Overview
CMS144v8
(2020)
CMS144v9
(2021)
CMS144v10
(2022)
Identifiers
| CMS eCQM ID | NQF eCQM ID | NQF | MIPS Quality ID |
| CMS144v10 | 0083e | 0083 | 008 |
*MIE only supports data collection and reporting using eCQM specifications
Definitions
| 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 beta-blocker 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 | Equals Initial Population with a current or prior LVEF < 40% |
| Denominator Exclusions | – |
| Numerator | Patients who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge |
| Numerator Exclusions | – |
| Denominator Exceptions | Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons). Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the healthcare system).
|
| Measure Type | Process measure |
| Measure Scoring | Proportion measure |
| Rate Aggregation | Population 1: Patients who were prescribed beta-blocker therapy within a 12-month period when seen in the outpatient setting
Population 2: Patients who were prescribed beta-blocker therapy at each hospital discharge Performance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)] |
| Granularity | Patient |
| Improvement Notation | Higher score indicates better quality |
| Domain | Effective Clinical Care |
Clinical Instructions
New UI Visit Encounter (valid RC202109+)
Original Visit Encounter
Track all patients aged 18+ prescribed beta-blocker therapy within a 12-month period of the diagnosis of heart failure with a current or prior left ventricular ejection fraction (LVEF) < 40%.
- Ensure patient has one of the following diagnoses:
- Moderate left ventricular systolic dysfunction (disorder) - SNOMED 981000124106
- Severe left ventricular systolic dysfunction (disorder) - SNOMED 991000124109
- Numerator will be populated with patients prescribed a beta-blocker therapy within the measurement period.
Evidence
Initial Patient Population
| Name | Value Set |
| Diagnosis: Heart Failure | 2.16.840.1.113883.3.526.3.376 |
| Encounter, Performed: Care Services in Long-Term Residential Facility | 2.16.840.1.113883.3.464.1003.101.12.1014 |
| Encounter, Performed: Discharge Services - Hospital Inpatient | 2.16.840.1.113883.3.464.1003.101.12.1007 |
| Encounter, Performed: Home Healthcare Services | 2.16.840.1.113883.3.464.1003.101.12.1016 |
| Encounter, Performed: Nursing Facility Visit | 2.16.840.1.113883.3.464.1003.101.12.1012 |
| Encounter, Performed: Office Visit | 2.16.840.1.113883.3.464.1003.101.12.1001 |
| Encounter, Performed: Outpatient Consultation | 2.16.840.1.113883.3.464.1003.101.12.1008 |
| Encounter, Performed: Patient Provider Interaction | 2.16.840.1.113883.3.526.3.1012 |
Denominator
| Name | Value Set |
| Diagnosis: Left ventricular systolic dysfunction (disorder) | SNOMEDCT Code 134401001 |
| Diagnosis: Moderate or Severe LVSD | 2.16.840.1.113883.3.526.3.1090 |
| Diagnostic Study, Performed: Ejection Fraction | 2.16.840.1.113883.3.526.3.1134 |
Numerator
| Name | Value Set |
| Medication, Active: Beta Blocker Therapy for LVSD" | 2.16.840.1.113883.3.526.3.1184 |
Denominator Exceptions
| Name | Value Set |
| Allergy/Intolerance: Beta Blocker Therapy Ingredient | 2.16.840.1.113883.3.526.3.1493 |
| Allergy/Intolerance: Substance with beta adrenergic receptor antagonist mechanism of action (substance) | SNOMEDCT Code 373254001 |
| Device, Applied: Cardiac Pacer | 2.16.840.1.113883.3.526.3.1193 |
| Diagnosis: Allergy to Beta Blocker Therapy | 2.16.840.1.113883.3.526.3.1177 |
| Diagnosis: Arrhythmia | 2.16.840.1.113883.3.526.3.366 |
| Diagnosis: Asthma | 2.16.840.1.113883.3.526.3.362 |
| Diagnosis: Atrioventricular Block | 2.16.840.1.113883.3.526.3.367 |
| Diagnosis: Bradycardia | 2.16.840.1.113883.3.526.3.412 |
| Diagnosis: Cardiac Pacer in Situ | 2.16.840.1.113883.3.526.3.368 |
| Diagnosis: Hypotension | 2.16.840.1.113883.3.526.3.370 |
| Diagnosis: Intolerance to Beta Blocker Therapy | 2.16.840.1.113883.3.526.3.1178 |
| Physical Exam, Performed: Heart Rate | 2.16.840.1.113883.3.526.3.1176 |
Source(s)
eCQI CMS144