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Children Who Have Dental Decay or Cavities

Compare Versions of: "Children Who Have Dental Decay or Cavities"

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.

Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.

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Measure Information 2022 Performance Period 2023 Performance Period 2024 Performance Period 2025 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 CMS75v10 CMS75v11 CMS75v12 CMS75v13
CBE ID* Not Applicable Not Applicable Not Applicable Not Applicable
MIPS Quality ID 378 378 378 378
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 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

Percentage of children, 1-20 years of age at the start of the measurement period, who have had dental decay or cavities during the measurement period as determined by a dentist

Measure Scoring Proportion measure Proportion measure Proportion measure Proportion measure
Measure Type Outcome Outcome Outcome Outcome
Stratification *See CMS75v10.html *See CMS75v11.html

None

None

Risk Adjustment *See CMS75v10.html *See CMS75v11.html

None

None

Rationale *See CMS75v10.html *See CMS75v11.html

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).

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 percent 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 percent, 50.5 percent, and 53.8 percent among ages 2-5, 6-11, and 12-19, respectively. Total dental caries was highest in Hispanic youths aged 2-19 at 57.1 percent compared to 48.1 percent for non-Hispanic black, 44.6 percent for non-Asian, and 40.4 percent 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).

Clinical Recommendation Statement *See CMS75v10.html *See CMS75v11.html

This is an outcome measure. As such, no clinical recommendations are included.

The American Academy of Pediatric Dentistry (AAPD) provides clinical recommendations for pediatric oral health assessments and preventative services (AAPD, 2023). The recommendation states that the first clinical oral examination should occur around 12 months of age. The clinical oral exam should be repeated every 6 months or as indicated by the child’s risk status or susceptibility to disease. Further, caries risk assessment must be repeated regularly and frequently to maximize effectiveness.

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

Definition *See CMS75v10.html *See CMS75v11.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 5.5. 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 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

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 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

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

Telehealth Eligible No No No No
Next Version No Version Available
Previous Version No Version Available
Specifications
Attachment Size
CMS75v13.html 55.8 KB
CMS75v13.zip 65.87 KB
CMS75v13-TRN.xlsx 21.07 KB
eCQM Jira Issue Tracker
*Note there may be more tickets in the eCQM Tracker - ONC Project Tracking System (Jira) for this measure. Only tickets tagged with their associated CMS measure ID appear.

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

  • Replaced 'tooth decay' with 'dental decay' to align with the measure title.

    Measure Section:

    Description

    Source of Change:

    Measure Lead

  • 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

  • Updated references and measure header to reflect current evidence and new or updated literature.

    Measure Section:

    Multiple Sections

    Source of Change:

    Measure Lead

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 Dental Caries (2.16.840.1.113883.3.464.1003.125.12.1004): Deleted 1 SNOMED CT code (163152009) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • 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

Last Updated: Jun 03, 2024