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2023 # 048 Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

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CMS Measure ID: #48

Collection Type: CQM

Reporting Frequency: Once per patient per year

Outcome: No

High Priority: No

NQS Domain: Effective Clinical Care

Measure Age: > 2 years

Instructions

This measure is to be submitted a minimum of once per performance period for patients seen during the performance period. This measure is appropriate for use in the ambulatory setting only and is considered a general screening measure. There is no diagnosis associated with this measure. 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.

NOTE: Patient encounters for this measure conducted via telehealth (e.g., encounters coded with GQ, GT, 95, or POS 02 modifiers) are allowable.

Measure Submission Type:

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 for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data.

Description

Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months

2023 Benchmarks (from 2021 CMS data)

Registry

Topped out: Yes
Capped at 7: No

Decile 0: 0 – 0.31
Decile 1: 0.32 – 32.45
Minimum: 32.46 – 58.06
Decile 3: 58.07 – 74.82
Decile 4: 74.83 – 85.24
Decile 5: 85.25 – 95
Decile 6: 95.01 – 98.38
Decile 7: 98.39 – 99.69
Decile 8: 99.7 – 99.99
Decile 10: 100 – 100

Denominator

All female patients aged 65 years and older with a visit during the measurement period

Denominator Criteria (Eligible Cases):

All female patients aged ≥ 65 years on date of encounter

AND

Patient encounter during the performance period (CPT or HCPCS): 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, G0402

AND NOT

DENOMINATOR EXCLUSION:

Patient use of hospice services any time during the measurement period: G9693

Numerator

Patients who were assessed for the presence or absence of urinary incontinence within 12 months

Definition:

Urinary Incontinence – Any involuntary leakage of urine

Numerator Options:

Performance Met:

Presence or absence of urinary incontinence assessed (1090F)

OR

Performance Not Met:

Presence or absence of urinary incontinence not assessed, reason not otherwise specified (1090F with 8P)

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