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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%"

The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.

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Table Options
Measure Information 2024 Performance Period
Title 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 CMS145v12
CBE ID* 0070e
MIPS Quality ID 007
Measure Steward American Heart Association
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

Measure Scoring Proportion measure
Measure Type Process
Stratification

None

Risk Adjustment

None

Rationale

For patients with coronary artery disease (CAD), beta-blockers are recommended for 3 years after myocardial infarction or acute coronary syndrome. Beta-blockers, particularly carvedilol, metoprolol succinate, or bisoprolol which have been shown to reduce risk of death, are recommended...

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Clinical Recommendation Statement

Beta-blocker therapy should be started and continued for 3 years in all patients with normal LV function after MI or ACS (Class I, Level of Evidence: B) (ACCF/AHA/ACP/AATS/PCNA/SCAI/STS, 2012).

Beta-blocker therapy should be used in all patients with LV systolic dysfunction (EF <= 40%)...

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Improvement Notation

Higher score indicates better quality

Definition

Prescribed may include prescription given to the patient for beta-blocker therapy at one or more visits in the measurement period OR patient already taking beta-blocker therapy as documented in current medication list.

Prior Myocardial Infarction (MI) for denominator 2 is limited to those...

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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...

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Initial Population

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%

Denominator Exclusions

None

Numerator

Patients who were prescribed beta-blocker therapy

Numerator Exclusions

Not Applicable

Denominator Exceptions

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).

Documentat...

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Telehealth Eligible Yes
Next Version
Previous Version

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: Jun 03, 2024