MBHR10 Symptom Improvement in adults with ADHD

Measure Title

Symptom Improvement in adults with ADHD

Measure Description

The percentage of adult patients (18 years of age or older) with a diagnosis of ADHD who show a reduction in symptoms of 25% on the Adult ADHD Self-Report Scale (ASRS-v1.1)- 18 item self-report scale of ADHD symptoms within 2 to 10 months after initially reporting significant symptoms.

There are two aspects to this measure. The first is the assessment of the use of the ASRS v.1. during the denominator identification period (Criteria 1 also referred to as Time 1) and the second is the assessment of improvement in the ASRS v.1.1 from the first administration to the second administration of the ASRS v.1.1 (Criteria 2 also referred to as Time 2).

 Denominator

Denominator (Submission Criteria 1)
All patients aged 18 years of age or older receiving a psychiatric or behavioral intake visit and a diagnosis of ADHD during the measurement period.  
 
Denominator Criteria (Eligible cases): 
Patients aged 18 years  and older
AND  
Diagnosis for ADHD (ICD-10-CM):
· F90 Attention-deficit hyperactivity disorders
· F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type
· F90.1 Attention-deficit hyperactivity disorder, predominantly hyperactive type
· F90.2 Attention-deficit hyperactivity disorder, combined type
· F90.8 Attention-deficit hyperactivity disorder, other type
· F90.9 Attention-deficit hyperactivity disorder, unspecified type
AND
Patient encounter during the performance period (CPT): 0362T, 0373T, 90785, 90791, 90792, 90832,90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90875, 90876, 96110, 96112, 96113, 96116, 96121, 96127, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146, 96156, 96158, 96159, 96164, 96165, 96167, 96170, 96171, 96178, 97129, 97130, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 98966, 98967, 98968, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215,99354,  99355, 99406, 99407, 99408, 99409, 99446, 99447, 99448, 99449, 99484, 99492, 99493, 99494, G2011, G2061, G2062, G2063, G0396, G0397, G0402, G0438, G0439  

Denominator (Submission Criteria 2) 
All patients aged 18 years of age or older  receiving a psychiatric or behavioral intake visit with a  clinically significant baseline ASRS v1.1 score of 18 or above for ADHD Inattentive (INN) or a score of 18 or above for ADHD Hyperactive (HYP) during the measurement period.  If either of these scores are 18 or above the total score will also be reported.

Denominator Criteria (Eligible cases): 
Patients aged 18 years or older
AND  
Diagnosis for ADHD (ICD-10-CM):
· F90 Attention-deficit hyperactivity disorders
· F90.0 Attention-deficit hyperactivity disorder, predominantly inattentive type
· F90.1 Attention-deficit hyperactivity disorder, predominantly hyperactive type
· F90.2 Attention-deficit hyperactivity disorder, combined type
· F90.8 Attention-deficit hyperactivity disorder, other type
· F90.9 Attention-deficit hyperactivity disorder, unspecified type
AND  
Patient encounter during the performance period (CPT): 0362T, 0373T, 90785, 90791, 90792, 90832,90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90875, 90876, 96110, 96112, 96113, 96116, 96121, 96127, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146, 96156, 96158, 96159, 96164, 96165, 96167, 96170, 96171, 96178, 97129, 97130, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 98966, 98967, 98968, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215,99354,  99355, 99406, 99407, 99408, 99409, 99446, 99447, 99448, 99449, 99484, 99492, 99493, 99494, G2011, G2061, G2062, G2063, G0396, G0397, G0402, G0438, G0439 

AND 
ASRS score of 18 or above for ADHD INN or ADHD HYP or a total ADHD score of 36 or above

Numerator

Numerator (Submission Criteria 1) 

Patients who were administered the ASRS v1.1 checklist and a documented care plan if positive.

Numerator (Submission Criteria 2) 

Patient administered a psychiatric or behavioral health intake visit with a clinically significant ASRS v1.1 score of 18 or above for ADHD INN or ADHD HYP or ADHD total symptoms of 36 who demonstrated an improvement (reduction) of 25% in symptoms on the ASRS assessment taken 2 to 10 months later on ADHD INN or ADHD HYP or ADHD TOTAL

Denominator Exclusions

• Patients who die OR
  • Are enrolled in hospice in the measurement year (PRO2010.1Y1) OR
  • Are unable to complete the measure at follow-up due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, AND a suitable recorder (e.g., advocate) is not available (PRO2010.1Y3)

Denominator Exceptions

• Patient refused to complete the measure at follow-up (PRO2010.2_E) OR
• Ongoing care not indicated (e.g., referred to another provider or facility, consultation only) OR Patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) OR • Medical reasons (e.g., scheduled for surgery or hospitalized) (PRO2010.8Y)

NQF Number    

N/A

NQS Domain

Effective Clinical Care

High Priority

Yes

High Priority Type

Outcome

Measure Type

Patient Reported Outcome (PRO)

Meaningful Measure Area

Prevention, Treatment, and Management of Mental Health

Inverse Measure

No

Proportional Measure

Yes

Continuous Variable Measure

No

Ratio Measure

No

Number of performance rates to be submitted

2

Measure Risk-Adjusted?

No

Care Setting

Ambulatory Care: Clinician Office/Clinic, Ambulatory Care: Hospital, Hospital Outpatient, Long Term Care, Nursing Home, Outpatient Services, Rehabilitation Facility             

Includes Telehealth?    

Yes