CMS 90 - Functional Status Assessments for Congestive Heart Failure

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Covered by this topic

Overview

CMS90v9 (2020)

CMS90v10 (2021)

CMS90v11 (2022)

Identifiers

CMS eCQM ID NQF eCQM ID NQF MIPS Quality ID
CMS90v11 – – 377

*MIE only supports data collection and reporting using eCQM specifications

Definitions

Description Percentage of patients 18 years of age and older with heart failure who completed initial and follow-up patient-reported functional status assessments
Initial Patient Population Patients 18 years of age and older who had two outpatient encounters during the measurement period and a diagnosis of heart failure that starts before and continues into the measurement period.
Denominator Equals Initial Population
Denominator Exclusions
  • Exclude patients with severe cognitive impairment in any part of the measurement period.
  • Exclude patients who are in hospice care for any part of the measurement period.
Numerator Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12]; VR-36; Kansas City Cardiomyopathy Questionnaire [KCCQ]; KCCQ-12; Minnesota Living with Heart Failure Questionnaire [MLHFQ]; Measurement Information System [PROMIS]-10 Global Health, PROMIS-29) present in the two weeks before or during the initial FSA encounter and results for the follow-up FSA at least 30 days but no more than 180 days after the initial FSA
Numerator Exclusions –
Denominator Exceptions –

Additional Information

Measure Type Process measure
Measure Scoring Proportion measure
Granularity Patient
Improvement Notation Higher score indicates better quality
Domain Person and Caregiver-Centered Experience and Outcomes

Clinical Instructions

Ensure all 18+ year-old patients with heart failure beginning prior to and continuing into the measurement period have a functional status assessment during the measurement period.

Workflow

Coming soon.

Evidence

Initial Patient Population

Name Value Set
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
Diagnosis: Heart Failure 2.16.840.1.113883.3.526.3.376

Denominator Exclusions

Name Value Set
Diagnosis: Severe dementia (disorder) SNOMEDCT Code 428351000124105
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
Assessment, Performed: Emotional score [MLHFQ] LOINC Code 85609-6
Assessment, Performed: Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12] LOINC Code 86923-0
Assessment, Performed: Overall summary score [KCCQ-12] LOINC Code 86924-8
Assessment, Performed: Overall summary score [KCCQ] LOINC Code 71940-1
Assessment, Performed: Physical limitation score [KCCQ] LOINC Code 72195-1
Assessment, Performed: Physical score [MLHFQ] LOINC Code 85618-7
Assessment, Performed: PROMIS-10 Global Mental Health (GMH) score T-score LOINC Code 71969-0
Assessment, Performed: PROMIS-10 Global Physical Health (GPH) score T-score LOINC Code 71971-6
Assessment, Performed: PROMIS-29 Anxiety score T-score LOINC Code 71967-4
Assessment, Performed: PROMIS-29 Depression score T-score LOINC Code 71965-8
Assessment, Performed: PROMIS-29 Fatigue score T-score LOINC Code 71963-3
Assessment, Performed: PROMIS-29 Pain interference score T-score LOINC Code 71961-7
Assessment, Performed: PROMIS-29 Physical function score T-score LOINC Code 71959-1
Assessment, Performed: PROMIS-29 Satisfaction with participation in social roles score T-score LOINC Code 71957-5
Assessment, Performed: PROMIS-29 Sleep disturbance score T-score LOINC Code 71955-9
Assessment, Performed: Quality of life score [KCCQ] LOINC Code 72189-4
Assessment, Performed: Self-efficacy score [KCCQ] LOINC Code 72190-2
Assessment, Performed: Social limitation score [KCCQ] LOINC Code 72196-9
Assessment, Performed: Symptom stability score [KCCQ] LOINC Code 72194-4
Assessment, Performed: Total symptom score [KCCQ] LOINC Code 72191-0
Assessment, Performed: VR-12 Mental component summary (MCS) score - oblique method T-score LOINC Code 72026-8
Assessment, Performed: VR-12 Mental component summary (MCS) score - orthogonal method T-score LOINC Code 72028-4
Assessment, Performed: VR-12 Physical component summary (PCS) score - oblique method T-score LOINC Code 72025-0
Assessment, Performed: VR-12 Physical component summary (PCS) score - orthogonal method T-score LOINC Code 72027-6
Assessment, Performed: VR-36 Mental component summary (MCS) score - oblique method T-score LOINC Code 71990-6
Assessment, Performed: VR-36 Mental component summary (MCS) score - orthogonal method T-score LOINC Code 72008-6
Assessment, Performed: VR-36 Physical component summary (PCS) score - oblique method T-score LOINC Code 71989-8
Assessment, Performed: VR-36 Physical component summary (PCS) score - orthogonal method T-score LOINC Code 72007-8

Source(s)

eCQI CMS90

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