CMS 144 - Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)

Share

Covered by this topic

Overview

CMS144v8 (2020)

CMS144v9 (2021)

CMS144v10 (2022)

Identifiers

CMS eCQM ID NQF eCQM ID NQF MIPS Quality ID
CMS144v10 0083e 0083 008

*MIE only supports data collection and reporting using eCQM specifications

Definitions

Description Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge
Initial Patient Population All patients aged 18 years and older with a diagnosis of heart failure
Denominator Equals Initial Population with a current or prior LVEF < 40%
Denominator Exclusions –
Numerator Patients who were prescribed beta-blocker therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge
Numerator Exclusions –
Denominator Exceptions
  • Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons).
  • Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).
  • Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the healthcare system).

Additional Information

Measure Type Process measure
Measure Scoring Proportion measure
Rate Aggregation Population 1: Patients who were prescribed beta-blocker therapy within a 12-month period when seen in the outpatient setting
Population 2: Patients who were prescribed beta-blocker therapy at each hospital discharge

Performance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)]
Granularity Patient
Improvement Notation Higher score indicates better quality
Domain Effective Clinical Care

Clinical Instructions

New UI Visit Encounter (valid RC202109+)

Original Visit Encounter

Track all patients aged 18+ prescribed beta-blocker therapy within a 12-month period of the diagnosis of heart failure with a current or prior left ventricular ejection fraction (LVEF) < 40%.

  1. Ensure patient has one of the following diagnoses:
    1. Moderate left ventricular systolic dysfunction (disorder) - SNOMED 981000124106
    2. Severe left ventricular systolic dysfunction (disorder) - SNOMED 991000124109
  2. Numerator will be populated with patients prescribed a beta-blocker therapy within the measurement period.

Evidence

Initial Patient Population

Name Value Set
Diagnosis: Heart Failure 2.16.840.1.113883.3.526.3.376
Encounter, Performed: Care Services in Long-Term Residential Facility 2.16.840.1.113883.3.464.1003.101.12.1014
Encounter, Performed: Discharge Services - Hospital Inpatient 2.16.840.1.113883.3.464.1003.101.12.1007
Encounter, Performed: Home Healthcare Services 2.16.840.1.113883.3.464.1003.101.12.1016
Encounter, Performed: Nursing Facility Visit 2.16.840.1.113883.3.464.1003.101.12.1012
Encounter, Performed: Office Visit 2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed: Outpatient Consultation 2.16.840.1.113883.3.464.1003.101.12.1008
Encounter, Performed: Patient Provider Interaction 2.16.840.1.113883.3.526.3.1012

Denominator

Name Value Set
Diagnosis: Left ventricular systolic dysfunction (disorder) SNOMEDCT Code 134401001
Diagnosis: Moderate or Severe LVSD 2.16.840.1.113883.3.526.3.1090
Diagnostic Study, Performed: Ejection Fraction 2.16.840.1.113883.3.526.3.1134

Numerator

Name Value Set
Medication, Active: Beta Blocker Therapy for LVSD" 2.16.840.1.113883.3.526.3.1184

Denominator Exceptions

Name Value Set
Allergy/Intolerance: Beta Blocker Therapy Ingredient 2.16.840.1.113883.3.526.3.1493
Allergy/Intolerance: Substance with beta adrenergic receptor antagonist mechanism of action (substance) SNOMEDCT Code 373254001
Device, Applied: Cardiac Pacer 2.16.840.1.113883.3.526.3.1193
Diagnosis: Allergy to Beta Blocker Therapy 2.16.840.1.113883.3.526.3.1177
Diagnosis: Arrhythmia 2.16.840.1.113883.3.526.3.366
Diagnosis: Asthma 2.16.840.1.113883.3.526.3.362
Diagnosis: Atrioventricular Block 2.16.840.1.113883.3.526.3.367
Diagnosis: Bradycardia 2.16.840.1.113883.3.526.3.412
Diagnosis: Cardiac Pacer in Situ 2.16.840.1.113883.3.526.3.368
Diagnosis: Hypotension 2.16.840.1.113883.3.526.3.370
Diagnosis: Intolerance to Beta Blocker Therapy 2.16.840.1.113883.3.526.3.1178
Physical Exam, Performed: Heart Rate 2.16.840.1.113883.3.526.3.1176

Source(s)

eCQI CMS144

Did this doc help you?

Enterprise Health and WebChart Preview Documentation

Last Updated:

Last Build: Fri, 13 Dec 2024 17:11:57 UTC
WikiGDrive Version: 2aacb51f060d0354a678419290943a99bd16aad1