Functional Status Assessments for Congestive Heart Failure

Last updated: March 22, 2017

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 Population

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 EHR 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 & Medicaid Services (CMS)
Domain: Person and Caregiver-Centered Experience and Outcomes
Previous Version: Functional Status Assessment for Complex Chronic Conditions
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.

Specifications

Release Notes

Header

  • Updated Clinical Recommendation Statement.

    Section: Clinical Recommendation Statement

    Source: Measure Lead

  • ‚ÄčUpdated Copyright.

    Section: Copyright

    Source: Annual Update

  • Removed the word 'active' from the denominator exclusion description to conform with QDM 4.2 changes.

    Section: Denominator Exclusions

    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 QRDA as it is not pertinent to the measure calculation.

    Section: Guidance

    Source: Measure Lead

  • Updated the Initial Population 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: Numerator

    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 Set

  • 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