Table of Contents


Population Criteria

Definitions

Functions

Terminology

  • code "Birth date" ("LOINC Code (21112-8)")
  • code "Discharge to healthcare facility for hospice care (procedure)" ("SNOMEDCT Code (428371000124100)")
  • code "Discharge to home for hospice care (procedure)" ("SNOMEDCT Code (428361000124107)")
  • code "Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if the discharge is on other than the initial date of observation status. To report services to a patient designated as observation status or inpatient status and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])" ("CPT Code (99217)")
  • valueset "ADHD Medications" (2.16.840.1.113883.3.464.1003.196.12.1171)
  • valueset "Ambulatory" (2.16.840.1.113883.3.464.1003.122.12.1003)
  • valueset "Behavioral Health Follow-up Visit" (2.16.840.1.113883.3.464.1003.101.12.1054)
  • valueset "Encounter Inpatient" (2.16.840.1.113883.3.666.5.307)
  • valueset "Ethnicity" (2.16.840.1.114222.4.11.837)
  • valueset "Home Healthcare Services" (2.16.840.1.113883.3.464.1003.101.12.1016)
  • valueset "Hospice care ambulatory" (2.16.840.1.113762.1.4.1108.15)
  • valueset "Hospital Observation Care - Initial" (2.16.840.1.113883.3.464.1003.101.12.1002)
  • valueset "Mental Health Diagnoses" (2.16.840.1.113883.3.464.1003.105.12.1004)
  • valueset "Narcolepsy" (2.16.840.1.113883.3.464.1003.114.12.1011)
  • valueset "Office Visit" (2.16.840.1.113883.3.464.1003.101.12.1001)
  • valueset "ONC Administrative Sex" (2.16.840.1.113762.1.4.1)
  • valueset "Outpatient Consultation" (2.16.840.1.113883.3.464.1003.101.12.1008)
  • valueset "Payer" (2.16.840.1.114222.4.11.3591)
  • valueset "Preventive Care Services - Group Counseling" (2.16.840.1.113883.3.464.1003.101.12.1027)
  • valueset "Preventive Care Services, Initial Office Visit, 0 to 17" (2.16.840.1.113883.3.464.1003.101.12.1022)
  • valueset "Preventive Care Services-Individual Counseling" (2.16.840.1.113883.3.464.1003.101.12.1026)
  • valueset "Preventive Care, Established Office Visit, 0 to 17" (2.16.840.1.113883.3.464.1003.101.12.1024)
  • valueset "Psych Visit - Diagnostic Evaluation" (2.16.840.1.113883.3.526.3.1492)
  • valueset "Psych Visit - Psychotherapy" (2.16.840.1.113883.3.526.3.1496)
  • valueset "Psychotherapy and Pharmacologic Management" (2.16.840.1.113883.3.464.1003.101.12.1055)
  • valueset "Race" (2.16.840.1.114222.4.11.836)
  • valueset "Substance Abuse" (2.16.840.1.113883.3.464.1003.106.12.1004)
  • valueset "Telehealth Services" (2.16.840.1.113883.3.464.1003.101.12.1031)
  • valueset "Telephone Management" (2.16.840.1.113883.3.464.1003.101.12.1053)

Data Criteria (QDM Data Elements)

  • "Diagnosis: Narcolepsy" using "Narcolepsy (2.16.840.1.113883.3.464.1003.114.12.1011)"
  • "Encounter, Performed: Behavioral Health Follow-up Visit" using "Behavioral Health Follow-up Visit (2.16.840.1.113883.3.464.1003.101.12.1054)"
  • "Encounter, Performed: Encounter Inpatient" using "Encounter Inpatient (2.16.840.1.113883.3.666.5.307)"
  • "Encounter, Performed: Home Healthcare Services" using "Home Healthcare Services (2.16.840.1.113883.3.464.1003.101.12.1016)"
  • "Encounter, Performed: Hospital Observation Care - Initial" using "Hospital Observation Care - Initial (2.16.840.1.113883.3.464.1003.101.12.1002)"
  • "Encounter, Performed: Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if the discharge is on other than the initial date of observation status. To report services to a patient designated as observation status or inpatient status and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.])" using "Observation care discharge day management (This code is to be utilized to report all services provided to a patient on discharge from outpatient hospital observation status if the discharge is on other than the initial date of observation status. To report services to a patient designated as observation status or inpatient status and discharged on the same date, use the codes for Observation or Inpatient Care Services [including Admission and Discharge Services, 99234-99236 as appropriate.]) (CPT Code 99217)"
  • "Encounter, Performed: Office Visit" using "Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001)"
  • "Encounter, Performed: Outpatient Consultation" using "Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008)"
  • "Encounter, Performed: Preventive Care Services - Group Counseling" using "Preventive Care Services - Group Counseling (2.16.840.1.113883.3.464.1003.101.12.1027)"
  • "Encounter, Performed: Preventive Care Services, Initial Office Visit, 0 to 17" using "Preventive Care Services, Initial Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1022)"
  • "Encounter, Performed: Preventive Care Services-Individual Counseling" using "Preventive Care Services-Individual Counseling (2.16.840.1.113883.3.464.1003.101.12.1026)"
  • "Encounter, Performed: Preventive Care, Established Office Visit, 0 to 17" using "Preventive Care, Established Office Visit, 0 to 17 (2.16.840.1.113883.3.464.1003.101.12.1024)"
  • "Encounter, Performed: Psych Visit - Diagnostic Evaluation" using "Psych Visit - Diagnostic Evaluation (2.16.840.1.113883.3.526.3.1492)"
  • "Encounter, Performed: Psych Visit - Psychotherapy" using "Psych Visit - Psychotherapy (2.16.840.1.113883.3.526.3.1496)"
  • "Encounter, Performed: Psychotherapy and Pharmacologic Management" using "Psychotherapy and Pharmacologic Management (2.16.840.1.113883.3.464.1003.101.12.1055)"
  • "Encounter, Performed: Telehealth Services" using "Telehealth Services (2.16.840.1.113883.3.464.1003.101.12.1031)"
  • "Encounter, Performed: Telephone Management" using "Telephone Management (2.16.840.1.113883.3.464.1003.101.12.1053)"
  • "Intervention, Order: Hospice care ambulatory" using "Hospice care ambulatory (2.16.840.1.113762.1.4.1108.15)"
  • "Intervention, Performed: Hospice care ambulatory" using "Hospice care ambulatory (2.16.840.1.113762.1.4.1108.15)"
  • "Medication, Active: ADHD Medications" using "ADHD Medications (2.16.840.1.113883.3.464.1003.196.12.1171)"
  • "Medication, Dispensed: ADHD Medications" using "ADHD Medications (2.16.840.1.113883.3.464.1003.196.12.1171)"
  • "Patient Characteristic Birthdate: Birth date" using "Birth date (LOINC Code 21112-8)"
  • "Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity (2.16.840.1.114222.4.11.837)"
  • "Patient Characteristic Payer: Payer" using "Payer (2.16.840.1.114222.4.11.3591)"
  • "Patient Characteristic Race: Race" using "Race (2.16.840.1.114222.4.11.836)"
  • "Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex (2.16.840.1.113762.1.4.1)"

Supplemental Data Elements

Risk Adjustment Variables