Overview
CMS145v8
(2020)
CMS145v9
(2021)
CMS145v10
(2022)
Identifiers
| CMS eCQM ID | NQF eCQM ID | NQF | MIPS Quality ID |
| CMS145v10 | 0070e | 0070 | 007 |
*MIE only supports data collection and reporting using eCQM specifications
Definitions
| Description | Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior LVEF < 40% who were prescribed beta-blocker therapy |
| Initial Patient Population | All patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period |
| Denominator | Equals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <40% |
| Denominator Exclusions | – |
| Numerator | Patients who were prescribed beta-blocker therapy |
| Numerator Exclusions | – |
| Denominator Exceptions | Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., 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 health care system).
|
| Measure Type | Process measure |
| Measure Scoring | Proportion measure |
| Rate Aggregation | Population 1: Patients with left ventricular systolic dysfunction (LVEF <40%)
Population 2: Patients with a prior (within the past 3 years) myocardial infarction 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 coronary artery disease with prior myocardial infarction (MI) or a current or prior 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 measure period.
Evidence
Initial Patient Population
| Name | Value Set |
| Diagnosis: Coronary Artery Disease No MI | 2.16.840.1.113883.3.526.3.369 |
| Encounter, Performed: Care Services in Long-Term Residential Facility | 2.16.840.1.113883.3.464.1003.101.12.1014 |
| 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 |
| Diagnosis: Myocardial Infarction | 2.16.840.1.113883.3.526.3.403 |
| Diagnostic Study, Performed: Ejection Fraction | 2.16.840.1.113883.3.526.3.1134 |
Numerator
| Name | Value Set |
| Medication, Active: Beta Blocker Therapy | 2.16.840.1.113883.3.526.3.1174 |
| 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 |
| Procedure, Performed: Cardiac Surgery | 2.16.840.1.113883.3.526.3.371 |
Source(s)
eCQI CMS145