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Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF) less than or equal to 40%

Compare Versions of: "Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF) less than or equal to 40%"

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Measure Information 2022 Performance Period 2023 Performance Period 2024 Performance Period
Title Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF less than 40%) Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF less than or equal to 40%) Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF) less than or equal to 40%
CMS eCQM ID CMS145v10 CMS145v11 CMS145v12
NQF Number 0070e 0070e 0070e
Description

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior LVEF < 40% who were prescribed beta-blocker therapy

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior LVEF <=40% who were prescribed beta-blocker therapy

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior LVEF <=40% who were prescribed beta-blocker therapy

Initial Population

All patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period

All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of coronary artery disease

All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of coronary artery disease

Denominator

Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <40%

Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <=40%

Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <=40%

Denominator Exclusions None None None
Numerator

Patients who were prescribed beta-blocker therapy

Patients who were prescribed beta-blocker therapy

Patients who were prescribed beta-blocker therapy

Numerator Exclusions

Not Applicable

Not Applicable

Not Applicable

Denominator Exceptions

Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., allergy, intolerance, other medical reasons).

Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).

Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the health care system).

Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons).

Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).

Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the health care system).

Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons).

Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).

Measure Steward American Heart Association-American Stroke Association American Heart Association American Heart Association
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

Beta-blocker therapy:

- For patients with prior MI, beta-blocker therapy includes any agent within the beta-blocker drug class. As of 2015, no recommendations or evidence are cited in current stable ischemic heart disease guidelines for preferential use of specific agents

- For patients with prior LVEF <40%, beta-blocker therapy includes the following: bisoprolol, carvedilol, or sustained release metoprolol succinate

The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient.

A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than 40% threshold noted in the denominator logic. A range that is inclusive of or greater than 40% would not meet the measure requirement.

If a patient has had a myocardial infarction (MI) within the past 3 years and a current or prior LVEF < 40% (or moderate or severe LVSD), the patient should only be counted in Population Criteria 1.

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.

Beta-blocker therapy:

- For patients with prior MI, beta-blocker therapy includes any agent within the beta-blocker drug class. As of 2015, no recommendations or evidence are cited in current stable ischemic heart disease guidelines for preferential use of specific agents

- For patients with prior LVEF <=40%, beta-blocker therapy includes the following: bisoprolol, carvedilol, or sustained release metoprolol succinate

The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient.

A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.

If a patient has had a myocardial infarction (MI) within the past 3 years and a current or prior LVEF <=40% (or moderate or severe LVSD), the patient should only be counted in Population Criteria 1.

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.

Beta-blocker therapy:

- For patients with prior MI, beta-blocker therapy includes any agent within the beta-blocker drug class. As of 2015, no recommendations or evidence are cited in current stable ischemic heart disease guidelines for preferential use of specific agents

- For patients with prior LVEF <=40%, beta-blocker therapy includes the following: bisoprolol, carvedilol, or sustained release metoprolol succinate

The requirement of two or more visits is to establish that the eligible professional or eligible clinician has an existing relationship with the patient.

A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than or equal to 40% threshold noted in the denominator logic. A range that is greater than 40% would not meet the measure requirement.

In order for the Ejection Fraction result pathway to be recognized as below 40%, the result must be reported as a number with unit of %. A text string of "below 40%" or "ejection fraction between 35 and 40%" will not be recognized through electronic data capture. Although, this criteria can also be met using the Diagnosis pathway if specified as "Moderate or Severe."

If a patient has had a myocardial infarction (MI) within the past 3 years and a current or prior LVEF <=40% (or moderate or severe LVSD), the patient should only be counted in Population Criteria 1.

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 007 007 007
Telehealth Eligible Yes Yes Yes
Next Version No Version Available
Previous Version No Version Available
Notes

*There is a known issue on CMS145v10. See issue EKI-12 on the ONC eCQM Known Issues Dashboard for details.

Header

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated disclaimer.

    Measure Section: Disclaimer

    Source of Change: Annual Update

  • Added guidance to clarify the options for capturing Ejection Fraction results to meet measure requirements.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Removed the system reason denominator exception due to wide-availability of medications.

    Measure Section: Denominator Exceptions

    Source of Change: Measure Lead

Logic

  • Updated Initial Population logic to ensure two distinct encounters are captured to satisfy the two qualifying encounters requirement and better align with measure intent.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Removed the system reason denominator exception due to wide-availability of medications.

    Measure Section: Denominator Exceptions

    Source of Change: Measure Lead

  • Added 'day of' specificity to definitions to harmonize with other measures and to align with the CQL Style Guide.

    Measure Section: Definitions

    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: Definitions

    Source of Change: Standards/Technical 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 Arrhythmia (2.16.840.1.113883.3.526.3.366): Added 2 SNOMED CT codes (1208832006, 1220643007) based on terminology update. Deleted 2 SNOMED CT codes (17338001, 251178007) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Beta Blocker Therapy (2.16.840.1.113883.3.526.3.1174): Added 1 RxNorm code (2598343) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Cardiac Pacer (2.16.840.1.113762.1.4.1178.53): Added 12 CPT codes based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Cardiac Pacer in Situ (2.16.840.1.113883.3.526.3.368): Added 3 SNOMED CT codes (441769002, 703396000, 86041000119107) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Cardiac Surgery (2.16.840.1.113883.3.526.3.371): Added 12 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback. Added 38 SNOMED CT codes based on terminology update.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Coronary Artery Disease No MI (2.16.840.1.113883.3.526.3.369): Added 9 ICD-10-CM codes (I20.2, I25.112, I25.702, I25.712, I25.722, I25.732, I25.752, I25.762, I25.792) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Hypotension (2.16.840.1.113883.3.526.3.370): Added 4 ICD-10-CM codes (O26.50, O26.51, O26.52, O26.53) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Intolerance to Beta Blocker Therapy (2.16.840.1.113883.3.526.3.1178): Added 1 SNOMED CT code (772020009) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Myocardial Infarction (2.16.840.1.113883.3.526.3.403): Added 6 SNOMED CT codes (1163440003, 1204151009, 1204152002, 1204154001, 1204155000, 1204222000) based on terminology update. Deleted 6 ICD-10-CM codes (I21.A1, I22.0, I22.1, I22.2, I22.8, I22.9) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Patient Reason (2.16.840.1.113883.3.526.3.1008): Deleted 3 SNOMED CT codes (183944003, 413310006, 413312003) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • 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

  • Removed value set System Reason (2.16.840.1.113883.3.526.3.1009) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: Jan 22, 2024