| Measure Type | High Priority Measure? | Collection Type(s) |
|---|---|---|
| Process | no | Medicare Part B Claims, MIPS CQM |
Measure Description
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
Instructions
This measure is to be submitted a minimum of once per performance period using the most recent spirometry results in the patient record for all COPD patients seen during the performance period. Do not limit the search for spirometry results to the performance period. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.
Measure Submission Type:
Measure data may be submitted by individual MIPS eligible clinicians, groups, or third party intermediaries. The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The quality-data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.
Denominator
All patients aged 18 and older with a diagnosis of COPD
Denominator Criteria (Eligible Cases): Patients aged ≥ 18 years on date of encounter
AND
Diagnosis for COPD (ICD-10-CM): J41.0, J41.1, J41.8, J42, J43.0, J43.1, J43.2, J43.8, J43.9, J44.0, J44.1, J44.9
AND
Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
WITHOUT
Telehealth Modifier: GQ, GT, 95, POS 02
Numerator
Patients with documented spirometry results in the medical record (FEV1 and FEV1/FVC)
Numerator Instructions:
Look for most recent documentation of spirometry results in the medical record; do not limit the search to the performance period.
NUMERATOR NOTE: Denominator Exception(s) are determined on the date of the denominator eligible encounter.
Numerator Options:
Performance Met: Spirometry results documented and reviewed (3023F)
OR
Denominator Exception: Documentation of medical reason(s) for not documenting and reviewing spirometry results (3023F with 1P)
OR
Denominator Exception: Documentation of patient reason(s) for not documenting and reviewing spirometry results (3023F with 2P)
OR
Denominator Exception: Documentation of system reason(s) for not documenting and reviewing spirometry results (3023F with 3P)
OR
Performance Not Met: Spirometry results not documented and reviewed, reason not otherwise specified (3023F with 8P)