Primary Caries Prevention Intervention as Offered by Dentists
Compare Versions of: "Primary Caries Prevention Intervention as Offered by Dentists"
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| Measure Information | 2022 Performance Period | 2023 Performance Period | 2024 Performance Period | 2025 Performance Period |
|---|---|---|---|---|
| Title | Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists | Primary Caries Prevention Intervention as Offered by Dentists | Primary Caries Prevention Intervention as Offered by Dentists | Primary Caries Prevention Intervention as Offered by Dentists |
| CMS eCQM ID | CMS74v11 | CMS74v12 | CMS74v13 | CMS74v14 |
| CBE ID* | Not Applicable | Not Applicable | Not Applicable | Not Applicable |
| MIPS Quality ID | 379 | 379 | 379 | 379 |
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) | Centers for Medicare & Medicaid Services (CMS) | Centers for Medicare & Medicaid Services (CMS) | Centers for Medicare & Medicaid Services (CMS) |
| Description |
Percentage of children, 6 months - 20 years of age, who received a fluoride varnish application during the measurement period |
Percentage of children, 6 months - 20 years of age, who received a fluoride varnish application during the measurement period as determined by a dentist |
Percentage of children, 1 - 20 years of age, who received two fluoride varnish applications during the measurement period as determined by a dentist |
Percentage of children, 1-20 years of age, who received two fluoride varnish applications during the measurement period as determined by a dentist |
| Measure Scoring | Proportion measure | Proportion measure | Proportion measure | Proportion measure |
| Measure Type | Process | Process | Process | Process |
| Stratification | *See CMS74v11.html | *See CMS74v12.html |
Population 1: Patients age 1-5 years at the start of the Measurement Period Population 2: Patients age 6-12 years at the start of the Measurement Period Population 3: Patients age 13-20 years at the start of the Measurement Period |
Population 1: Patients age 1-5 years at the start of the Measurement Period Population 2: Patients age 6-12 years at the start of the Measurement Period Population 3: Patients age 13-20 years at the start of the Measurement Period |
| Risk Adjustment | *See CMS74v11.html | *See CMS74v12.html |
None |
None |
| Rationale | *See CMS74v11.html | *See CMS74v12.html |
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 (Weyant et al., 2013). Evidence in the literature also specifically supports the effectiveness of professionally applied fluoride varnish at preventing caries in higher risk children (Chou et al., 2014). |
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 (Weyant et al., 2013). Evidence in the literature also specifically supports the effectiveness of professionally applied fluoride varnish at preventing caries in higher risk children (Chou et al., 2014). |
| Clinical Recommendation Statement | *See CMS74v11.html | *See CMS74v12.html |
The 2013 American Dental Association (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 United States Preventive Services Taskforce (USPSTF) recommends the use of professionally applied fluoride varnish for the prevention of dental caries in high risk children under 5 years of age (Chou et al., 2014). |
The 2013 American Dental Association (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 United States Preventive Services Taskforce (USPSTF) recommends the use of professionally applied fluoride varnish for the prevention of dental caries in high risk children under 5 years of age (Chou et al., 2014). |
| Improvement Notation |
A higher score indicates better quality |
A higher score indicates better quality |
A higher score indicates better quality |
A higher score indicates better quality |
| Definition | *See CMS74v11.html | *See CMS74v12.html |
None |
None |
| 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 for more information on the QDM. |
This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
| Initial Population |
Children, 6 months - 20 years of age, with a visit during the measurement period |
Children, 6 months - 20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period |
Children, 1 - 20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period |
Children, 1-20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period |
| Denominator |
Equals Initial Population |
Equals Initial Population |
Equals Initial Population |
Equals Initial Population |
| Denominator Exclusions |
Exclude patients who are in hospice care for any part of the measurement period. |
Exclude patients who are in hospice care for any part of the measurement period |
Exclude patients who are in hospice care for any part of the measurement period |
Exclude patients who are in hospice care for any part of the measurement period |
| Numerator |
Children who receive a fluoride varnish application during the measurement period |
Children who receive a fluoride varnish application during the measurement period |
Children who receive two fluoride varnish applications on different days during the measurement period |
Children who receive two fluoride varnish applications on different days during the measurement period |
| Numerator Exclusions |
Not Applicable |
Not Applicable |
Not Applicable |
Not Applicable |
| Denominator Exceptions |
None |
None |
None |
None |
| Telehealth Eligible | Yes | No | No | No |
| Next Version | No Version Available | |||
| Previous Version | No Version Available |
Additional Resources for CMS74v12
Header
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
Revised the stratification language in the header to better align with the logic and measure intent.
Measure Section: Stratification
Source of Change: Measure Lead
Updated the clinical recommendation statement based on the most recent findings from published literature and guidelines.
Measure Section: Clinical Recommendation Statement
Source of Change: Measure Lead
Updated references.
Measure Section: Reference
Source of Change: Measure Lead
Updated version number of the Quality Data Model (QDM) used in the measure specification to v5.6.
Measure Section: Guidance
Source of Change: Standards/Technical Update
Updated the header to explicitly state that the age criteria should be at the start of the measurement period to provide additional clarity.
Measure Section: Initial Population
Source of Change: Measure Lead
Revised the description and initial population statements to align with revisions to limit the measure reporting to dentists only.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Removed references to 'Primary Care Providers' in the measure title and header to clarify that this measure is to be reported by dentists.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Updated grammar and punctuation to improve readability.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Logic
Updated the logic to limit the eligible encounter for the denominator to the clinical oral evaluation value set, applicable to dentists only.
Measure Section: Definitions
Source of Change: Measure Lead
Added QDM datatypes Encounter, Performed and Assessment, Performed and associated logic to the Hospice.'Has Hospice Services' definition to provide additional approaches for identifying patients receiving hospice services.
Measure Section: Definitions
Source of Change: Measure Lead
Updated the version of the Quality Data Model (QDM) to 5.6 and Clinical Quality Language (CQL) to 1.5.
Measure Section: Multiple Sections
Source of Change: Standards/Technical Update
Updated the version number of the Hospice Library to v4.0.000.
Measure Section: Multiple Sections
Source of Change: Measure Lead
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/Technical Update
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v7.0.000.
Measure Section: Multiple Sections
Source of Change: Standards/Technical Update
Updated the stratification logic, to use closed brackets to capture the age intervals, and to better align with the measure header.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Updated the timing precision in the definitions from datetime to date by adding 'day of', 'date from', and/or function 'ToDateInterval' to align with the measure intent.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Refined the logic to update use of parentheses for added clarity.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Updated the age criteria in the logic to include patients who are 20 years of age at the start of the measurement period to align with the measure intent.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Replaced the Global.CalendarAgeInYearsAt function with the native CQL function AgeInYearsAt to take advantage of existing CQL features and increase human readability. As a result of this change, the LOINC code 21112-8 is no longer required and has been removed from the Terminology section of the human readable specification.
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.
Added direct reference code LOINC code (45755-6) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed direct reference code LOINC code (21112-8) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Fluoride Varnish Application for Children (2.16.840.1.113883.3.464.1003.125.12.1002): Deleted 1 CPT code (99188) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Preventive Care Services-Initial Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1023) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Preventive Care Services - Established Office Visit, 18 and Up (2.16.840.1.113883.3.464.1003.101.12.1025) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Telephone Visits (2.16.840.1.113883.3.464.1003.101.12.1080) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Online Assessments (2.16.840.1.113883.3.464.1003.101.12.1089) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Preventive Care Services, Initial Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1022) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Hospice Encounter (2.16.840.1.113883.3.464.1003.1003) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Replaced value set Hospice Care Ambulatory (2.16.840.1.113762.1.4.1108.15) with value set Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Preventive Care, Established Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1024) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Added direct reference code SNOMED CT code (373066001) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead