| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Registry | Process | No | Community/Population Health | Internal Medicine, Cardiology, Emergency Medicine, Gastroenterology, General Oncology, Hospitalists, Neurology, Obstetrics/Gynecology, Otolaryngology, Physical Medicine, Preventive Medicine, Mental/Behavioral Health, General Practice/Family Medicine |
Measure Description
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
Instruction
This measure is to be reported once per performance period for patients seen during the performance period. This measure is intended to reflect the quality of services provided for preventive screening for unhealthy alcohol use. There is no diagnosis associated with this measure. 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 aged 18 years and older seen for at least two visits or at least one preventive visit during the measurement period
DENOMINATOR NOTE: *Signifies that this CPT Category I code is a non-covered service under the Medicare Part B Physician Fee Schedule (PFS). These non-covered services should be counted in the denominator population for registry-based measures.
Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years
AND
At least two patient encounters during the performance period (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 90845, 96150, 96151, 96152, 97165, 97166, 97167, 97168, 97802, 97803, 97804, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, G0270, G0271
WITHOUT
Telehealth Modifier: GQ, GT
OR
At Least One Preventive Visit during the performance period (CPT or HCPCS): 96160, 96161, 99385*, 99386*, 99387*, 99395*, 99396*, 99397*, 99401*, 99402*, 99403*, 99404*, 99411*, 99412*, 99429*, G0438, G0439
WITHOUT
Telehealth Modifier: GQ, GT
Numerator
Patients who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
Definitions:
Systematic screening method – For purposes of this measure, one of the following systematic methods to assess unhealthy alcohol use must be utilized. Systematic screening methods and thresholds for defining unhealthy alcohol use include:
• AUDIT Screening Instrument (score ≥ 8)
• AUDIT-C Screening Instrument (score ≥ 4 for men; score ≥ 3 for women)
• Single Question Screening – How many times in the past year have you had 5 (for men) or 4 (for women and all adults older than 65 years) or more drinks in a day? (response ≥ 2)
Brief counseling – Brief counseling for unhealthy alcohol use refers to one or more counseling sessions, a minimum of 5-15 minutes, which may include: feedback on alcohol use and harms; identification of high risk situations for drinking and coping strategies; increased motivation and the development of a personal plan to reduce drinking.
NUMERATOR NOTE: In the event that a patient is screened for unhealthy alcohol use and identified as a user but did not receive brief alcohol cessation counseling report G9624.
Numerator Options:
Performance Met: Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling (G9621)
OR
Performance Met: Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method (G9622)
OR
Denominator Exception: Documentation of medical reason(s) for not screening
for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons) (G9623)
OR
Performance Not Met: Patient not screened for unhealthy alcohol screening using a systematic screening method OR patient did not receive brief counseling, reason not given (G9624)