Back to top
Top
U.S. flag

An official website of the United States government

Dot gov

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Https

Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Compare Versions of: "Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture"

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.

Compare version to

Table Options
Measure Information 2022 Performance Period 2023 Performance Period 2024 Performance Period 2025 Performance Period
Title Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
CMS eCQM ID CMS249v4 CMS249v5 CMS249v6 CMS249v7
CBE ID* 3475e 3475e 3475e 3475e
MIPS Quality ID 472 472 472 472
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 female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Measure Scoring Proportion measure Proportion measure Proportion measure Proportion measure
Measure Type Process Process Process Process
Stratification *See CMS249v4.html *See CMS249v5.html

None

None

Risk Adjustment *See CMS249v4.html *See CMS249v5.html

None

None

Rationale *See CMS249v4.html *See CMS249v5.html

This measure is expected to increase recording of patient risk for fracture data and decrease the amount of inappropriate DXA scans. Current osteoporosis guidelines recommend using bone measurement testing to assess osteoporosis risk in women 65 years and older. In postmenopausal women younger than age 65, guidelines recommend using a formal clinical risk assessment tool to establish a patient's risk for osteoporosis, in order to determine whether to screen a patient for osteoporosis using bone measurement testing. Clinical information, such as age, body mass index (BMI), parental hip fracture history, and alcohol use, can be used to determine a woman's fracture risk (U.S. Preventive Services Task Force [USPSTF], 2018). Additionally, there are potentially avoidable harms associated with screening for osteoporosis in general, including exposure to radiation, false positive exams, and resulting side effects from unnecessary osteoporosis medications, which add costs to an already burdened health care system (Lim, Hoeksema, & Sherin, 2009).

This measure is expected to increase recording of patient risk for fracture data and decrease the amount of inappropriate DXA scans. Current osteoporosis guidelines recommend using bone measurement testing to assess osteoporosis risk in women 65 years and older. In postmenopausal women younger than age 65, guidelines recommend using a formal clinical risk assessment tool to establish a patient's risk for osteoporosis, in order to determine whether to screen a patient for osteoporosis using bone measurement testing. Clinical information, such as age, body mass index (BMI), parental hip fracture history, and alcohol use, can be used to determine a woman's fracture risk (U.S. Preventive Services Task Force [USPSTF], 2018). Additionally, there are potentially avoidable harms associated with screening for osteoporosis in general, including exposure to radiation, false positive exams, and resulting side effects from unnecessary osteoporosis medications, which add costs to an already burdened health care system (Lim, Hoeksema, & Sherin, 2009).

Clinical Recommendation Statement *See CMS249v4.html *See CMS249v5.html

USPSTF:

"The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older." This is a B recommendation.

"The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis to prevent osteoporotic fractures in men." This is an I statement.

"The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool." This is a B recommendation.

"For postmenopausal women younger than 65 years who have at least 1 risk factor, a reasonable approach to determine who should be screened with bone measurement testing is to use a clinical risk assessment tool."

"Several tools are available to assess osteoporosis risk: the Simple Calculated Osteoporosis Risk Estimate (SCORE; Merck), Osteoporosis Risk Assessment Instrument (ORAI), Osteoporosis Index of Risk (OSIRIS), and the Osteoporosis Self-Assessment Tool (OST). These tools seem to perform similarly and are moderately accurate at predicting osteoporosis. The Fracture Risk Assessment (FRAX) tool (University of Sheffield), which assesses a person's 10-year risk of fracture, is also a commonly used tool."

"Because the benefits of treatment are greater in persons at higher risk of fracture, one approach is to perform bone measurement testing in postmenopausal women younger than 65 years who have a 10-year FRAX risk of major osteoporotic fracture (MOF) (without DXA) greater than that of a 65-year-old white woman without major risk factors. For example, in the United States, a 65-year-old white woman of mean height and weight without major risk factors has a 10-year FRAX risk of MOF of 8.4%."

USPSTF 2018:

"The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older." This is a B recommendation.

"The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for osteoporosis to prevent osteoporotic fractures in men." This is an I statement.

"The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in postmenopausal women younger than 65 years who are at increased risk of osteoporosis, as determined by a formal clinical risk assessment tool." This is a B recommendation.

"For postmenopausal women younger than 65 years who have at least 1 risk factor, a reasonable approach to determine who should be screened with bone measurement testing is to use a clinical risk assessment tool."

"Several tools are available to assess osteoporosis risk: the Simple Calculated Osteoporosis Risk Estimate (SCORE; Merck), Osteoporosis Risk Assessment Instrument (ORAI), Osteoporosis Index of Risk (OSIRIS), and the Osteoporosis Self-Assessment Tool (OST). These tools seem to perform similarly and are moderately accurate at predicting osteoporosis. The Fracture Risk Assessment (FRAX) tool (University of Sheffield), which assesses a person's 10-year risk of fracture, is also a commonly used tool."

"Because the benefits of treatment are greater in persons at higher risk of fracture, one approach is to perform bone measurement testing in postmenopausal women younger than 65 years who have a 10-year FRAX risk of major osteoporotic fracture (MOF) (without DXA) greater than that of a 65-year-old white woman without major risk factors. For example, in the United States, a 65-year-old white woman of mean height and weight without major risk factors has a 10-year FRAX risk of MOF of 8.4%."

Improvement Notation

Lower score indicates better quality

Lower score indicates better quality

Lower score indicates better quality

Lower score indicates better quality

Definition *See CMS249v4.html *See CMS249v5.html

The measure allows for clinicians to use 4 tools to assess osteoporosis or osteoporotic fracture risk.

1. The Fracture Risk Assessment Tool (FRAX[R]) is used to calculate 10-year absolute fracture risk. The FRAX evaluates a patient's 10-year probability of hip fracture and major osteoporotic fracture (clinical spine, forearm, hip, or shoulder fracture). It is applicable to people aged 40-90 years.

2. The Osteoporosis Risk Assessment Instrument (ORAI) is used to calculate osteoporosis risk. It is applicable to women >=45 years.

3. The Osteoporosis Index of Risk (OSIRIS) is used to calculate osteoporosis risk. It is applicable to patients of any age.

4. The Osteoporosis Self-Assessment Tool (OST) is used to calculate osteoporosis risk. It is applicable to patients of any age.

The measure allows for clinicians to use 4 tools to assess osteoporosis or osteoporotic fracture risk.

1. The Fracture Risk Assessment Tool (FRAX[R]) is used to calculate 10-year absolute fracture risk. The FRAX evaluates a patient's 10-year probability of hip fracture and major osteoporotic fracture (clinical spine, forearm, hip, or shoulder fracture). It is applicable to people aged 40-90 years.

2. The Osteoporosis Risk Assessment Instrument (ORAI) is used to calculate osteoporosis risk. It is applicable to women >=45 years.

3. The Osteoporosis Index of Risk (OSIRIS) is used to calculate osteoporosis risk. It is applicable to patients of any age.

4. The Osteoporosis Self-Assessment Tool (OST) is used to calculate osteoporosis risk. It is applicable to patients of any age.

Guidance

There are two ways that a patient can be excluded from the measure:

1. The patient has a specific number of "combination" risk factors (the number of risk factors varies by age).

2. The patient has one or more of the "independent" risk factors, including a 10-year probability of major osteoporotic fracture of 8.4 percent or higher as determined by the FRAX.

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.

Patients are excluded from the measure if they have one or more risk factors for osteoporosis, including a result indicating that the patient should be considered for bone density testing on one of the following risk assessment instruments:

• 10-year probability of major osteoporotic fracture of 8.4 percent or higher as determined by the FRAX

• ORAI score of >=9

• OSIRIS score of <1

• OST score of <2

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.

Patients are excluded from the measure if they have one or more risk factors for osteoporosis, including a result indicating that the patient should be considered for bone density testing on one of the following risk assessment instruments:

- 10-year probability of major osteoporotic fracture of 8.4 percent or higher as determined by the FRAX

- ORAI score of >=9

- OSIRIS score of <1

- OST score of <2

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.

Patients are excluded from the measure if they have one or more risk factors for osteoporosis, including a result indicating that the patient should be considered for bone density testing on one of the following risk assessment instruments:

- 10-year probability of major osteoporotic fracture of 8.4 percent or higher as determined by the FRAX

- ORAI score of >=9

- OSIRIS score of <1

- OST score of <2

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.

Initial Population

Female patients ages 50 to 64 years with an encounter during the measurement period

Female patients ages 50 to 63 years at the start of the measurement period with an encounter during the measurement period

Female patients ages 50 to 63 years at the start of the measurement period with an encounter during the measurement period

Female patients ages 50 to 63 years at the start of the measurement period with an encounter during the measurement period

Denominator

Equals Initial Population

Equals Initial Population

Equals Initial Population

Equals Initial Population

Denominator Exclusions

Exclude patients with a combination of risk factors (as determined by age) or one of the independent risk factors

Ages: 50-54 (>=4 combination risk factors) or 1 independent risk factor

Ages: 55-59 (>=3 combination risk factors) or 1 independent risk factor

Ages: 60-64 (>=2 combination risk factors) or 1 independent risk factor

COMBINATION RISK FACTORS [The following risk factors are all combination risk factors; they are grouped by when they occur in relation to the measurement period]:

The following risk factors may occur any time in the patient's history but must be active during the measurement period:

White (race)

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Smoker (current during the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factor may occur any time in the patient's history and must not start during the measurement period:

Osteopenia

The following risk factors may occur at any time in the patient's history or during the measurement period:

Rheumatoid arthritis

Hyperthyroidism

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic liver disease

Chronic malnutrition

Osteoporotic fracture

The following risk factors may occur any time in the patient's history prior to the start of the measurement period but do not need to be active at the start of the measurement period:

Documentation of history of hip fracture in parent

Glucocorticoids [cumulative medication duration >= 90 days]

INDEPENDENT RISK FACTORS (The following risk factors are all independent risk factors; they are grouped by when they occur in relation to the measurement period):

The following risk factors may occur at any time in the patient's history and must not start during the measurement period:

Osteoporosis

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period, but do not need to be active during the measurement period:

Gastric bypass

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent

Aromatase inhibitors

The following risk factors may occur at any time in the patient's history or during the measurement period:

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Exclude patients with one of the following risk factors.

Risk factors are grouped by when they occur in relation to the measurement period.

The following risk factors must be active during the measurement period:

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period:

Osteoporosis

Osteopenia

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period, but do not need to be active during the measurement period:

Gastric bypass

Aromatase inhibitors

Documentation of history of hip fracture in parent

The following risk factors may occur at any time in the patient's history or during the measurement period:

Glucocorticoids [cumulative medication duration >= 90 days]

Osteoporotic fracture

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic malnutrition

Chronic liver disease

Rheumatoid arthritis

Hyperthyroidism

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Chemotherapy

Multiple myeloma

Premature menopause

Double or bilateral oophorectomy

Eating disorder

Amenorrhea

Organ transplant

Exclude patients with one of the following risk factors.

Risk factors are grouped by when they occur in relation to the measurement period.

The following risk factors must be active during the measurement period:

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period:

Osteoporosis

Osteopenia

Gastric bypass

Aromatase inhibitors

Documentation of history of hip fracture in parent

The following risk factors may occur at any time in the patient's history or during the measurement period:

Glucocorticoids [cumulative medication duration >= 90 days]

Osteoporotic fracture

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic malnutrition

Chronic liver disease

Rheumatoid arthritis

Hyperthyroidism

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Chemotherapy

Multiple myeloma

Premature menopause

Double or bilateral oophorectomy

Eating disorder

Amenorrhea

Organ transplant

Exclude patients with one of the following risk factors.

Risk factors are grouped by when they occur in relation to the measurement period.

The following risk factors must be active during the measurement period:

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factors may occur at any time in the patient's history prior to the start of the measurement period:

Osteoporosis

Osteopenia

Gastric bypass

Aromatase inhibitors

Documentation of history of hip fracture in parent

The following risk factors may occur at any time in the patient's history or during the measurement period:

Glucocorticoids [cumulative medication duration >= 90 days]

Osteoporotic fracture

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic malnutrition

Chronic liver disease

Rheumatoid arthritis

Hyperthyroidism

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Chemotherapy

Multiple myeloma

Premature menopause

Double or bilateral oophorectomy

Eating disorder

Amenorrhea

Organ transplant

Numerator

Female patients who received an order for at least one DXA scan in the measurement period

Female patients who received an order for at least one DXA scan in the measurement period

Female patients who received an order for at least one DXA scan in the measurement period

Female patients who received an order for at least one DXA scan in the measurement period

Numerator Exclusions

Not Applicable

Exclude patients with a result on one of the following tools, which indicates the patient should be considered for bone density testing, anytime in the patient’s history prior to the time of the first DXA scan during the measurement period:

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent

ORAI score of >=9

OSIRIS score of <1

OST score of <2

Exclude patients with a result on one of the following tools, which indicates the patient should be considered for bone density testing, anytime in the patient’s history prior to the time of the first DXA scan during the measurement period:

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent

ORAI score of >=9

OSIRIS score of <1

OST score of <2

Exclude patients with a result on one of the following tools, which indicates the patient should be considered for bone density testing, anytime in the patient’s history prior to the time of the first DXA scan during the measurement period:

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent

ORAI score of >=9

OSIRIS score of <1

OST score of <2

Denominator Exceptions

None

None

None

None

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

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

  • Replaced value set 'Average Number of Drinks per Drinking Day' with direct reference code 'Alcoholic drinks per day' to align with measure intent.

    Measure Section:

    Definitions

    Source of Change:

    Measure Lead

  • Updated the value set name for 'Online Assessments' to 'Virtual Encounter' for a more accurate description.

    Measure Section:

    Definitions

    Source of Change:

    Measure Lead

  • 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.

  • Removed ICD-9 extensional value sets from select grouping value sets, leaving codes from active terminologies (ICD-10 and SNOMED), to reduce implementer burden.

    Measure Section:

    Terminology

    Source of Change:

    Standards/Technical Update

  • Value set Amenorrhea (2.16.840.1.113883.3.464.1003.1022): Deleted 1 ICD-9-CM code (626.0) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Ankylosing Spondylitis (2.16.840.1.113883.3.464.1003.113.12.1045): Deleted 1 ICD-9-CM code (720.0) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Aromatase Inhibitors (2.16.840.1.113883.3.464.1003.196.12.1265): Added 3 RxNorm codes (1923053, 1923055, 1923057) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Replaced value set Average Number of Drinks per Drinking Day (2.16.840.1.113883.3.464.1003.106.12.1018) with direct reference code LOINC code (74013-4) based on applicability of a single code to represent clinical data.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

  • Value set Bilateral Oophorectomy (2.16.840.1.113883.3.526.3.471): Added 18 CPT codes based on review by technical experts, SMEs, and/or public feedback. Deleted 4 ICD-9-CM codes (65.51, 65.53, 65.61, 65.63) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Bone Marrow Transplant (2.16.840.1.113883.3.666.5.336): Added 16 ICD-10-PCS codes based on review by technical experts, SMEs, and/or public feedback. Deleted 62 ICD-10-PCS codes based on review by technical experts, SMEs, and/or public feedback. Deleted 9 ICD-9-CM codes (41.00, 41.01, 41.02, 41.03, 41.04, 41.05, 41.07, 41.08, 41.09) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Chemotherapy (2.16.840.1.113883.3.526.3.485): Added 10 SNOMED CT codes (1172516002, 1254741007, 1254742000, 1255831008, 1255834000, 1255904006, 1259200004, 171765004, 230857009, 394934009) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Chronic Liver Disease (2.16.840.1.113883.3.464.1003.199.12.1035): Deleted 26 ICD-9-CM codes based on applicability of value set and/or OID. Deleted 5 SNOMED CT codes (186639003, 197279005, 235902006, 235870003, 81675001) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Chronic Malnutrition (2.16.840.1.113883.3.464.1003.199.12.1036): Deleted 6 ICD-9-CM codes (307.1, 307.50, 307.51, 307.54, 307.59, 783.0) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Cushings Syndrome (2.16.840.1.113883.3.464.1003.117.12.1009): Deleted 1 ICD-9-CM code (255.0) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Eating Disorders (2.16.840.1.113883.3.464.1003.1039): Added 2 SNOMED CT codes (192630004, 405788002) based on review by technical experts, SMEs, and/or public feedback. Deleted 2 SNOMED CT codes (270902002, 34923007) based on review by technical experts, SMEs, and/or public feedback. Deleted 7 ICD-9-CM codes (307.1, 307.50, 307.51, 307.54, 307.59, 307.52, 307.53) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Ehlers Danlos Syndrome (2.16.840.1.113883.3.464.1003.113.12.1047): Deleted 1 ICD-9-CM code (756.83) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Evidence of Bilateral Oophorectomy (2.16.840.1.113883.3.464.1003.1048): Deleted 4 ICD-9-CM codes (65.52, 65.54, 65.62, 65.64) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Glucocorticoids (oral only) (2.16.840.1.113883.3.464.1003.196.12.1266): Added 9 RxNorm codes (643125, 1869595, 1943550, 197782, 2387355, 2399644, 2399652, 2399656, 2399659) based on review by technical experts, SMEs, and/or public feedback. Deleted 2 RxNorm codes (313979, 793099) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Hyperparathyroidism (2.16.840.1.113883.3.464.1003.117.12.1016): Deleted 4 ICD-9-CM codes (252.00, 252.01, 252.02, 252.08) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Hyperthyroidism (2.16.840.1.113883.3.464.1003.117.12.1015): Deleted 14 ICD-9-CM codes based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Lupus (2.16.840.1.113883.3.464.1003.117.12.1010): Deleted 1 ICD-9-CM code (710.0) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Major Transplant (2.16.840.1.113883.3.464.1003.198.12.1075): Deleted 14 ICD-9-CM codes based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Malabsorption Syndromes (2.16.840.1.113883.3.464.1003.199.12.1050): Deleted 27 ICD-9-CM codes based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Marfan's Syndrome (2.16.840.1.113883.3.464.1003.113.12.1048): Deleted 1 ICD-9-CM code (759.82) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Multiple Myeloma (2.16.840.1.113883.3.464.1003.1011): Deleted 3 ICD-9-CM codes (203.00, 203.01, 203.02) based on applicability of value set and/or OID.

    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 Virtual Encounter (2.16.840.1.113883.3.464.1003.101.12.1089): Deleted 2 CPT codes (98969, 99444) based on review by technical experts, SMEs, and/or public feedback. Deleted 3 HCPCS codes (G2061, G2062, G2063) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Osteogenesis Imperfecta (2.16.840.1.113883.3.464.1003.113.12.1044): Deleted 1 ICD-9-CM code (756.51) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Osteopenia (2.16.840.1.113883.3.464.1003.113.12.1049): Deleted 2 ICD-9-CM codes (733.90, 733.99) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Osteoporosis Without Current Fracture (2.16.840.1.113883.3.464.1003.113.12.1038): Deleted 4 ICD-9-CM codes (733.01, 733.02, 733.03, 733.09) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

  • Value set (2.16.840.1.113883.3.464.1003.113.12.1050): Renamed to Osteoporosis With Current Fracture based on recommended value set naming conventions.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

  • Value set Osteoporosis With Current Fracture (2.16.840.1.113883.3.464.1003.113.12.1050): Added 1 SNOMED CT code (704330001) based on review by technical experts, SMEs, and/or public feedback. Deleted 2 SNOMED CT codes (431030000, 203449003) based on review by technical experts, SMEs, and/or public feedback. Added 36 ICD-10-CM codes based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set (2.16.840.1.113883.3.464.1003.113.12.1038): Renamed to Osteoporosis Without Current Fracture based on recommended value set naming conventions.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

  • 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 Premature Menopause (2.16.840.1.113883.3.464.1003.1013): Deleted 1 ICD-9-CM code (256.31) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Psoriatic Arthritis (2.16.840.1.113883.3.464.1003.113.12.1046): Deleted 1 ICD-9-CM code (696.0) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Rheumatoid Arthritis (2.16.840.1.113883.3.464.1003.113.12.1005): Deleted 4 ICD-9-CM codes (714.0, 714.1, 714.2, 714.81) based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Type 1 Diabetes (2.16.840.1.113883.3.464.1003.103.12.1020): Deleted 20 ICD-9-CM codes based on applicability of value set and/or OID.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Unilateral Oophorectomy, Unspecified Laterality (2.16.840.1.113883.3.464.1003.1035): Deleted 4 ICD-9-CM codes (65.31, 65.39, 65.41, 65.49) based on applicability of value set and/or OID. Deleted 1 SNOMED CT code (708816008) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set (2.16.840.1.113883.3.464.1003.101.12.1089): Renamed to Virtual Encounter based on recommended value set naming conventions.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

Last Updated: Aug 01, 2024