Preventive Care and Screening: Influenza Immunization

Last updated: October 25, 2017

CMS Measure ID: CMS147v7
Version: 7
NQF Number: 0041
Measure Description:

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

Initial Patient Population:

All patients aged 6 months and older seen for a visit during the measurement period

Denominator Statement:

Equals Initial Population and seen for a visit between October 1 and March 31

Denominator Exclusions:

None

Numerator Statement:

Patients who received an influenza immunization OR who reported previous receipt of an influenza immunization

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

Documentation of medical reason(s) for not receiving influenza immunization (eg, patient allergy, other medical reasons).

Documentation of patient reason(s) for not receiving influenza immunization (eg, patient declined, other patient reasons).

Documentation of system reason(s) for not receiving influenza immunization (eg, vaccine not available, other system reasons).

Measure Steward: PCPI(R) Foundation (PCPI[R])
Domain: Community/Population Health
Previous Version: Preventive Care and Screening: Influenza Immunization
Improvement Notation:

Higher score indicates better quality

Guidance:

The timeframe for the visit during the Encounter, Performed: Encounter-Influenza or Procedure, Performed: Peritoneal Dialysis or Procedure, Performed: Hemodialysis in the Population Criteria-Denominator, refers to the influenza season defined by the measure: October through March (October 1 for the year prior to the start of the reporting period through March 31 during the reporting period). The Encounter-Influenza Grouping OID detailed in the data criteria section below is comprised of several individual OIDs of different encounter types. The individual OIDs are included in the value set and should be reviewed to determine that an applicable visit occurred during the timeframe for Encounter, Performed: Encounter-Influenza as specified in the denominator.

To enable reporting of this measure at the close of the reporting period, this measure will only assess the influenza season that ends in March of the reporting period. The subsequent influenza season (ending March of the following year) will be measured and reported in the following year.

To account for the majority of reporting years' appropriate flu season duration, the measure logic will look at the first 89 days of the measurement period for the appropriate criteria and actions to be present/performed (January 1 through March 31). The measure developer believes it is best to keep the logic as static as possible from one reporting year to the next. Therefore, during leap years, only encounters that occur through March 30 will be counted in the denominator.

As a result of updated CDC/ACIP guidelines which include the interim recommendation that live attenuated influenza vaccine (LAIV) should not be used due to low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013-14 and 2015-16 seasons, the measure specifications have been updated and no longer include LAIV or intranasal flu vaccine as an option for numerator eligibility.

Addendum Notes: Value Set content updated Sept 2017, TRNs updated Oct 2017

Specifications

Release Notes

Header

  • ​Incremented eMeasure Version number.

    Measure Section: eMeasure Version number

    Source of Change: Measure Lead

  • ​Updated Copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • ​Updated Disclaimer.

    Measure Section: Disclaimer

    Source of Change: Measure Lead

  • Updated Rationale.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Updated Clinical Recommendation Statement.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated References.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Added Guidance regarding the removal of a particular influenza vaccine to align with current guidelines.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Removed the requirement for two or more visits for certain types of encounters to align with clinical experts' recommendations. As a result, updated the Initial Population language.

    Measure Section: Initial Population

    Source of Change: Expert Work Group Review

Logic

  • Removed the requirement for two or more visits for certain types of encounters to align with clinical experts' recommendations. As a result, updated the Initial Population logic.

    Measure Section: Initial Population

    Source of Change: Expert Work Group Review

  • ​Added new data element 'Substance, Allergy: Egg Substance' to provide an alternative approach to capturing an allergy to egg.

    Measure Section: Denominator Exceptions

    Source of Change: JIRA (CQM-1067)

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 Patient Reason (2.16.840.1.113883.3.526.3.1008): Added 1 SNOMEDCT code (713247000) and deleted 1 SNOMEDCT code (258147002).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Influenza Vaccine (2.16.840.1.113883.3.526.3.1254): Added 1 CVX code (171) and deleted 2 CVX codes (149, 151).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Influenza Vaccination (2.16.840.1.113883.3.526.3.402): Deleted 3 CPT codes (90660, 90664, 90672).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Egg Substance (2.16.840.1.113883.3.526.3.1537): Added Egg Substance.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Influenza Vaccine (2.16.840.1.113883.3.526.3.1254): Added 1 CVX code (185).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Influenza Vaccination (2.16.840.1.113883.3.526.3.402): Added 2 CPT codes (90674, 90682).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

  • Value set Encounter-Influenza (2.16.840.1.113883.3.526.3.1252): Deleted 1 CPT code (99420).

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

External Resources