General eCQM Information
| CMS Measure ID | CMS249v3 |
|---|---|
| NQF Number | 3475e |
| Measure 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 |
| Initial Population | Female patients ages 50 to 64 years with an encounter during the measurement period |
| Denominator Statement |
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 The following risk factors may occur any time in the patient's history and do not need to be active at the start of the measurement period: Documentation of history of hip fracture in parent Osteoporotic fracture Glucocorticoids (>= 5 mg/per day) [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 |
| Numerator Statement |
Female patients who received an order for at least one DXA scan in the measurement period |
| Numerator Exclusions |
Not Applicable |
| Denominator Exceptions |
None |
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) |
| Domain | Efficiency and Cost Reduction |
| Measure Scoring | Proportion measure |
| Measure Type | Process measure |
| Improvement Notation |
Lower score indicates better quality |
| 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. |
| Quality ID | 472 |
| Meaningful Measure | Appropriate Use of Healthcare |
| Telehealth Eligible | Yes |
| Previous Version |
Data Element Repository
Header
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Updated eCQM Version Number.
Measure Section: eCQM Version Number
Source of Change: Standards Update
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Updated National Quality Forum (NQF) Number to NQF #3475e.
Measure Section: NQF Number
Source of Change: Measure Lead
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Updated endorsed by to National Quality Forum.
Measure Section: Endorsed By
Source of Change: Measure Lead
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Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
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Updated references.
Measure Section: Reference
Source of Change: Standards Update
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Replaced ‘provider’ with ‘clinician’ in the definition statement to provide a more accurate description of who uses the tool.
Measure Section: Definition
Source of Change: Measure Lead
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Added text to identify the Quality Data Model (QDM) version used in the measure specification.
Measure Section: Guidance
Source of Change: Standards Update
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Added text to indicate whether the measure is patient-based or episode-based.
Measure Section: Guidance
Source of Change: Standards Update
Logic
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Updated the names of Clinical Quality Language (CQL) definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.
Measure Section: Definitions
Source of Change: Standards Update
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Updated timing logic for the follow-up assessment to use 'in Interval' to simplify logic and promote harmonization between measures.
Measure Section: Definitions
Source of Change: Measure Lead
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Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.
Measure Section: Functions
Source of Change: Standards Update
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QDM v5.5 standards update: Added 'relevantDatetime' attribute to QDM datatypes. 'RelevantDatetime' indicates when the action occurred whereas 'authorDatetime' indicates when the action was recorded.
Measure Section: Multiple Sections
Source of Change: Standards Update
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Updated CQL expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).
Measure Section: Multiple Sections
Source of Change: Standards Update
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Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-5.0.000). Updated definitions and functions in the MAT Global Common Functions Library to align with standards changes, CQL Style Guide, and to include one new function related to calculating length of hospital stays with observation stays.
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.
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Value set Aromatase Inhibitors (2.16.840.1.113883.3.464.1003.196.12.1265): Deleted 2 RxNorm codes (1098617, 795141) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Ehlers Danlos Syndrome (2.16.840.1.113883.3.464.1003.113.12.1047): Added 5 ICD-10-CM codes (Q79.60, Q79.61, Q79.62, Q79.63, Q79.69) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set End Stage Renal Disease (2.16.840.1.113883.3.526.3.353): Deleted 1 ICD-9-CM code (585.6) based on validity of code during timing of look back period.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Gastric Bypass Surgery (2.16.840.1.113883.3.464.1003.198.12.1050): Deleted 1 SNOMED CT code (73206007) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Glucocorticoids (oral only) (2.16.840.1.113883.3.464.1003.196.12.1266): Deleted 2 RxNorm codes (199320, 795858) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Malabsorption Syndromes (2.16.840.1.113883.3.464.1003.199.12.1050): Deleted 1 SNOMED CT code (12109003) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008): Deleted 1 SNOMED CT code (17436001) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Rheumatoid Arthritis (2.16.840.1.113883.3.464.1003.113.12.1005): Deleted 1 SNOMED CT code (239942007) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Value set Type 1 Diabetes (2.16.840.1.113883.3.464.1003.103.12.1020): Deleted 1 SNOMED CT code (314894004) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update