2017 MIPS Measure #283: Dementia: Neuropsychiatric Symptom Assessment

Valid Data Submission Method(s) Measure Type High Priority Measure? NQS Domain Specialty Measure Sets
Registry Process No Effective Clinical Care Neurology, Mental/Behavioral Health

Measure Description

Percentage of patients, regardless of age, with a diagnosis of dementia and for whom an assessment of neuropsychiatric symptoms is performed and results reviewed at least once in a 12 month period

Instruction

This measure is to be reported a minimum of once per performance period for patients with a diagnosis of dementia seen during the performance period. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

Denominator

All patients with a diagnosis of dementia

Denominator Criteria (Eligible Cases):
All patients regardless of age
AND
Diagnosis for dementia (ICD-10-CM): A52.17, F01.50, F01.51, F02.80, F02.81, F03.90, F03.91, F05, F06.8, G30.0, G30.1, G30.8, G30.9, G31.01, G31.09, G31.83
AND
Patient encounter during the performance period (CPT): 90791, 90792, 90832, 90834, 90837, 96116, 96118, 96119, 96120, 96150, 96151, 96152, 96154, 97165, 97166, 97167, 97168, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
WITHOUT
Telehealth Modifier: GQ, GT

Numerator

Patients for whom an assessment of neuropsychiatric symptoms is performed and results reviewed at least once in a 12 month period

Numerator Instructions: Neuropsychiatric symptoms can be assessed by direct examination of the patient or knowledgeable informant.
Examples of reliable and valid instruments that are commonly used in research settings and that can be used to assess behavior include, but are not limited to:

  • Dementia Signs and Symptoms (DSS) Scale
  • Neuropsychiatric Inventory (NPI)

The assessment of behavioral status may include the assessment of Behavioral and Psychological Symptoms of Dementia (BPSD). For patients residing in nursing homes, it may include an assessment of the behavioral symptom items from the Minimum Data Set (MDS).
The following is a non-exhaustive list of dimensions (based on items included in available validated instruments) that may be evaluated during an assessment of neuropsychiatric symptoms:
Activity disturbances:

  • agitation
  • wandering
  • purposeless hyperactivity
  • verbal or physical aggressiveness
  • resistiveness with care
  • apathy
  • impulsiveness
  • socially inappropriate behaviors
  • appetite
  • eating disturbances
  • sleep problems
  • diurnal/sleep-wake cycle disturbances
  • repetitive behavior

Mood disturbances:

  • anxiety
  • dysphoria
  • euphoria
  • irritability
  • mood lability/fluctuations

Thought and perceptual disturbances:

  • having fixed false beliefs (delusions)
  • hearing or seeing non-present entities (hallucinations)
  • paranoia

Numerator Options:
Performance Met: Neuropsychiatric symptoms assessed and results reviewed (1181F)
OR
Performance Not Met: Neuropsychiatric symptoms not assessed and results not reviewed, reason not otherwise specified
(1181F with 8P)

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