download chevron-down chevron-right chevron-with-circle-down chevron-with-circle-up check circle-with-minus circle-with-plus export help-with-circle inbox link mail old-phone star-outlined star user v-card close close close Back to top
Top

Use of High-Risk Medications in the Elderly

CMS Measure ID
CMS156v8
Version
8
NQF Number
Not Applicable
Measure Description

Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are reported.

a. Percentage of patients who were ordered at least one high-risk medication.

b. Percentage of patients who were ordered at least two of the same high-risk medications.

Initial Population

Patients 65 years and older who had a visit during the measurement period

Denominator Statement
Denominator Exclusions

Exclude patients whose hospice care overlaps the measurement period

Numerator Statement

Numerator 1: Patients with an order for at least one high-risk medication during the measurement period

Numerator 2: Patients with at least two orders for the same high-risk medication on different days during the measurement period

Numerator Exclusions

Not Applicable

Denominator Exceptions

None

Previous Version
Measure Scoring
Measure Type
Improvement Notation

Lower score indicates better quality

Guidance

The intent of Numerator 1 of the measure is to assess if the patient has been prescribed at least one high-risk medication. The intent of Numerator 2 of the measure is to assess if the patient has been prescribed at least two of the same high-risk medications on different days.

The intent of the measure is to assess if the reporting provider ordered the high-risk medication(s). If the patient had a high-risk medication previously prescribed by another provider, they would not be counted towards the numerator unless the reporting provider also ordered a high-risk medication for them.

Quality ID
238
Meaningful Measure

Specifications

Attachment Size
CMS156v8.html 108 KB
CMS156v8.zip 126.3 KB
CMS156v8-TRN.xlsx 22.75 KB

Release Notes

 

Header

  • Updated eCQM version number.

    Measure Section: eCQM Version number

    Source of Change: Measure Lead

  • Updated NQF number to 'Not Applicable.'

    Measure Section: NQF Number

    Source of Change: Standards Update

  • Updated endorsed by field to 'None.'

    Measure Section: Endorsed By

    Source of Change: Standards Update

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated rationale statement.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Updated clinical recommendation statement.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated references to align with American Psychological Association (APA) style.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated guidance statement with removal of cumulative medication duration as it was outdated.

    Measure Section: Guidance

    Source of Change: ONC Project Tracking System (JIRA): CQM-3153

  • Updated guidance statement for Numerator 2 to include 'on different days' to clarify the intent of the multiple high risk medication orders.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Updated numerator statement for Numerator 2 to include 'on different days' to clarify the intent of the multiple high risk medication orders.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated parenthetical citations to align with American Psychological Association (APA) style.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

 

Logic

  • Removed duplicate medication 'Acetaminophen / Diphenhydramine / Phenylephrine' in definition 'Same High Risk Medications Ordered on Different Days.'

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Updated the names of Clinical Quality Language (CQL) definitions, functions, and/or aliases for clarification and to align with CQL Style Guide.

    Measure Section: Definitions and Functions

    Source of Change: Standards Update

  • Updated Clinical Quality Language (CQL) expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 3 (CQL 1.3).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated definitions and functions in the Measure Authoring Tool (MAT) Global Common Functions Library to align with standards changes, Clinical Quality Language (CQL) Style Guide, and to include two new functions related to calculating hospital stays.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated version number of the Hospice Library (Hospice-2.0.000).

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-4.0.000).

    Measure Section: Multiple Sections

    Source of Change: Standards 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 Annual Wellness Visit (2.16.840.1.113883.3.526.3.1240): Added SNOMED CT extensional value set (2.16.840.1.113883.3.526.2.1772) including 2 codes.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Acetaminophen / Chlorpheniramine / Dextromethorphan / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1321): Deleted 1 RxNorm code (1293298).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Chlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1343): Deleted 1 RxNorm code (1876117).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Acetaminophen / Diphenhydramine (2.16.840.1.113883.3.464.1003.196.12.1350): Deleted 1 RxNorm code (1245374).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Diphenhydramine Hydrochloride (2.16.840.1.113883.3.464.1003.196.12.1371): Deleted 1 RxNorm code (1049918).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set (2.16.840.1.113883.3.464.1003.101.11.1206): Renamed to Ophthalmologic Services.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set List of Single RxNorm Code Concepts for High Risk Drugs for the Elderly (2.16.840.1.113883.3.464.1003.196.12.1272): Added RxNorm extensional value set (2.16.840.1.113883.3.464.1003.196.11.1302) including 1 code. Deleted 2 RxNorm codes (1291711, 251050).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set High Risk Medications for the Elderly (2.16.840.1.113883.3.464.1003.196.12.1253): Added 1 RxNorm code (1664543) and deleted 12 RxNorm codes.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Chlorpheniramine / Phenylephrine / Phenyltoloxamine (2.16.840.1.113883.3.464.1003.196.12.1453): Removed Chlorpheniramine / Phenylephrine / Phenyltoloxamine.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Chlorpheniramine / Codeine (2.16.840.1.113883.3.464.1003.196.12.1301): Removed Chlorpheniramine / Codeine.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Chlorpheniramine / Phenylephrine / Pyrilamine (2.16.840.1.113883.3.464.1003.196.12.1309): Removed Chlorpheniramine / Phenylephrine / Pyrilamine.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Brompheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1327): Removed Brompheniramine / Phenylephrine.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Direct reference code for Birth date (LOINC Code (21112-8)) now displayed in Human Readable.

    Measure Section: Terminology

    Source of Change: Annual Update

  • ​Removed code system versions from direct reference codes. Please refer to Appendix A of the Electronic Clinical Quality Measure Logic and Implementation Guidance document for a list of code system versions used in the eCQM specifications for 2020 reporting/performance.

    Measure Section: Terminology

    Source of Change: Standards Update

  • Standardized purpose statement language in value sets across eCQMs. Value set purpose statements are visible in the Value Set Authority Center (VSAC) as well as the downloadable eCQM value set files.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set High Risk Medications for the Elderly (2.16.840.1.113883.3.464.1003.196.12.1253): Removed three RxNorm extensional value sets (2.16.840.1.113883.3.464.1003.196.11.1454, 2.16.840.1.113883.3.464.1003.196.11.1310, 2.16.840.1.113883.3.464.1003.196.11.1379).

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set List of Single RxNorm Code Concepts for High Risk Drugs for the Elderly (2.16.840.1.113883.3.464.1003.196.12.1272): Removed two RxNorm extensional value sets (2.16.840.1.113883.3.464.1003.196.11.1379, 2.16.840.1.113883.3.464.1003.196.11.1454).

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: Oct 10, 2019