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Use of High-Risk Medications in Older Adults

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Measure Information 2021 Performance Period
CMS eCQM ID CMS156v9
NQF Number Not Applicable
MIPS Quality ID 238
Description

Percentage of patients 65 years of age and older who were ordered at least two of the same high-risk medications.
Initial Population

Patients 65 years and older who had a visit during the measurement period
Numerator

Patients with at least two orders for the same high-risk medication on different days during the measurement period
Numerator Exclusions

Not Applicable
Denominator

Equals Initial Population
Denominator Exclusions

Exclude patients whose hospice care overlaps the measurement period
Denominator Exceptions

None
Steward National Committee for Quality Assurance
Measure Scoring Proportion measure
Measure Type Process measure
Improvement Notation

Lower score indicates better quality
Guidance

The intent of the measure is to assess if the patient has been prescribed at least two of the same high-risk medications on different days.

The intent of the measure is to assess if the reporting provider ordered the high-risk medication(s). If the patient had a high-risk medication previously prescribed by another provider, they would not be counted towards the numerator unless the reporting provider also ordered a high-risk medication for them.

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.
Telehealth Eligible Yes
Next Version
CMS156v10
Previous Version No Version Available

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Measure Information 2021 Performance Period 2022 Performance Period 2023 Performance Period 2024 Performance Period
Title Use of High-Risk Medications in Older Adults Use of High-Risk Medications in Older Adults Use of High-Risk Medications in Older Adults Use of High-Risk Medications in Older Adults
CMS eCQM ID CMS156v9 CMS156v10 CMS156v11 CMS156v12
NQF Number Not Applicable Not Applicable Not Applicable Not Applicable
Description

Percentage of patients 65 years of age and older who were ordered at least two of the same high-risk medications.

Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported.

1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class.

2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses.

3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators).

Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported.

1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class.

2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses.

3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators).

Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported.

1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class.

2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses.

3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators).
Initial Population

Patients 65 years and older who had a visit during the measurement period

Patients 65 years and older who had a visit during the measurement period

Patients 65 years and older at the end of the measurement period who had a visit during the measurement period

Patients 65 years and older at the end of the measurement period who had a visit during the measurement period
Denominator

Equals Initial Population

Equals Initial Population

Equals Initial Population

Equals Initial Population
Denominator Exclusions Exclude patients whose hospice care overlaps the measurement period Exclude patients who are in hospice care for any part of the measurement period.Exclude patients receiving palliative care during the measurement period. Exclude patients who are in hospice care for any part of the measurement period.Exclude patients receiving palliative care for any part of the measurement period. Exclude patients who are in hospice care for any part of the measurement period.Exclude patients receiving palliative care for any part of the measurement period.
Numerator

Patients with at least two orders for the same high-risk medication on different days during the measurement period

Rate 1 : Patients with at least two orders of high-risk medications from the same drug class.

Rate 2: Patients with at least two orders of high-risk medications from the same drug class (i.e., antipsychotics and benzodiazepines).

Total rate (the sum of the two previous numerators, deduplicated).

Rate 1: Patients with at least two orders of high-risk medications from the same drug class on different days.

a. At least two orders of high-risk medications from the same drug class.

b. At least two orders of high-risk medications from the same drug class with summed days supply greater than 90 days.

c. At least two orders of high-risk medications from the same drug class each exceeding average daily dose criteria.

Rate 2: Patients with at least two orders of high-risk medications from the same drug class (i.e., antipsychotics and benzodiazepines) on different days.

Total rate (the sum of the two previous numerators, deduplicated).

Rate 1: Patients with at least two orders of high-risk medications from the same drug class on different days.

a. At least two orders of high-risk medications from the same drug class.

b. At least two orders of high-risk medications from the same drug class with summed days supply greater than 90 days.

c. At least two orders of high-risk medications from the same drug class each exceeding average daily dose criteria.

Rate 2: Patients with at least two orders of high-risk medications from the same drug class (i.e., antipsychotics and benzodiazepines) on different days except for appropriate diagnoses.

a. Patients with two or more antipsychotic prescriptions ordered on different days, and who did not have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between January 1 of the year prior to the measurement period and the IPSD for antipsychotics.

b. Patients with two or more benzodiazepine prescriptions ordered on different days, and who did not have a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between January 1 of the year prior to the measurement period and the IPSD for benzodiazepines.

Total rate (the sum of the two previous numerators, deduplicated).
Numerator Exclusions

Not Applicable

Rate 2: For patients with two or more antipsychotic prescriptions ordered, exclude patients who have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between January 1 of the year prior to the measurement period and the Index Prescription Start Date (IPSD) for antipsychotics.

For patients with two or more benzodiazepine prescriptions ordered, exclude patients who have a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between January 1 of the year prior to the measurement period and the IPSD for benzodiazepines.

Rate 2: For patients with two or more antipsychotic prescriptions ordered, exclude patients who have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between January 1 of the year prior to the measurement period and the IPSD for antipsychotics.

For patients with two or more benzodiazepine prescriptions ordered, exclude patients who have a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between January 1 of the year prior to the measurement period and the IPSD for benzodiazepines.

Not Applicable
Denominator Exceptions

None

None

None

None
Measure Steward National Committee for Quality Assurance National Committee for Quality Assurance National Committee for Quality Assurance National Committee for Quality Assurance
Measure Scoring Proportion measure Proportion measure Proportion measure Proportion measure
Measure Type Process measure Process measure Process measure Process measure
Improvement Notation

Lower score indicates better quality

Lower score indicates better quality

Lower score indicates better quality

Lower score indicates better quality
Guidance

The intent of the measure is to assess if the patient has been prescribed at least two of the same high-risk medications on different days.

The intent of the measure is to assess if the reporting provider ordered the high-risk medication(s). If the patient had a high-risk medication previously prescribed by another provider, they would not be counted towards the numerator unless the reporting provider also ordered a high-risk medication for them.

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.

The intent of the measure is to assess if the patient has been ordered at least two of the same high-risk medication prescriptions from the same medication class on different days.

The intent of the measure is to assess if the reporting provider ordered the high-risk medication(s). If the patient had a high-risk medication previously prescribed by another provider, they would not be counted towards the numerator unless the reporting provider also ordered a high-risk medication for them.

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.

The intent of the measure is to assess if the patient has been ordered at least two high-risk medication prescriptions from the same drug class on different days.

The intent of the measure is to assess if the reporting provider ordered the high-risk medication(s). If the patient had a high-risk medication previously prescribed by another provider, they would not be counted towards the numerator unless the reporting provider also ordered a high-risk medication from the same drug class for them.

Calculate average daily dose for each prescription event. To calculate average daily dose, multiply the quantity of pills prescribed by the dose of each pill and divide by the days supply. For example, a prescription for the 30-days supply of digoxin containing 15 pills, 0.25 mg each pill, has an average daily dose of 0.125 mg. To calculate average daily dose for elixirs and concentrates, multiply the volume prescribed by daily dose and divide by the days supply. Do not round when calculating average daily dose.

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.

The intent of the measure is to assess if the patient has been ordered at least two high-risk medication prescriptions from the same drug class on different days.

The intent of the measure is to assess if the reporting provider ordered the high-risk medication(s). If the patient had a high-risk medication previously prescribed by another provider, they would not be counted towards the numerator unless the reporting provider also ordered a high-risk medication from the same drug class for them.

Calculate average daily dose for each prescription event. To calculate average daily dose, multiply the quantity of pills prescribed by the dose of each pill and divide by the days supply. For example, a prescription for the 30-days supply of digoxin containing 15 pills, 0.25 mg each pill, has an average daily dose of 0.125 mg. To calculate average daily dose for elixirs and concentrates, multiply the volume prescribed by daily dose and divide by the days supply. Do not round when calculating average daily dose.

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 238 238 238 238
Telehealth Eligible Yes Yes Yes Yes
Next Version CMS156v10 CMS156v11 CMS156v12 No Version Available
Previous Version No Version Available
CMS156v9
CMS156v10
CMS156v11
Notes

*There is a known issue on CMS156v10. See issue EKI-17 on the ONC eCQM Known Issues Dashboard for details.

*There is a known issue on CMS156v11. See issue EKI-17 on the ONC eCQM Known Issues Dashboard for details.
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Specifications
Attachment Size
CMS156v9.html 88.96 KB
CMS156v9.zip 100.56 KB
CMS156v9-TRN.xlsx 27.05 KB

Data Element Repository

Value Sets
Value Sets to be used with CMS156v9
CMS156v9-TRN.xlsx

Header

  • Revised measure title by replacing the word 'elderly' with 'older adults' for harmonization with the health plan level version of the measure.

    Measure Section: eCQM Title

    Source of Change: Measure Lead

  • 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 the rationale to remove outdated references and content and to update references.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Updated the clinical recommendations statement to remove outdated references and update with the most recent clinical recommendations.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated references.

    Measure Section: Reference

    Source of Change: Standards Update

  • 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

  • Removed numerator rate 1 for harmonization with the health plan level version of the measure and to reduce reporting burden.

    Measure Section: Numerator

    Source of Change: ONC Project Tracking System (Jira): CQM-3804

Logic

  • Removed numerator rate 1 for harmonization with the health plan level version of the measure and to reduce reporting burden.

    Measure Section: Numerator

    Source of Change: ONC Project Tracking System (Jira): CQM-3804

  • Renamed 'More than 1 Of' function to 'More Than One of Same Medication Order' ​to clarify the purpose and argument type.

    Measure Section: Functions

    Source of Change: Measure Lead

  • Clinical Quality Language (CQL) Library version update: Updated version number of the Hospice Library (Hospice-2.2.000).

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • 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

  • 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 the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-5.0.000). Updated definitions and functions in the MAT Global Common Functions Library to align with standards changes, CQL Style Guide, and to include one new function related to calculating length of hospital stays with observation stays.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

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 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

  • Added value sets: Scopolamine (2.16.840.1.113883.3.464.1003.196.12.1520); Secobarbital (2.16.840.1.113883.3.464.1003.196.12.1521); Propantheline (2.16.840.1.113883.3.464.1003.196.12.1519); Doxylamine (2.16.840.1.113883.3.464.1003.196.12.1515); Ergoloid Mesylates (2.16.840.1.113883.3.464.1003.196.12.1516); Butalbital (2.16.840.1.113883.3.464.1003.196.12.1514); Amobarbital (2.16.840.1.113883.3.464.1003.196.12.1512); Pentobarbital (2.16.840.1.113883.3.464.1003.196.12.1518) for consistency with the Beers Criteria for Potentially Inappropriate Medication list, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed the following value sets: Acetaminophen / Butalbital / Caffeine / Codeine (2.16.840.1.113883.3.464.1003.196.12.1326); Acetaminophen / Butalbital / Caffeine (2.16.840.1.113883.3.464.1003.196.12.1363); Acetaminophen / Butalbital (2.16.840.1.113883.3.464.1003.196.12.1317); Aspirin / Butalbital / Caffeine (2.16.840.1.113883.3.464.1003.196.12.1347) due to combining all Butalbital value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value sets: Acetaminophen / Chlorpheniramine / Dextromethorphan / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1310); Acetaminophen / Chlorpheniramine / Dextromethorphan / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1321); Acetaminophen / Chlorpheniramine / Dextromethorphan (2.16.840.1.113883.3.464.1003.196.12.1421); Acetaminophen / Chlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1328); Acetaminophen / Chlorpheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1316) due to combining codes into the Chlorpheniramine value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value set: Acetaminophen / Dexbrompheniramine (2.16.840.1.113883.3.464.1003.196.12.1405) due to combining codes into the Dexbrompheniramine value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed the following value sets: Acetaminophen / Dextromethorphan / Diphenhydramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1399); Acetaminophen / Diphenhydramine (2.16.840.1.113883.3.464.1003.196.12.1350); Acetaminophen / Diphenhydramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1318) due to combining all Diphenhydramine value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value sets due to combining into the Doxylamine value set, based on expert review and/or public feedback: Acetaminophen / Dextromethorphan / Doxylamine (2.16.840.1.113883.3.464.1003.196.12.1338); Acetaminophen / Dextromethorphan / Doxylamine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1287).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value sets: Amitriptyline / Chlordiazepoxide (2.16.840.1.113883.3.464.1003.196.12.1286); Amitriptyline / Perphenazine (2.16.840.1.113883.3.464.1003.196.12.1428) due to combining into the Amitriptyline Hydrochloride value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Amitriptyline Hydrochloride (2.16.840.1.113883.3.464.1003.196.12.1373): Added 7 RxNorm codes (856706, 856720, 856769, 856792, 856797, 856825, 856840) to combine all the Amitriptyline drugs into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Anti Infectives, other (2.16.840.1.113883.3.464.1003.196.12.1481): Added 1 RxNorm code (311988) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set (2.16.840.1.113883.3.464.1003.196.12.1302): Renamed to Orphenadrine.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Orphenadrine (2.16.840.1.113883.3.464.1003.196.12.1302): Added 7 RxNorm codes (994521, 994810, 994811, 994824, 994837, 994841, 994847) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set (2.16.840.1.113883.3.464.1003.196.12.1274): Renamed to Atropine.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Atropine (2.16.840.1.113883.3.464.1003.196.12.1274): Added 29 RxNorm codes to combine all Atropine value sets into one value set, based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Atropine / Hyoscyamine / Phenobarbital / Scopolamine (2.16.840.1.113883.3.464.1003.196.12.1355): Removed value set and added codes into new combined Atropine value set.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value sets : Brompheniramine / Codeine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1409); Brompheniramine / Codeine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1450); Brompheniramine / Dextromethorphan / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1325); Brompheniramine / Dextromethorphan / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1339); Brompheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1332) due to combining all Brompheniramine value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Brompheniramine (2.16.840.1.113883.3.464.1003.196.12.1427): Added 69 RxNorm codes to combine all Brompheniramine value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Butabarbital (2.16.840.1.113883.3.464.1003.196.12.1402): Added 4 RxNorm codes (1047805, 1251600, 1251610, 1251625) and deleted 1 RxNorm code (1251621) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Carbinoxamine (2.16.840.1.113883.3.464.1003.196.12.1306): Added 9 RxNorm codes (1010696, 1010946, 1010980, 1012681, 1012956, 1012984, 1374770, 1424307, 1795581) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Carisoprodol (2.16.840.1.113883.3.464.1003.196.12.1369): Added 3 RxNorm codes (105974, 197447, 994226) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value sets: Chlophedianol / Chlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1412); Chlophedianol / Dexchlorpheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1447); Chlorpheniramine / Dextromethorphan / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1312); Chlorpheniramine / Dextromethorphan / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1337); Chlorpheniramine / Hydrocodone / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1299); Chlorpheniramine / Hydrocodone (2.16.840.1.113883.3.464.1003.196.12.1330); Chlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1343); Chlorpheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1315) due to combining all Chlorpheniramine value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Chlorpheniramine (2.16.840.1.113883.3.464.1003.196.12.1352): Added 217 RxNorm codes and deleted 2 RxNorm codes (239981, 309249) to combine all Chlorpheniramine value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Chlorzoxazone (2.16.840.1.113883.3.464.1003.196.12.1362): Added 1 RxNorm code (197501) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Clemastine (2.16.840.1.113883.3.464.1003.196.12.1308): Added 5 RxNorm codes (857420, 857430, 857452, 857454, 857457) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Clomipramine (2.16.840.1.113883.3.464.1003.196.12.1336): Added 5 RxNorm codes (857291, 857292, 857296, 857315, 857326) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed the following value set due to combining codes into the Conjugated Estrogens value set, based on expert review and/or public feedback: Conjugated Estrogens / Medroxyprogesterone (2.16.840.1.113883.3.464.1003.196.12.1324).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Conjugated Estrogens (2.16.840.1.113883.3.464.1003.196.12.1357): Added 10 RxNorm codes (1000353, 1000354, 1000395, 1000398, 1000486, 1000490, 1000496, 1441392, 197663, 432572) and deleted 8 RxNorm codes (310204, 310206, 476540, 618368, 618370, 618376, 618378, 730878) to combine all Conjugated Estrogens value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Cyclobenzaprine Hydrochloride (2.16.840.1.113883.3.464.1003.196.12.1372): Added 1 RxNorm code (999731) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Desiccated Thyroid (2.16.840.1.113883.3.464.1003.196.12.1354): Added 1 RxNorm code (242927) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value sets: Dexbrompheniramine / Dextromethorphan / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1426); Dexbrompheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1430); Dexbrompheniramine Maleate / Pseudoephedrine Hydrochloride (2.16.840.1.113883.3.464.1003.196.12.1429) due to combining all Dexbrompheniramine value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Dexbrompheniramine (2.16.840.1.113883.3.464.1003.196.12.1375): Added 12 RxNorm codes (1190580, 1190600, 1251806, 1305588, 1369403, 1441376, 1491637, 1539185, 1545306, 1545309, 1551286, 1798453) and deleted 1 RxNorm code (240826) to combine all Dexbrompheniramine value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set (2.16.840.1.113883.3.464.1003.196.12.1300): Renamed to Dexchlorpheniramine.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value set: Dexchlorpheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1425) due to combining codes into the Dexchlorpheniramine value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Dexchlorpheniramine (2.16.840.1.113883.3.464.1003.196.12.1300): Added 17 RxNorm codes to combine all Dexchlorpheniramine value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Dextromethorphan / Diphenhydramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1397): Removed Dextromethorphan / Diphenhydramine / Phenylephrine based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value set: Dextromethorphan / Doxylamine (2.16.840.1.113883.3.464.1003.196.12.1452) due to combining codes into the Doxylamine value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Dicyclomine (2.16.840.1.113883.3.464.1003.196.12.1279): Added 4 RxNorm codes (199725, 755900, 991151, 991616) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value sets: Dienogest / Estradiol Multiphasic (2.16.840.1.113883.3.464.1003.196.12.1398); Drospirenone / Estradiol (2.16.840.1.113883.3.464.1003.196.12.1410); Estradiol / Norethindrone (2.16.840.1.113883.3.464.1003.196.12.1323 due to combining all Estradiol value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Estradiol (2.16.840.1.113883.3.464.1003.196.12.1365): Added 26 RxNorm codes to combine all Estradiol value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Dimenhydrinate (2.16.840.1.113883.3.464.1003.196.12.1500): Added 7 RxNorm codes (1245184, 1294446, 245357, 245358, 309913, 429720, 755901) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set (2.16.840.1.113883.3.464.1003.196.12.1293): Renamed to Diphenhydramine.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value set: Diphenhydramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1307) due to combining all Diphenhydramine value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Diphenhydramine (2.16.840.1.113883.3.464.1003.196.12.1293): Added 96 RxNorm codes to combine all Diphenhydramine value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Dipyridamole (2.16.840.1.113883.3.464.1003.196.12.1349): Added 2 RxNorm codes (199314, 392451) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Disopyramide (2.16.840.1.113883.3.464.1003.196.12.1311): Added 3 RxNorm codes (104285, 199730, 199824) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value set: Esterified Estrogens / Methyltestosterone (2.16.840.1.113883.3.464.1003.196.12.1320) due to combining all Esterified Estrogens value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Esterified Estrogens (2.16.840.1.113883.3.464.1003.196.12.1419): Added 1 RxNorm code (1000353) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value set: Glyburide / Metformin (2.16.840.1.113883.3.464.1003.196.12.1360) due to combining all Glyburide value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Glyburide (2.16.840.1.113883.3.464.1003.196.12.1368): Added 4 RxNorm codes (252960, 861743, 861748, 861753) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Guanfacine (2.16.840.1.113883.3.464.1003.196.12.1341): Added 1 RxNorm code (1092566) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set High Risk Medications for the Elderly (2.16.840.1.113883.3.464.1003.196.12.1253): Removed High Risk Medications for the Elderly due to removal of numerator rate 1 for harmonization with the health plan level version of the measure and reduce reporting burden.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set High-Risk Medications With Days Supply Criteria (2.16.840.1.113883.3.464.1003.196.12.1254): Removed High-Risk Medications With Days Supply Criteria due to removal of numerator rate 1 for harmonization with the health plan level version of the measure and reduce reporting burden.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value set: Hydrochlorothiazide / Methyldopa (2.16.840.1.113883.3.464.1003.196.12.1414) due to combining all Methyldopa value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Methyldopa (2.16.840.1.113883.3.464.1003.196.12.1331): Added 7 RxNorm codes (104357, 197955, 197959, 197960, 197961, 197962, 197963) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Hydroxyzine (2.16.840.1.113883.3.464.1003.196.12.1374): Added 6 RxNorm codes (1794552, 1794554, 995241, 995270, 995274, 995428) and deleted 2 RxNorm codes (995235, 995253) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value sets: Hyoscyamine / Methenamine / Mblue / Phenyl Salicyl / Sodium Biphosphate (2.16.840.1.113883.3.464.1003.196.12.1504); Hyoscyamine / Methenamine / Mblue / Phenyl Salicyl (2.16.840.1.113883.3.464.1003.196.12.1503); Hyoscyamine / Methenamine / Mblue / Sodium Biphosphate (2.16.840.1.113883.3.464.1003.196.12.1505) due to combining all Hyoscyamine value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Hyoscyamine (2.16.840.1.113883.3.464.1003.196.12.1501): Added 19 RxNorm codes to combine all Hyoscyamine value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Imipramine (2.16.840.1.113883.3.464.1003.196.12.1359): Added 1 RxNorm code (835586) based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Indomethacin (2.16.840.1.113883.3.464.1003.196.12.1366): Added 2 RxNorm codes (251255, 392073) and deleted 1 RxNorm code (247069) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Ketorolac Tromethamine (2.16.840.1.113883.3.464.1003.196.12.1364): Added 9 RxNorm codes (1665459, 1665461, 1665675, 1665679, 1665682, 860113, 860114, 860115, 861846) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set List of Single RxNorm Code Concepts for High Risk Drugs for the Elderly (2.16.840.1.113883.3.464.1003.196.12.1272): Removed 63 RxNorm extensional value sets; codes added to active drug value sets based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Meclizine (2.16.840.1.113883.3.464.1003.196.12.1506): Added 2 RxNorm codes (1663815, 995682) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Megestrol (2.16.840.1.113883.3.464.1003.196.12.1342): Added 2 RxNorm codes (577154, 860231) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Meperidine (2.16.840.1.113883.3.464.1003.196.12.1351): Added 3 RxNorm codes (1655058, 1655060, 861479) and deleted 6 RxNorm codes (1665697, 860792, 861447, 861459, 861463, 861476) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Meprobamate (2.16.840.1.113883.3.464.1003.196.12.1284): Added 1 RxNorm code (197930) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Methocarbamol (2.16.840.1.113883.3.464.1003.196.12.1370): Added 1 RxNorm code (197945) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Nifedipine (2.16.840.1.113883.3.464.1003.196.12.1353): Added 5 RxNorm codes (199329, 199782, 314132, 391901, 391980) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Nonbenzodiazepine hypnotics (2.16.840.1.113883.3.464.1003.196.12.1480): Added 2 RxNorm codes (854885, 854886) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Nortriptyline (2.16.840.1.113883.3.464.1003.196.12.1507): Added 4 RxNorm codes (199283, 199406, 865143, 865146) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Phenobarbital (2.16.840.1.113883.3.464.1003.196.12.1348): Added 18 RxNorm codes and deleted 1 RxNorm code (199407).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Promethazine Hydrochloride (2.16.840.1.113883.3.464.1003.196.12.1367): Added 11 RxNorm codes (1248057, 756160, 861578, 991486, 991528, 992471, 992898, 992900, 992904, 992908, 996757) based on terminology update and deleted 3 RxNorm codes (992441, 992454, 992478) based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Removed value set: Pseudoephedrine / Triprolidine (2.16.840.1.113883.3.464.1003.196.12.1345) due to combining all Triprolidine value sets, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Triprolidine (2.16.840.1.113883.3.464.1003.196.12.1408): Added 15 RxNorm codes to combine all Triprolidine value sets into one value set, based on expert review and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Trihexyphenidyl (2.16.840.1.113883.3.464.1003.196.12.1334): Added 2 RxNorm codes (905273, 905292) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Trimipramine (2.16.840.1.113883.3.464.1003.196.12.1285): Added 6 RxNorm codes (199820, 245372, 245373, 245374, 250033, 313497) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

Last Updated: Apr 24, 2023