Last updated: June 9, 2017
| CMS Measure ID: | CMS135v6 |
|---|---|
| Version: | 6 |
| NQF Number: | 0081 |
| Measure Description: |
Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed ACE inhibitor or ARB therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge |
| Initial Patient Population: |
All patients aged 18 years and older with a diagnosis of heart failure |
| Denominator Statement: |
Equals Initial Population with a current or prior LVEF < 40% |
| Denominator Exclusions: |
None |
| Numerator Statement: |
Patients who were prescribed ACE inhibitor or ARB therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge |
| Numerator Exclusions: |
Not Applicable |
| Denominator Exceptions: |
Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB therapy (eg, hypotensive patients who are at immediate risk of cardiogenic shock, hospitalized patients who have experienced marked azotemia, allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB therapy (eg, patient declined, other patient reasons). Documentation of system reason(s) for not prescribing ACE inhibitor or ARB therapy (eg, other system reasons). |
| Measure Steward: | PCPI(R) Foundation (PCPI[R]) |
| Domain: | Effective Clinical Care |
| Previous Version: | Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD) |
| Improvement Notation: |
Higher score indicates better quality |
| Guidance: |
To satisfy this measure, it must be reported for all heart failure patients at least once during the measurement period if seen in the outpatient setting. If the patient has an eligible inpatient discharge during the measurement period, as defined in the measure logic, it is expected to be reported at each hospital discharge. The requirement of Count >=2 Encounter, Performed is to establish that the eligible professional or eligible clinician has an existing relationship with the patient. A range value should satisfy the logic requirement for 'Ejection Fraction' as long as the ranged observation value clearly meets the less than 40% threshold noted in the denominator logic. A range that is inclusive of or greater than 40% would not meet the measure requirement. |
Specifications
CMS135v6_0.html
CMS135v6_0.xml
CMS135v6_SimpleXML_0.xml
EP_EC_CMS135v6_NQF0081_HF_ACEARB_0.zip
CMS135v6_TRN_05.05.17_0.xlsx
Release Notes
Header
Incremented eMeasure Version number.
Section: eMeasure Version number
Source: Measure Lead
Reverted to the parent NQF Number, 0081, for CMS documentation per guidance from National Quality Forum.
Section: NQF Number
Source: Measure Lead
Updated Copyright.
Section: Copyright
Source: Annual Update
Updated Disclaimer.
Section: Disclaimer
Source: Measure Lead
Updated Guidance.
Section: Guidance
Source: Measure Lead
Added Guidance to provide clarification on what threshold range value(s) would satisfy the logic requirement for 'Ejection Fraction.'
Section: Guidance
Source: Measure Lead
Logic
Replaced value set ACE Inhibitor or ARB Ingredient (2.16.840.1.113883.3.526.3.1489) with value set ACE Inhibitor or ARB (2.16.840.1.113883.3.526.3.1139) in the 'Medication, Order not done' logic. As a result, the Data Criteria (QDM Data Element) 'Medication, Order: ACE Inhibitor or ARB Ingredient' has been removed.
Section: Denominator Exceptions
Source: JIRA (CQM-1812)
Value Set
The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.
Removed term types BN, PIN, and MIN from value set ACE Inhibitor or ARB Ingredient (2.16.840.1.113883.3.526.3.1489) value set.
Section: None
Source: JIRA (CQM-1812)
Value set Patient Reason (2.16.840.1.113883.3.526.3.1008): Added 1 SNOMEDCT code (713247000) and deleted 1 SNOMEDCT code (258147002).
Section: None
Source: None
Value set Ejection Fraction (2.16.840.1.113883.3.526.3.1134): Added 8 LOINC codes (77889-4, 77890-2, 77891-0, 77892-8, 79990-8, 79991-6, 79992-4, 79993-2).
Section: None
Source: None
Value set ACE Inhibitor or ARB Ingredient (2.16.840.1.113883.3.526.3.1489): Deleted 68 RXNORM codes.
Section: None
Source: None
Value set Pregnancy (2.16.840.1.113883.3.526.3.378): Removed ICD-9 extensional value set (2.16.840.1.113883.3.526.2.243).
Section: None
Source: None

