Last updated: June 9, 2017
| CMS Measure ID: | CMS90v7 |
|---|---|
| Version: | 7 |
| NQF Number: | None |
| Measure Description: |
Percentage of patients 18 years of age and older with congestive heart failure who completed initial and follow-up patient-reported functional status assessments |
| Initial Patient Population: |
Patients 18 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: |
Exclude patients with severe cognitive impairment or patients with a diagnosis of cancer. Exclude patients who were in hospice care during the measurement year. |
| 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 two weeks before or during the initial FSA encounter and results for the follow-up FSA at least 30 days but no more than 180 days after the initial functional status assessment |
| 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 Assessments for Congestive Heart Failure |
| Improvement Notation: |
A higher score indicates better quality |
| Guidance: |
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. Initial Functional Status Assessment (FSA) and Encounter: The initial FSA is the first FSA during the measurement year that also occurs two weeks before or during the first encounter in the first 185 days of the measurement year. Follow-up FSA: The follow-up FSA must be completed at least 30 days but no more than 180 days after the initial FSA. The same FSA instrument must be used for the initial and follow-up assessment. |
Specifications
CMS90v7_1.html
CMS90v7_1.xml- CMS90v7_SimpleXML_1.xml
EP_EC_CMS90v7_NQFXXXX_FSA_Complex_Chronic_Cond_1.zip
CMS90v7_TRN_05.05.17_1.xlsx
Release Notes
Header
Incremented eMeasure Version number.
Section: eMeasure Version number
Source: Measure Lead
Expanded patient age range from 65 years and older to 18 years and older to be as inclusive as possible for this measure per clinical experts' recommendations.
Section: Description
Source: Expert Work Group
Updated Copyright.
Section: Copyright
Source: Annual Update
Updated Disclaimer.
Section: Disclaimer
Source: Measure Lead
Updated Guidance.
Section: Guidance
Source: Measure Lead
Expanded patient age range from 65 years and older to 18 years and older to be as inclusive as possible for this measure per clinical experts' recommendations.
Section: Initial Population
Source: Expert Work Group
Updated the exclusion statement in the header to exclude patients in hospice care from the Denominator. Measures that focus on screenings and procedures may not be appropriate or a priority for those who are at end of life (ie, on hospice).
Section: Denominator Exclusions
Source: Measure Lead
Changed the timing of the follow-up FSA to be in relation to the initial FSA (at least 30 days but no more than 180 days after the initial FSA) to better meet the intent of the measure (previously the timing was in relation to the encounter).
Section: Numerator
Source: Measure Lead
Logic
Expanded patient age in the Initial Population logic from '>=65 years(s)' to '>= 18 year(s)' to be as inclusive as possible for this measure per clinical experts' recommendations.
Section: Initial Population
Source: Expert Work Group
Added new lines of logic to the Denominator Exclusions for all NCQA-stewarded measures (except CMS82) to ensure patients in hospice care are excluded from the Denominator.
Section: Denominator Exclusions
Source: Measure Lead
Changed the logical operator in the Numerator to include patients who have results documented in the EHR for the follow-up FSA that is at least 30 days but no more than 180 days after the initial FSA (previously the timing was in relation to the encounter).
Section: Numerator
Source: Measure Lead
Replaced the 'ends before end of' logical operator to address situations where time stamps are not attached to procedures, diagnosis, and immunizations. Wherever applicable, the operators have been changed to 'ends before or concurrent with end of'.
Section: Numerator
Source: JIRA (CQM-1936)
Replaced 'Functional Status, Performed' datatype with 'Assessment, Performed' datatype to conform with QDM 4.3 changes.
Section: Numerator
Source: QDM Standards
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 All Cancer (2.16.840.1.113883.3.464.1003.108.12.1011): Added 85 ICD9CM codes and deleted 2 ICD9CM codes (154.2, 154.3). Added 261 ICD10CM codes and deleted 2 ICD10CM codes (C21.0, C21.1). Added 28 SNOMEDCT codes.
Section: None
Source: None