Use of High-Risk Medications in Older Adults
Compare Versions of: "Use of High-Risk Medications in Older Adults"
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
| Measure Information | 2022 Performance Period | 2023 Performance Period | 2024 Performance Period | 2025 Performance Period |
|---|---|---|---|---|
| Title | Use of High-Risk Medications in Older Adults | Use of High-Risk Medications in Older Adults | Use of High-Risk Medications in Older Adults | Use of High-Risk Medications in Older Adults |
| CMS eCQM ID | CMS156v10 | CMS156v11 | CMS156v12 | CMS156v13 |
| CBE ID* | Not Applicable | Not Applicable | Not Applicable | Not Applicable |
| MIPS Quality ID | 238 | 238 | 238 | 238 |
| Measure Steward | National Committee for Quality Assurance | National Committee for Quality Assurance | National Committee for Quality Assurance | National Committee for Quality Assurance |
| Description |
Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported. 1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. 2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses. 3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators). |
Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported. 1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. 2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses. 3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators). |
Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported. 1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. 2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses. 3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators). |
Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. Three rates are reported. 1. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class. 2. Percentage of patients 65 years of age and older who were ordered at least two high-risk medications from the same drug class, except for appropriate diagnoses. 3. Total rate (the sum of the two numerators divided by the denominator, deduplicating for patients in both numerators). |
| Measure Scoring | Proportion measure | Proportion measure | Proportion measure | Proportion measure |
| Measure Type | Process | Process | Process | Process |
| Stratification | *See CMS156v10.html | *See CMS156v11-v2.html |
None |
None |
| Risk Adjustment | *See CMS156v10.html | *See CMS156v11-v2.html |
None |
None |
| Rationale | *See CMS156v10.html | *See CMS156v11-v2.html |
Certain medications (MacKinnon & Hepler, 2003) are associated with increased risk of harm from drug side-effects and drug toxicity and pose a concern for patient safety. There is clinical consensus that these drugs pose increased risks in older adults (Kaufman, Brodin, & Sarafian, 2005). Potentially inappropriate medication use in older adults has been connected to significantly longer hospital stay lengths and increased hospitalization costs (Hagstrom et al., 2015) as well as increased risk of death (Lau et al., 2004). Use of specific high-risk medications such as hypnotics, including benzodiazepine receptor agonists, and nonsteroidal anti-inflammatory drugs (NSAIDS) can result in increased risk of delirium, falls, fractures, gastrointestinal bleeding and acute kidney injury (Merel et al., 2017). Long-term use of benzodiazepines in older adults has been associated with increased risk of dementia (Zhong et al., 2015; Takada et al., 2016). Additionally, the use of antipsychotics can lead to increased risk of stroke and greater cognitive decline in older adults with dementia (Tampi et al., 2016). Older adults receiving inappropriate medications are more likely to report poorer health status at follow-up, compared to those who receive appropriate medications (Fu, Liu, & Christensen, 2004). A study of the prevalence of potentially inappropriate medication use in older adults found that 40 percent of individuals 65 and older filled at least one prescription for a potentially inappropriate medication and 13 percent filled two or more (Fick et al., 2008). While some adverse drug events (ADEs) are unavoidable, studies estimate that between 30 and 80 percent of ADEs in older adults are preventable (MacKinnon & Hepler, 2003). More recently with the onset of the COVID-19 pandemic, several studies have shown an increase in anxiety, insomnia and depression rates, which could result in an increase in the use of high-risk medications in order to treat these conditions (Agrawal, 2020). Reducing the number of inappropriate prescriptions can lead to improved patient safety and significant cost savings. Conservative estimates of extra costs due to potentially inappropriate medications in older adults average $7.2 billion a year (Fu et al., 2007). Medication use by older adults will likely increase further as the U.S. population ages, new drugs are developed, and new therapeutic and preventive uses for medications are discovered (Rothberg et al., 2008). The annual direct costs of preventable ADEs in the Medicare population have been estimated to exceed $800 million (Institute of Medicine, 2007). By the year 2030, nearly one in five U.S. residents is expected to be aged 65 years or older; this age group is projected to more than double from 38.7 million in 2008 to more than 88.5 million in 2050. Likewise, the population aged 85 years or older is expected to increase almost four-fold, from 5.4 million to 19 million between 2008 and 2050. As the older adult population continues to grow, the number of older adults who present with multiple medical conditions for which several medications are prescribed will likely continue to increase, resulting in polypharmacy concerns (Gray & Gardner, 2009). |
Certain medications (MacKinnon & Hepler, 2003) are associated with increased risk of harm from drug side-effects and drug toxicity and pose a concern for patient safety. There is clinical consensus that these drugs pose increased risks in older adults (Kaufman, Brodin, & Sarafian, 2005). Potentially inappropriate medication (PIM) use in older adults has been connected to significantly longer hospital stay lengths and increased hospitalization costs (Hagstrom et al., 2015) as well as increased risk of death (Lau et al., 2004). Use of specific high-risk medications such as hypnotics, including benzodiazepine receptor agonists, and nonsteroidal anti-inflammatory drugs (NSAIDS) can result in increased risk of delirium, falls, fractures, gastrointestinal bleeding and acute kidney injury (Merel & Paauw, 2017). Long-term use of benzodiazepines in older adults has been associated with increased risk of dementia (Zhong, Wang, Zhang, & Zhao, 2015; Takada et al., 2016). Additionally, the use of antipsychotics can lead to increased risk of stroke and greater cognitive decline in older adults with dementia (Tampi et al., 2016). Among Medicare beneficiaries it is estimated that the prevalence of PIM use was 77% among long-stay nursing home residents (defined as >101 consecutive days in a nursing home). The most common PIMs were benzodiazepines, antipsychotics, and insulin (Riester et al., 2023). Older adults receiving inappropriate medications are more likely to report poorer health status at follow-up, compared to those who receive appropriate medications (Fu, Liu, & Christensen, 2004). A study of the prevalence of potentially inappropriate medication use in older adults found that 40 percent of individuals 65 and older filled at least one prescription for a potentially inappropriate medication and 13 percent filled two or more (Fick et al., 2008). While some adverse drug events (ADEs) are unavoidable, studies estimate that between 30 and 80 percent of ADEs in older adults are preventable (MacKinnon & Hepler, 2003). More recently with the onset of the COVID-19 pandemic, several studies have shown an increase in anxiety, insomnia and depression rates, which could result in an increase in the use of high-risk medications in order to treat these conditions (Agrawal, 2020). Reducing the number of inappropriate prescriptions can lead to improved patient safety and significant cost savings. Conservative estimates of extra costs due to potentially inappropriate medications in older adults average $7.2 billion a year (Fu et al., 2007). Medication use by older adults will likely increase further as the U.S. population ages, new drugs are developed, and new therapeutic and preventive uses for medications are discovered (Rothberg et al., 2008). The annual direct costs of preventable ADEs in the Medicare population have been estimated to exceed $800 million (Institute of Medicine, 2007). By the year 2030, nearly one in five U.S. residents is expected to be aged 65 years or older; this age group is projected to more than double from 38.7 million in 2008 to more than 88.5 million in 2050. Likewise, the population aged 85 years or older is expected to increase almost four-fold, from 5.4 million to 19 million between 2008 and 2050. As the older adult population continues to grow, the number of older adults who present with multiple medical conditions for which several medications are prescribed will likely continue to increase, resulting in polypharmacy concerns (Gray & Gardner, 2009). |
| Clinical Recommendation Statement | *See CMS156v10.html | *See CMS156v11-v2.html |
The measure is based on recommendations from the American Geriatrics Society Beers Criteria[R] for Potentially Inappropriate Medication Use in Older Adults (2019 Update). The criteria were developed through key clinical expert consensus processes by Beers in 1997, Zhan in 2001, and an updated process by Fick et al. in 2003, 2012, 2015, and 2019. The Beers Criteria identifies lists of drugs that are potentially inappropriate for all older adults, except for those with certain conditions for which some high-risk medications may be warranted, and drugs that are potentially inappropriate in older adults based on various high-risk factors such as dosage, days supply and underlying diseases or conditions. NCQA's Geriatric Measurement Advisory Panel recommended a subset of drugs that should be used with caution in older adults for inclusion in the measure based upon the recommendations in the Beers Criteria. |
The measure is based on recommendations from the American Geriatrics Society Beers Criteria[R] for Potentially Inappropriate Medication Use in Older Adults (2023). The criteria were developed through key clinical expert consensus processes by Beers in 1997, Zhan in 2001, Fick et al. in 2003, 2012, 2015, and 2019 and, most recently the American Geriatrics Society Beers Criteria Update Expert Panel in 2023. The Beers Criteria identifies lists of drugs that are potentially inappropriate for all older adults, except for those with certain conditions for which some high-risk medications may be warranted, and drugs that are potentially inappropriate in older adults based on various high-risk factors such as dosage, days supply and underlying diseases or conditions. NCQA's Geriatric Measurement Advisory Panel recommended a subset of drugs that should be used with caution in older adults for inclusion in the measure based upon the recommendations in the Beers Criteria. |
| Improvement Notation |
Lower score indicates better quality |
Lower score indicates better quality |
Lower score indicates better quality |
Lower score indicates better quality |
| Definition | *See CMS156v10.html | *See CMS156v11-v2.html |
Index Prescription Start Date (IPSD). The start date of the earliest prescription ordered for a high-risk medication during the measurement period. A high-risk medication is identified by any one of the following: a. A prescription for medications classified as high risk at any dose and for any duration. b. A prescription for medications classified as high risk at any dose with greater than a 90 day supply. c. A prescription for medications classified as high risk exceeding average daily dose criteria. An order is identified by either a prescription order or a prescription refill. |
Index Prescription Start Date (IPSD). The start date of the earliest prescription ordered for a high-risk medication during the measurement period. A high-risk medication is identified by any one of the following: a. A prescription for medications classified as high risk at any dose and for any duration. b. A prescription for medications classified as high risk at any dose with greater than a 90 day supply. c. A prescription for medications classified as high risk exceeding average daily dose criteria. An order is identified by either a prescription order or a prescription refill. |
| Guidance |
The intent of the measure is to assess if the patient has been ordered at least two of the same high-risk medication prescriptions from the same medication class 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. 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. |
The intent of the measure is to assess if the patient has been ordered at least two high-risk medication prescriptions from the same drug class 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 from the same drug class for them. Calculate average daily dose for each prescription event. To calculate average daily dose, multiply the quantity of pills prescribed by the dose of each pill and divide by the days supply. For example, a prescription for the 30-days supply of digoxin containing 15 pills, 0.25 mg each pill, has an average daily dose of 0.125 mg. To calculate average daily dose for elixirs and concentrates, multiply the volume prescribed by daily dose and divide by the days supply. Do not round when calculating average daily dose. 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. |
The intent of the measure is to assess if the patient has been ordered at least two high-risk medication prescriptions from the same drug class 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 from the same drug class for them. Calculate average daily dose for each prescription event. To calculate average daily dose, multiply the quantity of pills prescribed by the dose of each pill and divide by the days supply. For example, a prescription for the 30-days supply of digoxin containing 15 pills, 0.25 mg each pill, has an average daily dose of 0.125 mg. To calculate average daily dose for elixirs and concentrates, multiply the volume prescribed by daily dose and divide by the days supply. Do not round when calculating average daily dose. 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. |
The intent of the measure is to assess if the patient has been ordered at least two high-risk medication prescriptions from the same drug class 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 from the same drug class for them. Calculate average daily dose for each prescription event. To calculate average daily dose, multiply the quantity of pills prescribed by the dose of each pill and divide by the days supply. For example, a prescription for the 30-days supply of digoxin containing 15 pills, 0.25 mg each pill, has an average daily dose of 0.125 mg. To calculate average daily dose for elixirs and concentrates, multiply the volume prescribed by daily dose and divide by the days supply. Do not round when calculating average daily dose. 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 |
Patients 65 years and older who had a visit during the measurement period |
Patients 65 years and older at the end of the measurement period who had a visit during the measurement period |
Patients 65 years and older at the end of the measurement period who had a visit during the measurement period |
Patients 65 years and older at the end of the measurement period who had a visit 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 receiving palliative care during the measurement period. |
Exclude patients who are in hospice care for any part of the measurement period. Exclude patients receiving palliative care for any part of the measurement period. |
Exclude patients who are in hospice care for any part of the measurement period. Exclude patients receiving palliative care for any part of the measurement period. |
Exclude patients who are in hospice care for any part of the measurement period. Exclude patients receiving palliative care for any part of the measurement period. |
| Numerator |
Rate 1 : Patients with at least two orders of high-risk medications from the same drug class. Rate 2: Patients with at least two orders of high-risk medications from the same drug class (i.e., antipsychotics and benzodiazepines). Total rate (the sum of the two previous numerators, deduplicated). |
Rate 1: Patients with at least two orders of high-risk medications from the same drug class on different days. a. At least two orders of high-risk medications from the same drug class. b. At least two orders of high-risk medications from the same drug class with summed days supply greater than 90 days. c. At least two orders of high-risk medications from the same drug class each exceeding average daily dose criteria. Rate 2: Patients with at least two orders of high-risk medications from the same drug class (i.e., antipsychotics and benzodiazepines) on different days. Total rate (the sum of the two previous numerators, deduplicated). |
Rate 1: Patients with at least two orders of high-risk medications from the same drug class on different days. a. At least two orders of high-risk medications from the same drug class. b. At least two orders of high-risk medications from the same drug class with summed days supply greater than 90 days. c. At least two orders of high-risk medications from the same drug class each exceeding average daily dose criteria. Rate 2: Patients with at least two orders of high-risk medications from the same drug class (i.e., antipsychotics and benzodiazepines) on different days except for appropriate diagnoses. a. Patients with two or more antipsychotic prescriptions ordered on different days, and who did not have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between January 1 of the year prior to the measurement period and the IPSD for antipsychotics. b. Patients with two or more benzodiazepine prescriptions ordered on different days, and who did not have a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between January 1 of the year prior to the measurement period and the IPSD for benzodiazepines. Total rate (the sum of the two previous numerators, deduplicated). |
Rate 1: Patients with at least two orders of high-risk medications from the same drug class on different days. a. At least two orders of high-risk medications from the same drug class. b. At least two orders of high-risk medications from the same drug class with summed days supply greater than 90 days. c. At least two orders of high-risk medications from the same drug class each exceeding average daily dose criteria. Rate 2: Patients with at least two orders of high-risk medications from the same drug class (i.e., antipsychotics and benzodiazepines) on different days except for appropriate diagnoses. a. Patients with two or more antipsychotic prescriptions ordered on different days, and who did not have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between January 1 of the year prior to the measurement period and the IPSD for antipsychotics. b. Patients with two or more benzodiazepine prescriptions ordered on different days, and who did not have a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between January 1 of the year prior to the measurement period and the IPSD for benzodiazepines. Total rate (the sum of the two previous numerators, deduplicated). |
| Numerator Exclusions |
Rate 2: For patients with two or more antipsychotic prescriptions ordered, exclude patients who have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between January 1 of the year prior to the measurement period and the Index Prescription Start Date (IPSD) for antipsychotics. For patients with two or more benzodiazepine prescriptions ordered, exclude patients who have a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between January 1 of the year prior to the measurement period and the IPSD for benzodiazepines. |
Rate 2: For patients with two or more antipsychotic prescriptions ordered, exclude patients who have a diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder on or between January 1 of the year prior to the measurement period and the IPSD for antipsychotics. For patients with two or more benzodiazepine prescriptions ordered, exclude patients who have a diagnosis of seizure disorders, rapid eye movement sleep behavior disorder, benzodiazepine withdrawal, ethanol withdrawal, or severe generalized anxiety disorder on or between January 1 of the year prior to the measurement period and the IPSD for benzodiazepines. |
Not Applicable |
Not Applicable |
| Denominator Exceptions |
None |
None |
None |
None |
| Telehealth Eligible | Yes | Yes | Yes | Yes |
| Next Version | No Version Available | |||
| Previous Version | No Version Available |
There is a known issue on CMS156v10. See issue EKI-17 on the ONC eCQM Known Issues Dashboard for details.
Additional Resources for CMS156v10
Header
Updated the eCQM version number.
Measure Section: eCQM Version Number
Source of Change: Standards Update
Revised the description to add a new rate (rate 2).
Measure Section: Description
Source of Change: Measure Lead
Revised the measure description to align with the measure intent and guidance.
Measure Section: Description
Source of Change: Measure Lead
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
Updated the rationale to align with current evidence.
Measure Section: Rationale
Source of Change: Measure Lead
Updated references.
Measure Section: Reference
Source of Change: Standards Update
Revised the definition to clarify timing related to the Index Prescription Start Date.
Measure Section: Definition
Source of Change: Measure Lead
Updated the guidance to clarify the measure intent and support implementation.
Measure Section: Guidance
Source of Change: Measure Lead
Replaced 'overlaps' or 'overlapping' in the denominator exclusions with plain language to clarify the measure intent.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
Updated the Denominator Exclusions to add an exclusion for palliative care.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
Revised the numerator to add a new rate (rate 2).
Measure Section: Numerator
Source of Change: Measure Lead
Revised the numerator to add a new rate (rate 2).
Measure Section: Numerator Exclusions
Source of Change: Measure Lead
Logic
Added online assessments and telephone visits as appropriate encounters based on the increased use of telehealth services.
Measure Section: Initial Population
Source of Change: Measure Lead
Updated Denominator Exclusions definition and added PalliativeCare.Palliative Care in the Measurement Period definition to add an exclusion for palliative care.
Measure Section: Denominator Exclusions
Source of Change: Measure Lead
Revised the numerator logic to add a new rate (rate 2).
Measure Section: Numerator
Source of Change: Measure Lead
Added exclusion criteria for numerator 2 to align with the American Geriatric Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.
Measure Section: Numerator Exclusions
Source of Change: Measure Lead
Removed the days supply requirement for nonbenzodiazepine hypnotics by removing the Cumulative Medication Duration requirement for Hypnotics During Measurement Period in the Two High Risk Medications with Prolonged Duration definition and deleting the Hypnotics During Measurement Period definition to align with the American Geriatric Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.
Measure Section: Definitions
Source of Change: Measure Lead
Updated Denominator Exclusions definition and added PalliativeCare.Palliative Care in the Measurement Period definition to add an exclusion for palliative care.
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 the CQL Style Guide.
Measure Section: Multiple Sections
Source of Change: Standards Update
Removed and added medications to the Same High Risk Medications Ordered on Different Days definition to align with the American Geriatric Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-6.2.000). Updated the 'Inpatient Encounter' definition to include a 'day of' timing clarification. Added the following timing functions: Normalize Interval, Has Start, Has End, Latest, Latest Of, Earliest, and Earliest Of. Please see individual measure details for application of specific timing functions.
Measure Section: Multiple Sections
Source of Change: Standards Update
Added new NormalizeInterval function to timing attributes to decrease implementation burden due to variable use of timing attributes for select QDM data types. The NormalizeInterval function was applied, where applicable, for the following data elements: Assessment, Performed; Device, Applied; Diagnostic Study, Performed; Intervention, Performed; Laboratory Test, Performed; Medication, Administered; Medication, Dispensed; Physical Exam, Performed; Procedure, Performed; Substance, Administered.
Measure Section: Multiple Sections
Source of Change: Standards Update
Updated Hospice CQL Library to version 3.0.000.
Measure Section: Multiple Sections
Source of Change: Measure Lead
Added PalliativeCareExclusion CQL library to version 1.0.000.
Measure Section: Multiple Sections
Source of Change: Measure Lead
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 Meprobamate (2.16.840.1.113883.3.464.1003.196.12.1284): Deleted 1 RxNorm code (197930) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Trimipramine (2.16.840.1.113883.3.464.1003.196.12.1285): Deleted 6 RxNorm codes (199820, 313497, 245372, 245373, 245374, 250033) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Diphenhydramine (2.16.840.1.113883.3.464.1003.196.12.1293): Deleted 37 RxNorm codes based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Dexchlorpheniramine (2.16.840.1.113883.3.464.1003.196.12.1300): Deleted 7 RxNorm codes (2184088, 1305775, 1357940, 1370680, 2168002, 2184127, 2184130) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Orphenadrine (2.16.840.1.113883.3.464.1003.196.12.1302): Deleted 6 RxNorm codes (994824, 994810, 994811, 994837, 994841, 994847) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Carbinoxamine (2.16.840.1.113883.3.464.1003.196.12.1306): Added 1 RxNorm code (359329) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 6 RxNorm codes (1010946, 1010980, 1012681, 1012956, 1012984, 1424307) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Clemastine (2.16.840.1.113883.3.464.1003.196.12.1308): Deleted 3 RxNorm codes (857452, 857454, 857457) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Disopyramide (2.16.840.1.113883.3.464.1003.196.12.1311): Deleted 3 RxNorm codes (104285, 199730, 199824) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Methyldopa (2.16.840.1.113883.3.464.1003.196.12.1331): Deleted 5 RxNorm codes (104357, 197955, 197959, 197961, 197962) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Trihexyphenidyl (2.16.840.1.113883.3.464.1003.196.12.1334): Deleted 1 RxNorm code (905292) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Clomipramine (2.16.840.1.113883.3.464.1003.196.12.1336): Deleted 5 RxNorm codes (857291, 857296, 857315, 857292, 857326) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Megestrol (2.16.840.1.113883.3.464.1003.196.12.1342): Deleted 1 RxNorm code (860231) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Phenobarbital (2.16.840.1.113883.3.464.1003.196.12.1348): Added 5 RxNorm codes (1046787, 1046815, 1046997, 1048147, 702519) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 14 RxNorm codes based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Dipyridamole (2.16.840.1.113883.3.464.1003.196.12.1349): Deleted 2 RxNorm codes (199314, 392451) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Nifedipine (2.16.840.1.113883.3.464.1003.196.12.1353): Deleted 5 RxNorm codes (199329, 314132, 199782, 391901, 391980) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Desiccated Thyroid (2.16.840.1.113883.3.464.1003.196.12.1354): Deleted 1 RxNorm code (242927) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Imipramine (2.16.840.1.113883.3.464.1003.196.12.1359): Deleted 1 RxNorm code (835586) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Indomethacin (2.16.840.1.113883.3.464.1003.196.12.1366): Deleted 2 RxNorm codes (251255, 392073) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Promethazine Hydrochloride (2.16.840.1.113883.3.464.1003.196.12.1367): Deleted 7 RxNorm codes (861578, 992900, 756160, 992471, 992898, 992904, 992908) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Glyburide (2.16.840.1.113883.3.464.1003.196.12.1368): Deleted 1 RxNorm code (252960) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Carisoprodol (2.16.840.1.113883.3.464.1003.196.12.1369): Deleted 1 RxNorm code (105974) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
Value set Methocarbamol (2.16.840.1.113883.3.464.1003.196.12.1370): Deleted 1 RxNorm code (197945) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Diphenhydramine Hydrochloride (2.16.840.1.113883.3.464.1003.196.12.1371) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Cyclobenzaprine Hydrochloride (2.16.840.1.113883.3.464.1003.196.12.1372): Deleted 1 RxNorm code (999731) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Dexbrompheniramine (2.16.840.1.113883.3.464.1003.196.12.1375): Added 1 RxNorm code (2391334) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 2 RxNorm codes (1251806, 1305588) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Butabarbital (2.16.840.1.113883.3.464.1003.196.12.1402): Deleted 4 RxNorm codes (1047805, 1251600, 1251610, 1251625) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Triprolidine (2.16.840.1.113883.3.464.1003.196.12.1408): Deleted 2 RxNorm codes (1099711, 996640) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Esterified Estrogens (2.16.840.1.113883.3.464.1003.196.12.1419): Added 2 RxNorm codes (197670, 238006) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 1 RxNorm code (1000353) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Chlorpheniramine (2.16.840.1.113883.3.464.1003.196.12.1352): Added 1 RxNorm code (2383312) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 100 RxNorm codes based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Conjugated Estrogens (2.16.840.1.113883.3.464.1003.196.12.1357): Added 4 RxNorm codes (1000351, 1000352, 1000355, 1000356) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 4 RxNorm codes (1000353, 1000354, 197663, 432572) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Ketorolac Tromethamine (2.16.840.1.113883.3.464.1003.196.12.1364): Added 8 RxNorm codes (1665459, 1665461, 1665675, 1665679,1665682, 860113, 860114, 860115) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 1 RxNorm code (861846) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Estradiol (2.16.840.1.113883.3.464.1003.196.12.1365): Added 2 RxNorm codes (2371764, 2371767) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 5 RxNorm codes (249869, 1000161, 250213, 250838, 483169) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Hydroxyzine (2.16.840.1.113883.3.464.1003.196.12.1374): Deleted 2 RxNorm codes (995428, 995274) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Brompheniramine (2.16.840.1.113883.3.464.1003.196.12.1427): Added 11 RxNorm codes (1357013, 1014331, 1053258, 1090463, 1098497, 1098498, 1111065, 1148155, 1192477, 1244523, 1245722) based on review by technical experts, SMEs, and/or public feedback. Deleted 34 RxNorm codes based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Meperidine (2.16.840.1.113883.3.464.1003.196.12.1351): Added 15 RxNorm codes based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations. Deleted 1 RxNorm code (861578) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Dicyclomine (2.16.840.1.113883.3.464.1003.196.12.1279): Deleted 4 RxNorm codes (991616, 199725, 755900, 991151) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Dimenhydrinate (2.16.840.1.113883.3.464.1003.196.12.1500): Deleted 5 RxNorm codes (1294446, 245357, 245358, 429720, 755901) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Hyoscyamine (2.16.840.1.113883.3.464.1003.196.12.1501): Deleted 5 RxNorm codes (1044608, 1046820, 1047805, 1048078, 1048411) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Meclizine (2.16.840.1.113883.3.464.1003.196.12.1506): Deleted 1 RxNorm code (995682) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Nortriptyline (2.16.840.1.113883.3.464.1003.196.12.1507): Deleted 4 RxNorm codes (199283, 199406, 865143, 865146) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
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): Added 2 RxNorm codes (308170, 318179) based on change in measure requirements/measure specification. Deleted 3 RxNorm codes (860771, 889614, 1363513) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Nonbenzodiazepine hypnotics (2.16.840.1.113883.3.464.1003.196.12.1480): Deleted 2 RxNorm codes (854885, 854886) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Amobarbital (2.16.840.1.113883.3.464.1003.196.12.1512) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
Value set Butalbital (2.16.840.1.113883.3.464.1003.196.12.1514): Deleted 6 RxNorm codes (197425, 197427, 197428, 240093, 308322, 476152) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Doxylamine (2.16.840.1.113883.3.464.1003.196.12.1515): Deleted 29 RxNorm codes based on validity of code during timing of look back period or based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Removed value set Ergoloid Mesylates (2.16.840.1.113883.3.464.1003.196.12.1516) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Propantheline (2.16.840.1.113883.3.464.1003.196.12.1519): Deleted 1 RxNorm code (312673) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Scopolamine (2.16.840.1.113883.3.464.1003.196.12.1520): Deleted 9 RxNorm codes (1048078, 106507, 199442, 200059, 245350, 250536, 250537, 412723, 429720) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Value set Secobarbital (2.16.840.1.113883.3.464.1003.196.12.1521): Deleted 3 RxNorm codes (308167, 308171, 315201) based on updated evidence in published guidelines, published literature, or from published specialty medical society or group recommendations.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Alcohol Withdrawal (2.16.840.1.113883.3.464.1003.105.12.1209) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Benzodiazepine (2.16.840.1.113883.3.464.1003.196.12.1522) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Benzodiazepine Withdrawal (2.16.840.1.113883.3.464.1003.105.12.1208) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Bipolar Disorder (2.16.840.1.113883.3.464.1003.105.12.1157) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set General Anxiety Disorder (2.16.840.1.113883.3.464.1003.105.12.1210) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Other Bipolar Disorder (2.16.840.1.113883.3.464.1003.105.12.1204) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set REM Sleep Behavior Disorder (2.16.840.1.113883.3.464.1003.105.12.1207) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Schizophrenia (2.16.840.1.113883.3.464.1003.105.12.1205) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Seizure Disorder (2.16.840.1.113883.3.464.1003.105.12.1206) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Methscopolamine (2.16.840.1.113883.3.464.1003.196.12.1525) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Telephone Visits (2.16.840.1.113883.3.464.1003.101.12.1080) based on review by technical experts, SMEs, and/or public feedback.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Online Assessment (2.16.840.1.113883.3.464.1003.101.12.1089) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Palliative Care Encounter (2.16.840.1.113883.3.464.1003.101.12.1090) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added value set Palliative Care Intervention (2.16.840.1.113883.3.464.1003.198.12.1135) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added direct reference code CPT code (99211) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead
Added direct reference code LOINC code (71007-9) based on change in measure requirements/measure specification.
Measure Section: Terminology
Source of Change: Measure Lead