a diagnosis of dementia
Denominator Statement	Equals Initial Population	Equals Initial Population	Equals Initial Population
Denominator Exclusions	None	None	None
Numerator Statement	Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period	Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period	Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period
Numerator Exclusions	Not Applicable	Not Applicable	Not Applicable
Denominator Exceptions	Documentation of patient reason(s) for not assessing cognition	Documentation of patient reason(s) for not assessing cognition	Documentation of patient reason(s) for not assessing cognition
Measure Steward	PCPI(R) Foundation (PCPI[R])	American Academy of Neurology	American Academy of Neurology
Quality Domain	Effective Clinical Care	Effective Clinical Care	Effective Clinical Care
Measure Scoring	Proportion measure	Proportion measure	Proportion measure
Measure Type	Process measure	Process measure	Process measure
Improvement Notation	Higher score indicates better quality	Higher score indicates better quality	Higher score indicates better quality
Guidance	Use of a standardized tool or instrument to assess cognition other than those listed will meet numerator performance. Standardized tools can be mapped to the concept "Intervention, Performed": "Cognitive Assessment" included in the numerator logic below. The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. In recognition of the growing use of integrated and team-based care, the diagnosis of dementia and the assessment of cognitive function need not be performed by the same provider or clinician. The DSM-5 has replaced the term dementia with major neurocognitive disorder and mild neurocognitive disorder. For the purposes of this measure, the terms are equivalent. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.	Use of a standardized tool or instrument to assess cognition other than those listed will meet numerator performance. Standardized tools can be mapped to the concept "Intervention, Performed": "Cognitive Assessment" included in the numerator logic below. The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. In recognition of the growing use of integrated and team-based care, the diagnosis of dementia and the assessment of cognitive function need not be performed by the same provider or clinician. The DSM-5 has replaced the term dementia with major neurocognitive disorder and mild neurocognitive disorder. For the purposes of this measure, the terms are equivalent. 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.	Use of a standardized tool or instrument to assess cognition other than those listed will meet numerator performance. Standardized tools can be mapped to the concept "Intervention, Performed": "Cognitive Assessment" included in the numerator logic below. The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. In recognition of the growing use of integrated and team-based care, the diagnosis of dementia and the assessment of cognitive function need not be performed by the same provider or clinician. The DSM-5 has replaced the term dementia with major neurocognitive disorder and mild neurocognitive disorder. For the purposes of this measure, the terms are equivalent. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
MIPS Quality ID	281	281	281
Meaningful Measure	Prevention, Treatment, and Management of Mental Health	Prevention, Treatment, and Management of Mental Health	Prevention, Treatment, and Management of Mental Health
Telehealth Eligible	Yes	Yes	Yes
Next Version	CMS149v10	CMS149v11	No Version Available
Previous Version	No Version Available	CMS149v9	CMS149v10

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CMS149v9-TRN.xlsx	22.12 KB

Data Element Repository

Data Elements contained within CMS149v9

Value Sets

Value Sets to be used with CMS149v9

Release Notes

CMS149v9-TRN.xlsx

Header

Updated eCQM Version Number.

Measure Section: eCQM Version Number

Source of Change: Standards Update
Updated copyright.

Measure Section: Copyright

Source of Change: Annual Update
Updated disclaimer.

Measure Section: Disclaimer

Source of Change: Standards Update
Updated rationale to align with most recent National Quality Forum (NQF) submission and American Psychological Association (APA) formatting.

Measure Section: Rationale

Source of Change: Measure Lead
Added new guidelines to clinical recommendation statement to align with most recent NQF submission.

Measure Section: Clinical Recommendation Statement

Source of Change: Measure Lead
Updated existing references to align with APA formatting and most recent NQF submission. Added references related to new clinical recommendation statements.

Measure Section: Reference

Source of Change: Measure Lead
Added guidance, based upon technical expert panel feedback, to recognize the appropriateness of team-based care for this measure.

Measure Section: Guidance

Source of Change: Measure Lead
Added text to identify the Quality Data Model (QDM) version used in the measure specification.

Measure Section: Guidance

Source of Change: Standards Update
Added text to indicate whether the measure is patient-based or episode-based.

Measure Section: Guidance

Source of Change: Standards Update

Logic

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
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
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
Updated CQL 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

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

Value set Dementia & Mental Degenerations (2.16.840.1.113883.3.526.3.1005): 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
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
Value set Psych Visit - Diagnostic Evaluation (2.16.840.1.113883.3.526.3.1492): Deleted 1 SNOMED CT code (32537008) based on terminology update.

Measure Section: Terminology

Source of Change: Annual Update
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
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, to capture additional nursing facility visit encounter types.

Measure Section: Terminology

Source of Change: Annual Update
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