| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Registry | Process | No | Effective Clinical Care |
Measure Description
Percentage of visits for patients aged 18 years and older with a diagnosis of obstructive sleep apnea who were prescribed positive airway pressure therapy who had documentation that adherence to positive airway pressure therapy was objectively measured
Instruction
This measure is to be reported a minimum of once per performance period for patients with sleep apnea 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 aged 18 years and older with a diagnosis of sleep apnea
Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter
AND
Diagnosis for sleep apnea (ICD-10-CM): G47.30, G47.33
AND
Patient encounter during the 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
WITHOUT
Telehealth Modifier: GQ, GT
AND
Positive airway pressure therapy was prescribed: G8852
Numerator
Patient visits with documentation that adherence to positive airway pressure therapy was objectively measured
Definition:
Objectively Measured is defined as – positive airway pressure machine-generated measurement of hours of use.
Numerator Options:
Performance Met: Objective measurement of adherence to positive airway pressure therapy, documented (G8851)
OR
Denominator Exception: Documentation of reason(s) for not objectively measuring adherence to positive airway pressure therapy (e.g., patient didn’t bring data from continuous positive airway pressure [CPAP], therapy not yet initiated, not available on machine) (G8854)
OR
Performance Not Met: Objective measurement of adherence to positive airway pressure therapy not performed, reason not given (G8855)