Children Who Have Dental Decay or Cavities
| Measure Information | 2024 Performance Period |
|---|---|
| CMS eCQM ID | CMS75v12 |
| NQF Number | Not Applicable |
| MIPS Quality ID | 378 |
| Description |
Percentage of children, 1 - 20 years of age at the start of the measurement period, who have had tooth decay or cavities during the measurement period as determined by a dentist |
| Definition |
None |
| Initial Population |
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 |
| Numerator |
Children who had a diagnosis of cavities or decayed teeth in any part of the measurement period |
| Numerator Exclusions |
Not Applicable |
| Denominator |
Equals Initial Population |
| Denominator Exclusions |
Exclude patients who are in hospice care for any part of the measurement period |
| Denominator Exceptions |
None |
| Steward | Centers for Medicare & Medicaid Services (CMS) |
| Measure Scoring | Proportion measure |
| Measure Type | Outcome measure |
| Improvement Notation |
A lower score indicates better quality |
| Guidance |
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. |
| Telehealth Eligible | No |
| Rationale |
Dental caries is the most chronic disease among youth aged 6-19 years. Data from the National Health and Nutrition Examination Survey from 2015-2016 showed that approximately 45.8% of children and youth aged 2-19 years had total caries (untreated and treated). Prevalence of total dental caries (untreated and treated) in primary or permanent teeth increases with age, going from 21.4%, 50.5%, and 53.8% among ages 2-5, 6-11, and 12-19, respectively. Total dental caries was highest in Hispanic youths aged 2-19 at 57.1% compared to 48.1% for non-Hispanic black, 44.6% for non-Asian, and 40.4% for non-Hispanic white youth. Monitoring prevalence of untreated and total caries is vital to preventing and controlling oral disease (Fleming & Afful, 2018). Children who have dental decay or cavities are less likely to be in very good or excellent overall health than children without decay or cavities (Edelstein & Chinn, 2009). Children with decay are also more likely to have other oral health problems such as toothaches, broken teeth, and bleeding gums (Data Resource Center for Child and Adolescent Health, 2007). |
| Stratification |
None |
| Risk Adjustment |
None |
| Clinical Recommendation |
This is an outcome measure. As such, no clinical recommendations are included. |
| Next Version | No Version Available |
| Previous Version |
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| Measure Information | 2021 Performance Period | 2022 Performance Period | 2023 Performance Period | 2024 Performance Period |
|---|---|---|---|---|
| Title | Children Who Have Dental Decay or Cavities | Children Who Have Dental Decay or Cavities | Children Who Have Dental Decay or Cavities | Children Who Have Dental Decay or Cavities |
| CMS eCQM ID | CMS75v9 | CMS75v10 | CMS75v11 | CMS75v12 |
| NQF Number | Not Applicable | Not Applicable | Not Applicable | Not Applicable |
| Description |
Percentage of children, 6 months - 20 years of age, who have had tooth decay or cavities during the measurement period |
Percentage of children, 6 months - 20 years of age at the start of the measurement period, who have had tooth decay or cavities during the measurement period |
Percentage of children, 6 months - 20 years of age at the start of the measurement period, who have had tooth decay or cavities during the measurement period as determined by a dentist |
Percentage of children, 1 - 20 years of age at the start of the measurement period, who have had tooth decay or cavities during the measurement period as determined by a dentist |
| Initial Population |
Children, 6 months - 20 years of age, with a clinical oral evaluation during the measurement period |
Children, 6 months - 20 years of age, with a clinical oral evaluation 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 |
| 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 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 had a diagnosis of cavities or decayed teeth overlapping the measurement period |
Children who had a diagnosis of cavities or decayed teeth in any part of the measurement period |
Children who had a diagnosis of cavities or decayed teeth in any part of the measurement period |
Children who had a diagnosis of cavities or decayed teeth in any part of the measurement period |
| Numerator Exclusions |
Not applicable |
Not applicable |
Not Applicable |
Not Applicable |
| Denominator Exceptions |
None |
None |
None |
None |
| 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) |
| Measure Scoring | Proportion measure | Proportion measure | Proportion measure | Proportion measure |
| Measure Type | Outcome measure | Outcome measure | Outcome measure | Outcome measure |
| Improvement Notation |
A lower score indicates better quality |
A lower score indicates better quality |
A lower score indicates better quality |
A lower score indicates better quality |
| 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 5.5. 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. |
| MIPS Quality ID | 378 | 378 | 378 | 378 |
| Telehealth Eligible | No | No | No | No |
| Next Version | CMS75v10 | CMS75v11 | CMS75v12 | No Version Available |
| Previous Version | No Version Available | |||
| Notes |
Data Element Repository
Header
Revised the age range from 6 months-20 years old to 1-20 years old to align with existing dental measures, such as those in the Medicaid Child Core set.
Measure Section: Description
Source of Change: Measure Lead
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
Revised the age range from 6 months-20 years old to 1-20 years old to align with existing dental measures, such as those in the Medicaid Child Core set.
Measure Section: Initial Population
Source of Change: Measure Lead
Logic
Revised the age range from 6 months-20 years old to 1-20 years old to align with existing dental measures, such as those in the Medicaid Child Core set.
Measure Section: Initial Population
Source of Change: Measure Lead
Added 'day of' specificity to hospice expressions for consistency.
Measure Section: Definitions
Source of Change: Measure Lead
Added QDM datatype 'Diagnosis' to the Hospice.'Has Hospice Services' definition referencing a new value set containing SNOMED finding codes to provide an additional approach for identifying patients receiving hospice care.
Measure Section: Definitions
Source of Change: Measure Lead
Updated the version number of the Hospice Library to v5.0.000.
Measure Section: Definitions
Source of Change: Annual Update
Updated the version number of the Hospice Library to v5.0.000.
Measure Section: Functions
Source of Change: Annual 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 Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584): Deleted 3 SNOMED CT codes (170935008, 170936009, 305911006) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Hospice Diagnosis (2.16.840.1.113883.3.464.1003.1165) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Hospice Encounter (2.16.840.1.113883.3.464.1003.1003): Added 2 SNOMED CT codes (305911006, 385765002) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Payer (2.16.840.1.114222.4.11.3591): Added 5 SOP codes (1111, 1112, 142, 344, 141) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead