2021 AQI57: Safe Opioid Prescribing Practices

Measure Description

Percentage of patients, aged 18 years and older, prescribed opioid medications for longer than six weeks’ duration for whom ALL of the following opioid prescribing best practices are followed:

1. Chemical dependency screening (includes laboratory testing and/or questionnaire) within the immediate 6 months prior to the encounter
2. Co-prescription of naloxone or documented discussion regarding offer of Naloxone co-prescription, if prescription is ≥50 MME/day
3. Non co-prescription of benzodiazepine medications by prescribing pain physician and documentation of a discussion with patient regarding risks of concomitant use of benzodiazepine and opioid medications.

Denominator

All patients aged 18 years and older prescribed opioid medications for longer than six weeks’ duration

Denominator Criteria (Eligible Cases):
Patients aged 18 years and older
AND
Patient encounter during the reporting period (CPT): , 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99224, 99225, 99226, 99241, 99242, 99243, 99244, 99245, 99281, 99282, 99283, 99284, 99285
AND
Patients prescribed opioids for longer than six weeks’ duration: G9561

Numerator

Patients for whom ALL of the following opioid prescribing best practices are followed:

1. Chemical dependency screening (includes laboratory testing and/or questionnaire) within the immediate 6 months prior to the encounter
2. Co-prescription of Naloxone, or documented discussion regarding offer of Naloxone coprescription, if opioid prescription is ≥50 MME/day
3. Non co-prescription of benzodiazepine medications by prescribing pain physician and documentation of a discussion with patient regarding risks of concomitant use of benzodiazepine and opioid medications.

Numerator Note: Chemical Dependency Screening: Questionnaires for chemical dependency screening can include the Opioid Risk Tool (ORT), Screener and Opioid Assessment for Patients with Pain (SOAPP), Screener and Opioid Assessment for Patients with Pain-Revised (SOAPPR), or the Diagnosis, Intractability, Risk, Efficacy (DIRE) tool. Numerator Quality-Data Coding Options for Reporting Satisfactorily Measure Scoring Note: In order to receive credit for this measure, ALL three numerator criteria must be reported. See the “Composite Performance Score” section for more details on how this measure is scored.

Criterion 1:

Performance Met:
10A92 Chemical dependency screening (including laboratory testing and/or questionnaire) was performed within the immediate 6 months prior to the encounter
OR
Performance Not Met:
10A93 Chemical dependency screening (including laboratory testing and/or questionnaire) was NOT performed within the immediate 6 months prior to the encounter

Criterion 2:

Performance Met:
10A94 Naloxone co-prescribed or documented discussion regarding offer of Naloxone co-prescription for opioid prescription ≥50 MME/day
OR
10A95 Not applicable, opioid prescription <50 MME/day
OR
Performance Not Met:
10A96 Naloxone NOT co-prescribed AND discussion NOT documented regarding offer of Naloxone co-prescription for opioid prescription ≥50 MME/day

Criterion 3:

Performance Met:
10A97 Benzodiazepine medications NOT co-prescribed by prescribing pain physician AND documented discussion regarding risks of concomitant use of benzodiazepine and opioid medications
OR
Performance Not Met:
10A98 Benzodiazepine medications co-prescribed by prescribing pain physician AND/OR no documented discussion regarding risks of concomitant use of benzodiazepine and opioid medications

Numerator Exclusions

None

NQF ID Number

N/A

NQS Domain

Effective Clinical Care

High Priority Measure

Yes

Includes Telehealth?

No

Inverse Measure

No

Proportional Measure

Yes

Continuous Variable Measure

No

Ratio Measure

No

Number of performance rates to be calculated and submitted

1

Risk-Adjusted Status?

No