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Use of High-Risk Medications in the Elderly

Last updated: September 14, 2018

CMS Measure ID: CMS156v7
Version: 7
NQF Number: 0022
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 Patient Population:

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

Denominator Statement:

Equals Initial Populationinfo-icon

Denominator Exclusions:

Exclude patients whose hospice care overlaps the measurement period

Numerator Statement:

Numeratorinfo-icon 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 during the measurement period

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
Domain: Patient Safety
Previous Version:
Improvement Notation:

Lower score indicates better quality

Guidance:

The intent of Numeratorinfo-icon 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.

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.

CUMULATIVE MEDICATION DURATION is an individual's total number of medication days over a specific period; the period counts multiple prescriptions with gaps in between, but does not count the gaps during which a medication was not dispensed.

To determine the cumulative medication duration, determine first the number of the Medication Days for each prescription in the period: the number of doses divided by the dose frequency per day. Then add the Medication Days for each prescription without counting any days between the prescriptions.

For example, there is an original prescription for 30 days with 2 refills for thirty days each. After a gap of 3 months, the medication was prescribed again for 60 days with 1 refill for 60 days. The cumulative medication duration is (30 x 3) + (60 x 2) = 210 days over the 10 month period.

Quality ID: 238
Meaningful Measure: Medication Management

Specifications

Release Notes

Header

  • Updated Version Number.

    Measure Section: eMeasure Version number

    Source of Change: Measure Lead

  • Updated Copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated measure header rationale to align with most recent literature.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Updated header references to align with updated rationale and clinical recommendation statement.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Added 'of the' to the last sentence of the first paragraph under guidance to more accurately reflect the numeratorinfo-icon intent.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Updated the Denominator Exclusioninfo-icon statement for patients in hospice care to better align with the logic.

    Measure Section: Denominator Exclusionsinfo-icon

    Source of Change: JIRAinfo-icon (CQMinfo-icon-2815)

Logic

  • Replaced 'Discharge status' attribute with 'Admission Source' and 'Discharge Disposition' attributes for 'Encounter, Performed' and 'Encounter, Active' datatypes to align with QDMinfo-icon 5.3 changes.

    Measure Section: Denominator Exclusions

    Source of Change: Standards Update

  • Removed 'Cumulative Medication Duration' datatype to conform with QDM 5.3 changes. The concept of cumulative medication duration can now be expressed using CQLinfo-icon logic.

    Measure Section: Numerator

    Source of Change: Standards Update

  • Added supplemental timing attributes to most datatypes in QDM 5.3 to facilitate accurate retrieval of time related information within CQL logic. Timing attributes now include a time interval, such as prevalence period or relevant period, and/or actual time of documentation with Author Datetime. Relevant period is the general method to describe start and stop times for datatypes. Prevalence period is used for some datatypes to more accurately define onset and abatement times.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Assigned cardinality to each attribute to be more explicit in guiding specificationinfo-icon and implementation of QDM data elements. Cardinality refers to the number of instances of the attribute that can be included in the measure description. Cardinality for most attributes is 0.. 1 (i.e., can occur up to 1 time), but some attributes have a cardinality of 0.. * (i.e., can occur multiple times).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • CQL libraries contain sets of CQL definitions, or CQL expression statements. A context statement, patient or population, can now be used in a CQL library to clearly establish how the subsequent list of CQL expressions will be interpreted. A 'Population' context will interpret the CQL expression with reference to the entire population of the item being counted, patients or encounters. A 'Patient' context will interpret the CQL expression with reference to a single patient. Context statements are not required, but one or more context statements may be used within a library to help clarify how the CQL expressions will be interpreted. Patient context is the default if none is specified.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Replaced measure-defined definitions with similar definitions and functions from CQL shared libraries for consistency across measures.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated measure logic from Quality Data Model (QDM)-based logic to Clinical Quality Language (CQL)-based logic. Information on CQL can be found at the eCQI Resource centerinfo-icon (https://ecqi.healthit.gov/cql). Information about specific versions of the new standards in use for CMS reporting periods can be found at the eCQI Resource Center (https://ecqi.healthit.gov/ecqm-tools-key-resources). Switching from QDM to CQL brings with it many changes, as well as enhanced expression capability, but only those changes with significant impact will be outlined in technical release notes. For example, in the case of timing operators, changes may only be summarized if those changes impact the measure calculation.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

Value Setinfo-icon

The VSACinfo-icon is the source of truth for the value set content, please visit the VSAC for downloads of current value setsinfo-icon.

  • Value set Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1264) including 7 codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Home Healthcare Services (2.16.840.1.113883.3.464.1003.101.12.1016): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1265) including 11 codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Dextromethorphan / Doxylamine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1287): Deleted 1 RXNORM code (1657147).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Chlorpheniramine / Dextromethorphan / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1310): Deleted 1 RXNORM code (1537029).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Brompheniramine / Dextromethorphan / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1325): Added 1 RXNORM code (1423702).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Diphenhydramine (2.16.840.1.113883.3.464.1003.196.12.1350): Deleted 1 RXNORM code (1294607).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Estradiol / Norgestimate Biphasic (2.16.840.1.113883.3.464.1003.196.12.1396): Removed Estradiol / Norgestimate Biphasic.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dexbrompheniramine / Dextromethorphan / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1426): Added 2 RXNORM codes (1812101, 1946979).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dexbrompheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1430): Added 2 RXNORM codes (1299143, 1363513).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Chlorpheniramine / Dihydrocodeine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1434): Removed Chlorpheniramine / Dihydrocodeine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Brompheniramine / Codeine (2.16.840.1.113883.3.464.1003.196.12.1455): Removed Brompheniramine / Codeine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Estradiol / Levonorgestrel (2.16.840.1.113883.3.464.1003.196.12.1483): Removed Estradiol / Levonorgestrel.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Conjugated Estrogens (2.16.840.1.113883.3.464.1003.196.12.1357): Deleted 2 RXNORM codes (310205, 351228).

    Measure Section: QDM Data Elements

    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 RXNORM extensional value set (2.16.840.1.113883.3.464.1003.196.11.1504) including 4 codes. Added 72 RXNORM codes and deleted 92 RXNORM codes.

    Measure Section: QDM Data Elements

    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 List of Single RxNorm Code Concepts for High Risk Drugs for the Elderly.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Atropine / Diphenoxylate (2.16.840.1.113883.3.464.1003.196.12.1274): Added Atropine / Diphenoxylate.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Amoxapine (2.16.840.1.113883.3.464.1003.196.12.1273): Added Amoxapine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Cyproheptadine (2.16.840.1.113883.3.464.1003.196.12.1277): Added Cyproheptadine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Desipramine (2.16.840.1.113883.3.464.1003.196.12.1278): Added Desipramine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dicyclomine (2.16.840.1.113883.3.464.1003.196.12.1279): Added Dicyclomine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dimenhydrinate (2.16.840.1.113883.3.464.1003.196.12.1500): Added Dimenhydrinate.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Hyoscyamine (2.16.840.1.113883.3.464.1003.196.12.1501): Added Hyoscyamine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Hyoscyamine / Methenamine / Mblue / Phenyl Salicyl (2.16.840.1.113883.3.464.1003.196.12.1503): Added Hyoscyamine / Methenamine / Mblue / Phenyl Salicyl.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Hyoscyamine / Methenamine / Mblue / Phenyl Salicyl / Sodium Biphosphate (2.16.840.1.113883.3.464.1003.196.12.1504): Added Hyoscyamine / Methenamine / Mblue / Phenyl Salicyl / Sodium Biphosphate.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Hyoscyamine / Methenamine / Mblue / Sodium Biphosphate (2.16.840.1.113883.3.464.1003.196.12.1505): Added Hyoscyamine / Methenamine / Mblue / Sodium Biphosphate.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Meclizine (2.16.840.1.113883.3.464.1003.196.12.1506): Added Meclizine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Nortriptyline (2.16.840.1.113883.3.464.1003.196.12.1507): Added Nortriptyline.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Paroxetine (2.16.840.1.113883.3.464.1003.196.12.1508): Added Paroxetine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Protriptyline (2.16.840.1.113883.3.464.1003.196.12.1509): Added Protriptyline.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Payer (2.16.840.1.114222.4.11.3591): Added 11 SOP codes (299, 32127, 32128, 391, 517, 524, 614, 621, 622, 623, 629) and deleted 3 SOP codes (63, 64, 69).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Face-to-Face Interaction (2.16.840.1.113883.3.464.1003.101.12.1048): Removed Face-to-Face Interaction.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Thioridazine (2.16.840.1.113883.3.464.1003.196.12.1344): Removed Thioridazine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Dextromethorphan / Doxylamine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1329): Removed Acetaminophen / Dextromethorphan / Doxylamine / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Brompheniramine / Chlophedianol / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1445): Removed Brompheniramine / Chlophedianol / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Carbetapentane / Chlorpheniramine / Ephedrine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1420): Removed Carbetapentane / Chlorpheniramine / Ephedrine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Carbetapentane / Chlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1472): Removed Carbetapentane / Chlorpheniramine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Chlorpheniramine / Codeine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1446): Removed Chlorpheniramine / Codeine / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Chlorpheniramine / Dextromethorphan (2.16.840.1.113883.3.464.1003.196.12.1296): Removed Chlorpheniramine / Dextromethorphan.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Codeine / Pseudoephedrine / Triprolidine (2.16.840.1.113883.3.464.1003.196.12.1431): Removed Codeine / Pseudoephedrine / Triprolidine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dexchlorpheniramine (2.16.840.1.113883.3.464.1003.196.12.1391): Removed Dexchlorpheniramine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Mephobarbital (2.16.840.1.113883.3.464.1003.196.12.1413): Removed Mephobarbital.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Trimethobenzamide (2.16.840.1.113883.3.464.1003.196.12.1335): Removed Trimethobenzamide.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Aspirin / Diphenhydramine (2.16.840.1.113883.3.464.1003.196.12.1388): Removed Acetaminophen / Aspirin / Diphenhydramine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Brompheniramine (2.16.840.1.113883.3.464.1003.196.12.1389): Removed Acetaminophen / Brompheniramine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Chlorpheniramine (2.16.840.1.113883.3.464.1003.196.12.1289): Removed Acetaminophen / Chlorpheniramine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Chlorpheniramine / Dextromethorphan / Guaifenesin (2.16.840.1.113883.3.464.1003.196.12.1383): Removed Acetaminophen / Chlorpheniramine / Dextromethorphan / Guaifenesin.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Dextromethorphan / Diphenhydramine (2.16.840.1.113883.3.464.1003.196.12.1441): Removed Acetaminophen / Dextromethorphan / Diphenhydramine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Diphenhydramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1378): Removed Acetaminophen / Diphenhydramine / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Acetaminophen / Doxylamine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1400): Removed Acetaminophen / Doxylamine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Amobarbital (2.16.840.1.113883.3.464.1003.196.12.1297): Removed Amobarbital.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Aspirin / Butalbital / Caffeine / Codeine (2.16.840.1.113883.3.464.1003.196.12.1322): Removed Aspirin / Butalbital / Caffeine / Codeine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Aspirin / Carisoprodol (2.16.840.1.113883.3.464.1003.196.12.1313): Removed Aspirin / Carisoprodol.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Aspirin / Carisoprodol / Codeine (2.16.840.1.113883.3.464.1003.196.12.1305): Removed Aspirin / Carisoprodol / Codeine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Aspirin / Chlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1380): Removed Aspirin / Chlorpheniramine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Aspirin / Diphenhydramine Citrate (2.16.840.1.113883.3.464.1003.196.12.1376): Removed Aspirin / Diphenhydramine Citrate.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Aspirin / Meprobamate (2.16.840.1.113883.3.464.1003.196.12.1394): Removed Aspirin / Meprobamate.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Atropine / Chlorpheniramine / Hyoscyamine / Pseudoephedrine / Scopolamine (2.16.840.1.113883.3.464.1003.196.12.1411): Removed Atropine / Chlorpheniramine / Hyoscyamine / Pseudoephedrine / Scopolamine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Bazedoxifene / Conjugated Estrogens (2.16.840.1.113883.3.464.1003.196.12.1386): Removed Bazedoxifene / Conjugated Estrogens.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Brompheniramine / Chlophedianol / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1443): Removed Brompheniramine / Chlophedianol / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Chlophedianol / Dexbrompheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1440): Removed Chlophedianol / Dexbrompheniramine / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Chlorpheniramine / Codeine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1439): Removed Chlorpheniramine / Codeine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Codeine / Dexbrompheniramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1437): Removed Codeine / Dexbrompheniramine / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Codeine / Dexchlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1433): Removed Codeine / Dexchlorpheniramine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Codeine / Phenylephrine / Promethazine (2.16.840.1.113883.3.464.1003.196.12.1291): Removed Codeine / Phenylephrine / Promethazine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Codeine / Promethazine (2.16.840.1.113883.3.464.1003.196.12.1340): Removed Codeine / Promethazine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dexbrompheniramine / Dextromethorphan / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1438): Removed Dexbrompheniramine / Dextromethorphan / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dexbrompheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1384): Removed Dexbrompheniramine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dexchlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1403): Removed Dexchlorpheniramine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dextromethorphan / Doxylamine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1444): Removed Dextromethorphan / Doxylamine / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Dextromethorphan / Promethazine (2.16.840.1.113883.3.464.1003.196.12.1314): Removed Dextromethorphan / Promethazine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Diphenhydramine / Magnesium Salicylate (2.16.840.1.113883.3.464.1003.196.12.1395): Removed Diphenhydramine / Magnesium Salicylate.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Diphenhydramine / Naproxen (2.16.840.1.113883.3.464.1003.196.12.1406): Removed Diphenhydramine / Naproxen.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Diphenhydramine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1392): Removed Diphenhydramine / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Doxylamine (2.16.840.1.113883.3.464.1003.196.12.1290): Removed Doxylamine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Doxylamine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1387): Removed Doxylamine / Phenylephrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Doxylamine / Pseudoephedrine (2.16.840.1.113883.3.464.1003.196.12.1448): Removed Doxylamine / Pseudoephedrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Doxylamine / Pyridoxine (2.16.840.1.113883.3.464.1003.196.12.1379): Removed Doxylamine / Pyridoxine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Ergoloid Mesylates (2.16.840.1.113883.3.464.1003.196.12.1288): Removed Ergoloid Mesylates.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Meperidine / Promethazine (2.16.840.1.113883.3.464.1003.196.12.1393): Removed Meperidine / Promethazine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Naloxone / Pentazocine (2.16.840.1.113883.3.464.1003.196.12.1346): Removed Naloxone / Pentazocine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Orphenadrine (2.16.840.1.113883.3.464.1003.196.12.1356): Removed Orphenadrine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Pentazocine (2.16.840.1.113883.3.464.1003.196.12.1407): Removed Pentazocine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Pentobarbital (2.16.840.1.113883.3.464.1003.196.12.1401): Removed Pentobarbital.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Phenylephrine / Promethazine (2.16.840.1.113883.3.464.1003.196.12.1294): Removed Phenylephrine / Promethazine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Phenylephrine / Triprolidine (2.16.840.1.113883.3.464.1003.196.12.1385): Removed Phenylephrine / Triprolidine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Secobarbital (2.16.840.1.113883.3.464.1003.196.12.1298): Removed Secobarbital.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Ticlopidine (2.16.840.1.113883.3.464.1003.196.12.1304): Removed Ticlopidine.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Nursing Facility Visit (2.16.840.1.113883.3.464.1003.101.12.1012): Added Nursing Facility Visit.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Care Services in Long-Term Residential Facility (2.16.840.1.113883.3.464.1003.101.12.1014): Added Care Services in Long-Term Residential Facility.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Discharge Services - Nursing Facility (2.16.840.1.113883.3.464.1003.101.12.1013): Added Discharge Services - Nursing Facility.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Replaced SNOMEDCT single code value sets with direct referenced codes. A direct referenced code is a single concept code that is used to describe a clinical element directly within the logic. The use of direct referenced codes replaces the need for single code value sets. Measures using other code systems in single value sets may optionally transition to direct referenced codes.

    Measure Section: QDM Data Elements

    Source of Change: Standards Update

  • Value set Acetaminophen / Dextromethorphan / Doxylamine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1287): Added 1 RXNORM code (1492380).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

  • Value set Acetaminophen / Diphenhydramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1318): Added 1 RXNORM code (1804449).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

  • Value set Chlorpheniramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1343): Added 1 RXNORM code (1876117).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

  • Value set Phenobarbital (2.16.840.1.113883.3.464.1003.196.12.1348): Added 2 RXNORM codes (199407, 245385).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

  • Value set Indomethacin (2.16.840.1.113883.3.464.1003.196.12.1366): Added 1 RXNORM code (247069).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

  • Value set Dextromethorphan / Diphenhydramine / Phenylephrine (2.16.840.1.113883.3.464.1003.196.12.1397): Added 1 RXNORM code (1666116).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

  • 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 1 RXNORM code (1666116).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

  • Value set High Risk Medications for the Elderly (2.16.840.1.113883.3.464.1003.196.12.1253): Added 7 RXNORM codes (199407, 245385, 1492380, 1804449, 1876117, 247069, 1666116).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

  • Value set Payer (2.16.840.1.114222.4.11.3591): Deleted 1 SOP code (24).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

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