Primary Caries Prevention Intervention as Offered by Dentists
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| Measure Information | 2023 Performance Period | 2024 Performance Period | 2025 Performance Period |
|---|---|---|---|
| Title | 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 | CMS74v12 | CMS74v13 | CMS74v14 |
| CBE ID* | Not Applicable | Not Applicable | Not Applicable |
| MIPS Quality ID | 379 | 379 | 379 |
| Measure Steward | 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 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 |
| Measure Type | Process | Process | Process |
| Stratification | *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 CMS74v12.html |
None |
None |
| Rationale | *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 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 |
| Definition | *See CMS74v12.html |
None |
None |
| 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. |
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 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 |
| 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 |
| Numerator |
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 |
| Denominator Exceptions |
None |
None |
None |
| Telehealth Eligible | No | No | No |
| Next Version | No Version Available | ||
| Previous Version | No Version Available |
Additional Resources for CMS74v14
Header
Updated the eCQM version number.
Measure Section:
eCQM Version Number
Source of Change:
Annual Update
Changed all references from NQF to CBE to identify the consensus-based entity role.
Measure Section:
CBE Number
Source of Change:
Annual Update
Updated copyright.
Measure Section:
Copyright
Source of Change:
Annual Update
Updated grammar, wording, and/or formatting to improve readability and consistency.
Measure Section:
Multiple Sections
Source of Change:
Annual Update
Logic
Renamed value set to 'Payer Type' to more accurately reflect the contents and intent of the value set.
Measure Section:
Definitions
Source of Change:
Standards/Technical Update
Updated the version number of the Hospice Library to v6.0.000 and the library name from 'Hospice' to 'HospiceQDM.'
Measure Section:
Definitions
Source of Change:
Annual Update
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'
Measure Section:
Definitions
Source of Change:
Annual Update
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'
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): Added 2 SNOMED CT codes (170935008, 170936009) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 SNOMED CT code (385765002) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set (2.16.840.1.114222.4.11.3591): Renamed to Payer Type based on recommended value set naming conventions.
Measure Section:
Terminology
Source of Change:
Annual Update