| eCQM Title | Primary Caries Prevention Intervention as Offered by Dentists |
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|---|---|---|---|
| eCQM Identifier (Measure Authoring Tool) | 74 | eCQM Version Number | 14.1.000 |
| CBE Number | Not Applicable | GUID | 0b81b6ba-3b30-41bf-a2f3-95bdc9f558f2 |
| Measurement Period | January 1, 20XX through December 31, 20XX | ||
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) | ||
| Measure Developer | National Committee for Quality Assurance | ||
| Endorsed By | None | ||
| Description |
Percentage of children, 1-20 years of age, who received two fluoride varnish applications during the measurement period as determined by a dentist |
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| Copyright |
This Physician Performance Measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & Medicaid Services (CMS). CMS contracted (Contract HHSP23320095627WC; HHSP23337008T) with the National Committee for Quality Assurance (NCQA) to develop this electronic measure. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications. Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any third-party codes contained in the specifications. CPT(R) codes, descriptions and other data are copyright 2024. American Medical Association. All rights reserved. CPT is a trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein. Applicable FARS/DFARS restrictions apply to government use. The American Dental Association (“ADA”) holds a copyright to the Current Dental Terminology (“CDT”) codes contained in certain measure specifications. The CDT codes in the measure specifications are included with the permission of the ADA. All uses of the CDT codes require a license from the ADA. No alteration, amendments, or modifications of the CDT or any portion thereof is allowed. Resale, transmission, or distribution of copies of the CDT or other portions of the CDT is also not allowed. To inquire about licensing, contact CDT-SNODENT@ada.org. The measure specifications contain coding from LOINC(R) (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright 2004-2024 Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee, and are available at no cost under the license at http://loinc.org/terms-of-use. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2023 International Health Terminology Standards Development Organisation. ICD-10 copyright 2024 World Health Organization. All Rights Reserved. “HL7” is the registered trademark of Health Level Seven International. |
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| Disclaimer |
The performance Measure is not a clinical guideline and does not establish a standard of medical care, and has not been tested for all potential applications. THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM]. |
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| Measure Scoring | Proportion | ||
| Measure Type | Process | ||
| Stratification |
Population 1: Patients age 1-5 years at the start of the Measurement Period Population 2: Patients age 6-12 years at the start of the Measurement Period Population 3: Patients age 13-20 years at the start of the Measurement Period |
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| Risk Adjustment |
None |
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| Rate Aggregation |
None |
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| Rationale |
The literature reflects that fluoride varnish, when applied to the teeth of high-risk children, reduces, in conjunction with anticipatory guidance provided to the caregiver, the risk of the child developing caries (Weyant et al., 2013). Evidence in the literature also specifically supports the effectiveness of professionally applied fluoride varnish at preventing caries in higher risk children (Chou et al., 2014). |
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| Clinical Recommendation Statement |
The 2013 American Dental Association (ADA) clinical recommendations for use of professionally applied or prescription-strength, home-use topical fluorides for caries prevention in patients at elevated risk of developing caries: - Younger Than 6 Years - 2.26 percent fluoride varnish at least every three to six months. - 6-18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF*) gel for four minutes at least every three to six months. - Older Than 18 Years - 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months (Weyant et al., 2013). The United States Preventive Services Taskforce (USPSTF) recommends the use of professionally applied fluoride varnish for the prevention of dental caries in high risk children under 5 years of age (Chou et al., 2014). |
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| Improvement Notation |
A higher score indicates better quality |
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| Reference |
Reference Type: CITATION Reference Text: 'Chou, R., Cantor, A., Zakher, B., Mitchell, J.P., Pappas, M. (2014) Prevention of Dental Caries in Children Younger Than 5 Years Old: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation. Agency for Health Research and Quality (US), Report No.: 12-05170-EF-1.' |
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| Reference |
Reference Type: CITATION Reference Text: 'Weyant, R. J., Tracy, S. L., Anselmo, T. (Tracy), Beltrán-Aguilar, E. D., Donly, K. J., Frese, W. A., Hujoel, P. P., Iafolla, T., Kohn, W., Kumar, J., Levy, S. M., Tinanoff, N., Wright, J. T., Zero, D., Aravamudhan, K., Frantsve-Hawley, J., & Meyer, D. M. (2013). Topical Fluoride for Caries Prevention. The Journal of the American Dental Association, 144(11), 1279–1291. https://doi.org/10.14219/jada.archive.2013.0057' |
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| Definition |
None |
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| Guidance |
This eCQM is a patient-based measure. Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM. |
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| Transmission Format |
TBD |
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| Initial Population |
Children, 1-20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period |
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| Denominator |
Equals Initial Population |
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| Denominator Exclusions |
Exclude patients who are in hospice care for any part of the measurement period |
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| Numerator |
Children who receive two fluoride varnish applications on different days during the measurement period |
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| Numerator Exclusions |
Not Applicable |
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| Denominator Exceptions |
None |
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| Supplemental Data Elements |
For every patient evaluated by this measure also identify payer, race, ethnicity and sex |
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AgeInYearsAt(date from start of "Measurement Period") in Interval[1, 20] and exists ( "Qualifying Encounters" )
"Initial Population"
Hospice."Has Hospice Services"
Count(["Procedure, Performed": "Fluoride Varnish Application for Children"] FluorideApplication
where Global."NormalizeInterval"(FluorideApplication.relevantDatetime, FluorideApplication.relevantPeriod) ends during day of "Measurement Period"
return distinct date from
end of Global."NormalizeInterval"(FluorideApplication.relevantDatetime, FluorideApplication.relevantPeriod)
) >= 2
None
None
AgeInYearsAt(date from start of "Measurement Period") in Interval[1, 5]
AgeInYearsAt(date from start of "Measurement Period") in Interval[6, 12]
AgeInYearsAt(date from start of "Measurement Period") in Interval[13, 20]
"Initial Population"
Hospice."Has Hospice Services"
exists ( ["Encounter, Performed": "Encounter Inpatient"] InpatientEncounter
where ( InpatientEncounter.dischargeDisposition ~ "Discharge to home for hospice care (procedure)"
or InpatientEncounter.dischargeDisposition ~ "Discharge to healthcare facility for hospice care (procedure)"
)
and InpatientEncounter.relevantPeriod ends during day of "Measurement Period"
)
or exists ( ["Encounter, Performed": "Hospice Encounter"] HospiceEncounter
where HospiceEncounter.relevantPeriod overlaps day of "Measurement Period"
)
or exists ( ["Assessment, Performed": "Hospice care [Minimum Data Set]"] HospiceAssessment
where HospiceAssessment.result ~ "Yes (qualifier value)"
and Global."NormalizeInterval" ( HospiceAssessment.relevantDatetime, HospiceAssessment.relevantPeriod ) overlaps day of "Measurement Period"
)
or exists ( ["Intervention, Order": "Hospice Care Ambulatory"] HospiceOrder
where HospiceOrder.authorDatetime during day of "Measurement Period"
)
or exists ( ["Intervention, Performed": "Hospice Care Ambulatory"] HospicePerformed
where Global."NormalizeInterval" ( HospicePerformed.relevantDatetime, HospicePerformed.relevantPeriod ) overlaps day of "Measurement Period"
)
or exists ( ["Diagnosis": "Hospice Diagnosis"] HospiceCareDiagnosis
where HospiceCareDiagnosis.prevalencePeriod overlaps day of "Measurement Period"
)
AgeInYearsAt(date from start of "Measurement Period") in Interval[1, 20] and exists ( "Qualifying Encounters" )
Count(["Procedure, Performed": "Fluoride Varnish Application for Children"] FluorideApplication
where Global."NormalizeInterval"(FluorideApplication.relevantDatetime, FluorideApplication.relevantPeriod) ends during day of "Measurement Period"
return distinct date from
end of Global."NormalizeInterval"(FluorideApplication.relevantDatetime, FluorideApplication.relevantPeriod)
) >= 2
["Encounter, Performed": "Clinical Oral Evaluation"] ValidEncounter where ValidEncounter.relevantPeriod during day of "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer Type"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
AgeInYearsAt(date from start of "Measurement Period") in Interval[1, 5]
AgeInYearsAt(date from start of "Measurement Period") in Interval[6, 12]
AgeInYearsAt(date from start of "Measurement Period") in Interval[13, 20]
if pointInTime is not null then Interval[pointInTime, pointInTime] else if period is not null then period else null as Interval<DateTime>
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer Type"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
| Measure Set |
Not Applicable |
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|---|---|---|---|