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Functional Status Assessments for Congestive Heart Failure

Last updated: May 3, 2018

CMS Measure ID: CMS90v6
Version: 6
NQF Number: None
Measure Description:

Percentage of patients 65 years of age and older with congestive heart failure who completed initial and follow-up patient-reported functional status assessments

Initial Patient Population:

Patients 65 years of age and older who had two outpatient encounters during the measurement year and a diagnosis of congestive heart failure

Denominator Statement:

Equals Initial Populationinfo-icon

Denominator Exclusions:

Patients with severe cognitive impairment or patients with a diagnosis of cancer

Numerator Statement:

Patients with patient reported functional status assessment results (eg, VR-12; VR-36; MLHF-Q; KCCQ; PROMIS-10 Global Health, PROMIS-29) present in the EHRinfo-icon within two weeks before or during the initial encounter and the follow-up encounter during the measurement year

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: Centers for Medicare and Medicaid Services (CMS)
Domain: Person and Caregiver-Centered Experience and Outcomes
Next Version:
Improvement Notation:

A higher score indicates better quality

Guidance:

Initial encounter: The first encounter during the first 185 days of the measurement year.

Follow-up encounter: The last encounter that is at least 30 days but no more than 180 days after the initial encounter.

A Functional Status Assessment (FSA) is based on administration of a validated instrument to eligible patients that asks patients to answer questions related to various domains including: pain, physical function, emotional well-being, health-related quality of life, symptom acuity.

The same FSA instrument must be used for the initial and follow-up assessment.

Notes: Value Set content updated
Quality ID: 377
High Priority Measure: Yes
Data Submission Method: EHR

Specifications

Release Notes

Header

  • Updated Clinical Recommendation Statement.

    Section: Clinical Recommendation Statement

    Source: Measure Lead

  • ​Updated Copyright.

    Section: Copyright

    Source: Annual Update

  • Removed the word 'active' from the denominator exclusioninfo-icon description to conform with QDMinfo-icon 4.2 changes.

    Section: Denominator Exclusionsinfo-icon

    Source: QDM Standards

  • Updated the measure description to align with the measure intent.

    Section: Description

    Source: Measure Lead

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • Added the word 'days' after 180 to clarify the unit. Added guidance to indicate the same FSA instrument should be used. Removed the statement about QRDAinfo-icon as it is not pertinent to the measure calculation.

    Section: Guidance

    Source: Measure Lead

  • Updated the Initial Populationinfo-icon description to align with the measure intent.

    Section: Initial Population

    Source: Measure Lead

  • Updated Rationale.

    Section: Rationale

    Source: Measure Lead

  • Updated References.

    Section: Reference

    Source: Measure Lead

  • Updated measure name to reflect the measure intent.

    Section: Title

    Source: Measure Lead

Logic

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Denominator Exclusions

    Source: QDM Standards

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Initial Population

    Source: QDM Standards

  • Revised '$CCFollowUp' variable logic to capture the most recent encounter so occurencing is no longer needed.

    Section: Initial Population

    Source: Measure Lead

  • Revised '$CCFollowUp' variable logic to capture the most recent encounter so occurencing is no longer needed.

    Section: Numeratorinfo-icon

    Source: Measure Lead

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

  • Revised '$CCFollowUp' variable logic to capture the most recent encounter so occurencing is no longer needed.

    Section: QDM Variables

    Source: Measure Lead

Value Setinfo-icon

  • Value set All Cancer (2.16.840.1.113883.3.464.1003.108.12.1011): Added 12 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

External Resources