| Title |
Primary Caries Prevention Intervention as Offered by Dentists |
||
|---|---|---|---|
| CMS eCQM ID | CMS74v15 | CBE ID | Not Applicable |
| MIPS Quality ID | 379 | ||
| Measure Steward | Centers for Medicare & Medicaid Services (CMS) | ||
| Description | Percentage of children, 1-20 years of age, who received two fluoride varnish applications during the measurement period as determined by a dentist | ||
| Measure Scoring | Proportion | ||
| Measure Type | Process | ||
| Stratification | Population 1: Patients age 1-5 years at the start of the Measurement Period
Population 2: Patients age 6-12 years at the start of the Measurement Period Population 3: Patients age 13-20 years at the start of the Measurement Period |
||
| Risk Adjustment | None | ||
| Rationale | The literature reflects that fluoride varnish, when applied to the teeth of high-risk children, reduces, in conjunction with anticipatory guidance provided to the caregiver, the risk of the child developing caries (Weyant et al., 2013). Evidence in the literature also specifically supports the effectiveness of professionally applied fluoride varnish at preventing caries in higher risk children (Chou et al., 2014). | ||
| Clinical Recommendation Statement | The 2013 American Dental Association (ADA) clinical recommendations for use of professionally applied or prescription-strength, home-use topical fluorides for caries prevention in patients at elevated risk of developing caries:
– Younger Than 6 Years – 2.26 percent fluoride varnish at least every three to six months. – 6-18 Years – 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF*) gel for four minutes at least every three to six months. – Older Than 18 Years – 2.26 percent fluoride varnish at least every three to six months OR 1.23 percent fluoride (APF) gel for four minutes at least every three to six months (Weyant et al., 2013). The United States Preventive Services Taskforce (USPSTF) recommends the use of professionally applied fluoride varnish for the prevention of dental caries in high risk children under 5 years of age (Chou et al., 2014). The American Academy of Pediatric Dentistry (AAPD) recommends the application of topical fluoride treatments at least twice per year to reduce the incidence of dental caries, with precise timing based upon the unique needs, risks, and benefits inherent to the individual patient (AAPD, 2023). |
||
| Improvement Notation | A higher score indicates better quality | ||
| Definition | None | ||
| Guidance | This eCQM is a patient-based measure.
Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes and requires a clinical action that cannot be conducted via telehealth. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
||
| Initial Population | Children, 1-20 years of age at the start of the measurement period, with a clinical oral evaluation by a dentist during the measurement period | ||
| Denominator | Equals Initial Population | ||
| Denominator Exclusions | Exclude patients who are in hospice care or have a hospice care order documented during any part of the measurement period | ||
| Numerator | Children who receive two fluoride varnish applications on different days during the measurement period | ||
| Numerator Exclusions | None | ||
| Denominator Exceptions | None | ||
| Telehealth Eligible | No | ||
| Next Version | No Version Available | ||
| Previous Version | CMS74v14 | ||
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