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Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

Compare Versions of: "Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)"

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Measure Information 2022 Performance Period 2023 Performance Period 2024 Performance Period 2025 Performance Period
Title Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD) Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD) Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD) Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS eCQM ID CMS135v10 CMS135v11 CMS135v12 CMS135v13
CBE ID* 0081e 0081e 0081e 0081e
MIPS Quality ID 005 005 005 005
Measure Steward American Heart Association-American Stroke Association American Heart Association American Heart Association American Heart Association
Description

Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed ACE inhibitor or ARB or ARNI therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge

Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) <=40% who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period

Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) =40% who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period

Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) <=40% who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period

Measure Scoring Proportion measure Proportion measure Proportion measure Proportion measure
Measure Type Process Process Process Process
Stratification *See CMS135v10.html *See CMS135v11.html

None

None

Risk Adjustment *See CMS135v10.html *See CMS135v11.html

None

None

Rationale *See CMS135v10.html *See CMS135v11.html

Use of ACE inhibitor, ARB, or ARNI therapy has been associated with improved outcomes in patients with reduced LVEF. Long-term therapy with ARBs have also been shown to reduce morbidity and mortality, especially in ACE inhibitor–intolerant patients. More recently, ARNI therapy has also been shown to more significantly improve outcomes, such that the newest guidelines recommend replacement of ACE inhibitors or ARBs with ARNI therapy in eligible patients. However, despite the benefits of these drugs, use of ACE inhibitor, ARB, or ARNI remains suboptimal.

Use of ACE inhibitor, ARB, or ARNI therapy has been associated with improved outcomes in patients with reduced LVEF. Long-term therapy with ARBs have also been shown to reduce morbidity and mortality, especially in ACE inhibitor–intolerant patients. More recently, ARNI therapy has also been shown to more significantly improve outcomes, such that the newest guidelines recommend replacement of ACE inhibitors or ARBs with ARNI therapy in eligible patients. However, despite the benefits of these drugs, use of ACE inhibitor, ARB, or ARNI remains suboptimal.

Clinical Recommendation Statement *See CMS135v10.html *See CMS135v11.html

In patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and New York Heart Association (NYHA) class II to III symptoms, the use of ARNI is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (ACC/AHA/HFSA, 2022).

In patients with previous or current symptoms of chronic HFrEF, the use of ACEi is beneficial to reduce morbidity and mortality when the use of ARNI is not feasible (Class I, Level of Evidence A) (ACC/AHA/HFSA, 2022).

In patients with previous or current symptoms of chronic HFrEF who are intolerant to ACEi because of cough or angioedema and when the use of ARNI is not feasible, the use of ARB is recommended to reduce morbidity and mortality. (Class I, Level of Evidence A) (ACC/AHA/HFSA, 2022).

In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEi or ARB, replacement by an ARNI is recommended to further reduce morbidity and mortality (Class I, Level of Evidence B-R) (ACC/AHA/HFSA, 2022).

ARNI should not be administered concomitantly with ACEi or within 36 hours of the last dose of an ACEi (Class II: Harm, Level of Evidence B-R) (ACC/AHA/HFSA, 2022).

ARNI should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (ACC/AHA/HFSA, 2022).

ACEi should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (ACC/AHA/HFSA, 2022).

Drugs Commonly Used for Stage C HFrEF (abbreviated to align with focus of measure to include only ACE inhibitors, ARB and ARNI therapy)

Drug Initial Daily Dose(s) Target Dose(s) Mean Doses Achieved in

Clinical Trials

ACEi

Captopril 6.25 mg 3 times 50 mg 3 times 122.7 mg total daily

Enalapril 2.5 mg twice 10 to 20 mg twice 16.6 mg total daily

Fosinopril 5 to 10 mg once 40 mg once N/A

Lisinopril 2.5 to 5 mg once 20 to 40 mg once 32.5 to 35.0 mg total daily

Perindopril 2 mg once 8 to 16 mg once N/A

Quinapril 5 mg twice 20 mg twice N/A

Ramipril 1.25 to 2.5 mg once 10 mg once N/A

Trandolapril 1 mg once 4 mg once N/A

ARB

Candesartan 4 to 8 mg once 32 mg once 24 mg total daily

Losartan 25 to 50 mg once 50 to 150 mg once 129 mg total daily

Valsartan 20 to 40 mg twice 160 mg twice 254 mg total daily

ARNI

Sacubitril- 49/51 mg twice 97/103 mg twice 182/193 mg

valsartan (sacubitril/valsartan) (sacubitril/valsartan) (sacubitril/valsartan) total

(therapy may be initiated daily

at 24/26 mg twice)

In patients with Heart Failure with Reduced Ejection Fraction (HFrEF) and New York Heart Association (NYHA) class II to III symptoms, the use of ARNI is recommended to reduce morbidity and mortality (Class I, Level of Evidence A) (Heidenreich et al., 2022).

In patients with previous or current symptoms of chronic HFrEF, the use of angiotension-converting enzyme inhibitors (ACEi) is beneficial to reduce morbidity and mortality when the use of ARNI is not feasible (Class I, Level of Evidence A) (Heidenreich et al., 2022).

In patients with previous or current symptoms of chronic HFrEF who are intolerant to ACEi because of cough or angioedema and when the use of ARNI is not feasible, the use of ARB is recommended to reduce morbidity and mortality. (Class I, Level of Evidence A) (Heidenreich et al., 2022).

In patients with chronic symptomatic HFrEF NYHA class II or III who tolerate an ACEi or ARB, replacement by an ARNI is recommended to further reduce morbidity and mortality (Class I, Level of Evidence B-R) (Heidenreich et al., 2022).

ARNI should not be administered concomitantly with ACEi or within 36 hours of the last dose of an ACEi (Class II: Harm, Level of Evidence B-R) (Heidenreich et al., 2022).

ARNI should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022).

ACEi should not be administered to patients with any history of angioedema (Class III: Harm, Level of Evidence C-LD) (Heidenreich et al., 2022).

Drugs Commonly Used for Stage C HFrEF (abbreviated to align with focus of measure to include only ACE inhibitors, ARB and ARNI therapy)

Drug Initial Daily Dose(s) Target Dose(s) Mean Doses Achieved in

Clinical Trials

ACEi

Captopril 6.25 mg 3 times 50 mg 3 times 122.7 mg total daily

Enalapril 2.5 mg twice 10 to 20 mg twice 16.6 mg total daily

Fosinopril 5 to 10 mg once 40 mg once N/A

Lisinopril 2.5 to 5 mg once 20 to 40 mg once 32.5 to 35.0 mg total daily

Perindopril 2 mg once 8 to 16 mg once N/A

Quinapril 5 mg twice 20 mg twice N/A

Ramipril 1.25 to 2.5 mg once 10 mg once N/A

Trandolapril 1 mg once 4 mg once N/A

ARB

Candesartan 4 to 8 mg once 32 mg once 24 mg total daily

Losartan 25 to 50 mg once 50 to 150 mg once 129 mg total daily

Valsartan 20 to 40 mg twice 160 mg twice 254 mg total daily

ARNI

Sacubitril- 49/51 mg twice 97/103 mg twice 182/193 mg

valsartan (sacubitril/valsartan) (sacubitril/valsartan) (sacubitril/valsartan) total

(therapy may be initiated daily

at 24/26 mg twice)

Improvement Notation

Higher score indicates better quality

Higher score indicates better quality

Higher score indicates better quality

Higher score indicates better quality

Definition *See CMS135v10.html *See CMS135v11.html

Prescribed - prescription given to the patient for ACE inhibitor or ARB or ARNI therapy at one or more visits in the measurement period OR patient already taking ACE inhibitor or ARB or ARNI therapy as documented in current medication list.

LVEF <=40% corresponds to qualitative documentation of moderate dysfunction or severe dysfunction (LVSD). The LVSD may be determined by quantitative or qualitative assessment, which may be current or historical. Examples of a quantitative or qualitative assessment may include an echocardiogram:

1) that provides a numerical value of LVSD or 2) that uses descriptive terms such as moderately or severely depressed left ventricular systolic function. Any current or prior ejection fraction study documenting LVSD can be used to identify patients.

Prescribed - prescription given to the patient for ACE inhibitor or ARB or ARNI therapy at one or more visits in the measurement period OR patient already taking ACE inhibitor or ARB or ARNI therapy as documented in current medication list.

LVEF <=40% corresponds to qualitative documentation of moderate dysfunction or severe dysfunction (LVSD). The LVSD may be determined by quantitative or qualitative assessment, which may be current or historical. Examples of a quantitative or qualitative assessment may include an echocardiogram:

1) that provides a numerical value of LVSD or 2) that uses descriptive terms such as moderately or severely depressed left ventricular systolic function. Any current or prior ejection fraction study documenting LVSD can be used to identify patients.

Guidance

This eCQM is to be reported as patient-based or episode-based, depending on the clinical setting. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period if seen in the outpatient setting. If the patient has an eligible inpatient discharge during the measurement period, as defined in the measure logic, it is expected to be reported at each hospital discharge.

The requirement of two or more visits used in Population Criteria 1 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.

Eligible clinicians who have given a prescription for or whose patient is already taking an Angiotensin-Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) would meet performance for this measure. Other combination therapies that consist of an ACEI plus diuretic, ARB + neprilysin inhibitor (ARNI), ARB plus diuretic, ACEI plus calcium channel blocker, ARB plus calcium channel blocker, or ARB plus calcium channel blocker plus diuretic would also meet performance for this 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 to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period if seen in the outpatient setting.

The requirement of two or more visits is used 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.

Eligible clinicians who have given a prescription for or whose patient is already taking an Angiotensin-Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) would meet performance for this measure. Other combination therapies that consist of an ACEI plus diuretic, ARB + neprilysin inhibitor (ARNI), ARB plus diuretic, ACEI plus calcium channel blocker, ARB plus calcium channel blocker, or ARB plus calcium channel blocker plus diuretic would also meet performance for this measure.

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 to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period.

The requirement of two or more visits is used 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."

Eligible clinicians who have given a prescription for or whose patient is already taking an Angiotensin-Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) would meet performance for this measure. Other combination therapies that consist of an ACEI plus diuretic, ARB + neprilysin inhibitor (ARNI), ARB plus diuretic, ACEI plus calcium channel blocker, ARB plus calcium channel blocker, or ARB plus calcium channel blocker plus diuretic would also meet performance for this measure.

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 to be reported as patient-based. To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period.

The requirement of two or more visits is used to establish that the 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."

Eligible clinicians who have given a prescription for or whose patient is already taking an Angiotensin-Converting Enzyme Inhibitor (ACEI) or Angiotensin Receptor Blocker (ARB) would meet performance for this measure. Other combination therapies that consist of an ACEI plus diuretic, ARB + neprilysin inhibitor (ARNI), ARB plus diuretic, ACEI plus calcium channel blocker, ARB plus calcium channel blocker, or ARB plus calcium channel blocker plus diuretic would also meet performance for this measure.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

Initial Population

All patients aged 18 years and older with a diagnosis of heart failure

All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure

All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure

All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure on or before at least one qualifying encounter

Denominator

Equals Initial Population with a current or prior LVEF < 40%

Equals Initial Population with a current or prior LVEF <= 40%

Equals Initial Population with a current or prior LVEF <= 40%

Equals Initial Population with a current or prior LVEF <= 40%

Denominator Exclusions

None

Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD

Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD

Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD

Numerator

Patients who were prescribed ACE inhibitor or ARB or ARNI therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge

Patients who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period

Patients who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period

Patients who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period

Numerator Exclusions

Not Applicable

Not Applicable

Not Applicable

Not Applicable

Denominator Exceptions

Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., hypotensive patients who are at immediate risk of cardiogenic shock, hospitalized patients who have experienced marked azotemia, allergy, intolerance, other medical reasons).

Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).

Documentation of system reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., other system reasons).

Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons).

Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).

Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons).

Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).

Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons).

Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).

Telehealth Eligible Yes Yes Yes Yes
Next Version No Version Available
Previous Version No Version Available
Specifications
Attachment Size
CMS135v13.html 86.68 KB
CMS135v13.zip 87.39 KB
CMS135v13-TRN.xlsx 22.27 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

  • Updated copyright.

    Measure Section:

    Copyright

    Source of Change:

    Annual Update

  • Updated disclaimer.

    Measure Section:

    Disclaimer

    Source of Change:

    Annual Update

  • Updated Guidance to remove any instances of 'Eligible Professional(s)' to align with other eCQMs.

    Measure Section:

    Guidance

    Source of Change:

    Measure Lead

  • 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

  • Updated the version number of the HFCommonDefinitions library to v3.0.000 and the library name from 'HFCommonDefinitions' to 'HFCommonDefinitionsQDM.'

    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

  • 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 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

  • Updated the version number of the HFCommonDefinitions library to v3.0.000 and the library name from 'HFCommonDefinitions' to 'HFCommonDefinitionsQDM.'

    Measure Section:

    Functions

    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 Allergy to ACE Inhibitor or ARB (2.16.840.1.113883.3.526.3.1211): Added 2 SNOMED CT codes (18321000122100, 18361000122109) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Care Services in Long Term Residential Facility (2.16.840.1.113883.3.464.1003.101.12.1014): Deleted 9 CPT codes (99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Heart Transplant Complications (2.16.840.1.113762.1.4.1178.56): Added 1 SNOMED CT code (12224461000119108) based on terminology update.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

  • Value set Home Healthcare Services (2.16.840.1.113883.3.464.1003.101.12.1016): Deleted 1 CPT code (99343) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Intolerance to ACE Inhibitor or ARB (2.16.840.1.113883.3.526.3.1212): Added 7 SNOMED CT codes (720672008, 720673003, 720674009, 720675005, 720676006, 720677002, 720678007) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Nursing Facility Visit (2.16.840.1.113883.3.464.1003.101.12.1012): Deleted 1 CPT code (99318) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001): Deleted 2 SNOMED CT codes (30346009, 37894004) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 CPT code (99201) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008): Deleted 1 CPT code (99241) 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

  • Value set Pregnancy (2.16.840.1.113883.3.526.3.378): Added 1 SNOMED CT code (169560008) based on applicability of value set and/or OID. Added 1 SNOMED CT code (567941000005109) based on terminology update. Deleted 1 SNOMED CT code (199064003) based on terminology update. Added 4 ICD-10-CM codes (O26.641, O26.642, O26.643, O26.649) based on terminology update. Added 1 ICD-10-CM code (Z32.01) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

Last Updated: Jun 03, 2024