Overview
CMS137v8
(2020)
CMS137v9
(2021)
CMS137v10
(2022)
Identifiers
| CMS eCQM ID | NQF eCQM ID | NQF | MIPS Quality ID |
| CMS137v10 | – | – | 305 |
*MIE only supports data collection and reporting using eCQM specifications
Definitions
| Description | Percentage of patients 13 years of age and older with a new episode of alcohol or other drug abuse or (AOD) dependence who received the following. |
| Percentage of patients who initiated treatment including either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis | Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention. |
| Initial Patient Population | Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period |
| Denominator | Equals Initial Population |
| Denominator Exclusions | Exclude patients with a negative diagnosis history, defined as an encounter or medication treatment for a diagnosis of alcohol, opioid or other drug abuse or dependence in the 60 days prior to the first episode of alcohol or drug dependence. Exclude patients who are in hospice care for any part of the measurement period.
|
| Numerator | Initiation of treatment includes either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis. | Engagement in ongoing treatment within 34 days of initiation includes:Patients that initiated treatment with a psychosocial visit, and whose engagement criteria was fulfilled by a dispensed medication. Patients that initiated treatment with a psychosocial visit, and whose engagement criteria was fulfilled by two further psychosocial visits. Patients that initiated treatment with a dispensed medication, and whose engagement criteria was fulfilled by both a further medication dispense and a psychosocial visit. Patients that initiated treatment with a dispensed medication, and whose engagement criteria was fulfilled by two psychosocial visits.
|
| Numerator Exclusions | – |
| Denominator Exceptions | – |
| Measure Type | Process measure |
| Measure Scoring | Proportion measure |
| Stratification | 13-17 years 18 or greater years
|
| Granularity | Patient |
| Improvement Notation | Higher score indicates better quality |
| Domain | Effective Clinical Care |
Clinical Instructions
New UI Visit Encounter (valid RC202109+)
Original Visit Encounter
Evidence
Initial Patient Population
| Name | Value Set |
| Diagnosis: Alcohol and Drug Dependence | 2.16.840.1.113883.3.464.1003.106.12.1001 |
| Encounter, Performed: Discharge Services - Hospital Inpatient | 2.16.840.1.113883.3.464.1003.101.12.1007 |
| Encounter, Performed: Discharge Services - Hospital Inpatient Same Day Discharge | 2.16.840.1.113883.3.464.1003.101.12.1006 |
| Encounter, Performed: Emergency Department Visit | 2.16.840.1.113883.3.464.1003.101.12.1010 |
| Encounter, Performed: Hospital Inpatient Visit - Initial | 2.16.840.1.113883.3.464.1003.101.12.1004 |
| Encounter, Performed: Hospital Observation Care - Initial | 2.16.840.1.113883.3.464.1003.101.12.1002 |
| Encounter, Performed: Office Visit | 2.16.840.1.113883.3.464.1003.101.12.1001 |
| Encounter, Performed: Online Assessments | 2.16.840.1.113883.3.464.1003.101.12.1089 |
| Encounter, Performed: Telephone Visits | 2.16.840.1.113883.3.464.1003.101.12.1080 |
Denominator Exclusions
| Name | Value Set |
| Encounter, Performed: Encounter Inpatient | 2.16.840.1.113883.3.666.5.307 |
| Intervention, Order: Hospice care ambulatory | 2.16.840.1.113762.1.4.1108.15 |
| Intervention, Performed: Hospice care ambulatory | 2.16.840.1.113762.1.4.1108.15 |
Numerator
| Name | Value Set |
| Encounter, Performed: Detoxification Visit | 2.16.840.1.113883.3.464.1003.101.12.1059 |
| Intervention, Performed: Alcohol and Drug Dependence Treatment | 2.16.840.1.113883.3.464.1003.106.12.1005 |
| Intervention, Performed: Psych Visit - Psychotherapy | 2.16.840.1.113883.3.526.3.1496 |
| Medication, Order: Opiate Antagonists | 2.16.840.1.113883.3.464.1003.198.12.1132 |
Source(s)
eCQI CMS137