Overview
CMS137v8 (2020)
CMS137v9 (2021)
CMS137v10 (2022)
Identifiers
| CMS eCQM ID |
NQF eCQM ID |
NQF |
MIPS Quality ID |
| CMS137v10 |
– |
– |
305 |
*MIE only supports data collection and reporting using eCQM specifications
Definitions
| Description |
Percentage of patients 13 years of age and older with a new episode of alcohol or other drug abuse or (AOD) dependence who received the following. |
| Percentage of patients who initiated treatment including either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis |
Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention. |
| Initial Patient Population |
Patients age 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency during a visit between January 1 and November 14 of the measurement period |
| Denominator |
Equals Initial Population |
| Denominator Exclusions |
- Exclude patients with a negative diagnosis history, defined as an encounter or medication treatment for a diagnosis of alcohol, opioid or other drug abuse or dependence in the 60 days prior to the first episode of alcohol or drug dependence.
- Exclude patients who are in hospice care for any part of the measurement period.
|
| Numerator |
Initiation of treatment includes either an intervention or medication for the treatment of AOD abuse or dependence within 14 days of the diagnosis. |
Engagement in ongoing treatment within 34 days of initiation includes:
- Patients that initiated treatment with a psychosocial visit, and whose engagement criteria was fulfilled by a dispensed medication.
- Patients that initiated treatment with a psychosocial visit, and whose engagement criteria was fulfilled by two further psychosocial visits.
- Patients that initiated treatment with a dispensed medication, and whose engagement criteria was fulfilled by both a further medication dispense and a psychosocial visit.
- Patients that initiated treatment with a dispensed medication, and whose engagement criteria was fulfilled by two psychosocial visits.
|
| Numerator Exclusions |
– |
| Denominator Exceptions |
– |
| Measure Type |
Process measure |
| Measure Scoring |
Proportion measure |
| Stratification |
- 13-17 years
- 18 or greater years
|
| Granularity |
Patient |
| Improvement Notation |
Higher score indicates better quality |
| Domain |
Effective Clinical Care |
Clinical Instructions
New UI Visit Encounter (valid RC202109+)
Original Visit Encounter
Evidence
Initial Patient Population
| Name |
Value Set |
| Diagnosis: Alcohol and Drug Dependence |
2.16.840.1.113883.3.464.1003.106.12.1001 |
| Encounter, Performed: Discharge Services - Hospital Inpatient |
2.16.840.1.113883.3.464.1003.101.12.1007 |
| Encounter, Performed: Discharge Services - Hospital Inpatient Same Day Discharge |
2.16.840.1.113883.3.464.1003.101.12.1006 |
| Encounter, Performed: Emergency Department Visit |
2.16.840.1.113883.3.464.1003.101.12.1010 |
| Encounter, Performed: Hospital Inpatient Visit - Initial |
2.16.840.1.113883.3.464.1003.101.12.1004 |
| Encounter, Performed: Hospital Observation Care - Initial |
2.16.840.1.113883.3.464.1003.101.12.1002 |
| Encounter, Performed: Office Visit |
2.16.840.1.113883.3.464.1003.101.12.1001 |
| Encounter, Performed: Online Assessments |
2.16.840.1.113883.3.464.1003.101.12.1089 |
| Encounter, Performed: Telephone Visits |
2.16.840.1.113883.3.464.1003.101.12.1080 |
Denominator Exclusions
| Name |
Value Set |
| Encounter, Performed: Encounter Inpatient |
2.16.840.1.113883.3.666.5.307 |
| Intervention, Order: Hospice care ambulatory |
2.16.840.1.113762.1.4.1108.15 |
| Intervention, Performed: Hospice care ambulatory |
2.16.840.1.113762.1.4.1108.15 |
Numerator
| Name |
Value Set |
| Encounter, Performed: Detoxification Visit |
2.16.840.1.113883.3.464.1003.101.12.1059 |
| Intervention, Performed: Alcohol and Drug Dependence Treatment |
2.16.840.1.113883.3.464.1003.106.12.1005 |
| Intervention, Performed: Psych Visit - Psychotherapy |
2.16.840.1.113883.3.526.3.1496 |
| Medication, Order: Opiate Antagonists |
2.16.840.1.113883.3.464.1003.198.12.1132 |
Source(s)
eCQI CMS137