2017 MIPS Measure #442: Persistence of Beta-Blocker Treatment After a Heart Attack

Valid Data Submission Method(s) Measure Type High Priority Measure? NQS Domain Specialty Measure Sets
Registry Process No Effective Clinical Care General Practice/Family Medicine

Measure Description

The percentage of patients 18 years of age and older during the measurement year who were hospitalized and discharged from July 1 of the year prior to the measurement year to June 30 of the measurement year with a diagnosis of acute myocardial infarction (AMI) and who were prescribed persistent beta-blocker treatment for six months after discharge

Instruction

This measure is to be reported a minimum of once per performance period for patients 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.

NOTE: Include only patients that are discharged through June 30 of the performance period. This will allow the evaluation of at least 180 days after discharge within the reporting year.

Denominator

Patients 18 years of age and older as of December 31 of the measurement year who were hospitalized and discharged from July 1 of the year prior to the measurement year to June 30 of the measurement year with diagnosis of AMI

Table PBH-D: Medications to Identify Exclusions (History of Asthma)

Description

 Prescription

 

 

Bronchodilator combinations

  • Albuterolipratropium
  • Budesonideformoterol
  • Fluticasone-salmeterol
  • Mometasone-formoterol
 

 

Inhaled corticosteroids

  • Beclomethasone
  • Budesonide
  • Ciclesonide
  • Flunisolide
  • Fluticasone
  • Fluticasone CFC free
  • Mometasone
   

Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years within measure ent year
AND
Discharge(s) for AMI between July 1 of the year prior measurement year to June 30 of the measurement period: G9798
AND
Patient encounter(s) during performance period (CPT): 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
AND NOT
DENOMINATOR EXCLUSIONS:
Patients with a diagnosis of Asthma, COPD, Obstructive chronic bronchitis, Chronic respiratory conditions due to fumes and vapors, Hypotension, heart block >1 or sinus bradycardia any time during the patient’s history through the end of the measurement period: J45.20, J45.21, J45.22, J45.30, J45.31, J45.32, J45.40, J45.41, J45.42, J45.50, J45.51, J45.52, J45.901, J45.902, J45.909, J45.990, J45.991, J45.998, I44.1, I44.2, I44.4, I44.5, I44.60, I44.69, I44.7, I45.0, I45.10, I45.19, I45.2, I45.3, I45.6, I49.5, I95.0, I95.1, I95.2, I95.3, I95.81, I95.89, I95.9, R00.1, J68.4, J44.0, J44.1, J44.9
OR
Patients with a medication dispensing event indicator of a history of asthma any time during the patient’s history through the end of the measure period: G9799
OR
Patients who are identified as having an intolerance or allergy to beta-blocker therapy: G9800
OR
Hospitalizations in which the patient was transferred directly to a non-acute care facility for any diagnosis: G9801
OR
Patients who use hospice services any time during the measurement period: G9802

Numerator

Patients who had a 180-day course of treatment with beta-blockers post discharge

Table: Beta-Blocker Medications

Description

Prescription

 

Noncardioselective betablockers

  • Carvedilol Penbutolol
  • Labetalol Pindolol
  • Nadolol Propranolol
  • Timolol
  • Sotalol
 

Cardioselective beta-blockers

  • Acebutolol Betaxolol
  • Atenolol Bisoprolol
  • Metoprolol
  • Nebivolol
 

Antihypertensive combinations

  • Atenolol-chlorthalidone
  • Bendroflumethiazide-nadolol
  • Bisoprolol-hydrochlorothiazide
  • Hydrochlorothiazide-metoprolol
  • Hydrochlorothiazide-propranolol
 

Numerator Options:
Performance Met: Patient prescribed a 180-day course of treatment with beta-blockers post discharge for AMI (G9803)
OR
Performance Not Met: Patient was not prescribed a 180-day course of treatment with beta-blockers post discharge for AMI (G9804)

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