| Measure Type | High Priority Measure? | NQS Domain |
|---|---|---|
| Process | No | Effective Clinical Care |
| Data Submission Method(s) | ||
| Claims, Registry | ||
Measure Description
All female patients of childbearing potential (12 – 44 years old) diagnosed with epilepsy who were counseled or referred for counseling for how epilepsy and its treatment may affect contraception OR pregnancy at least once a year
Instructions
This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of epilepsy during the performance period. This measure may be submitted by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.
Measure Submission:
The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry-submissions; however, these codes may be submitted for those registries that utilize claims data.
Denominator
All females of childbearing potential (12-44 years old) with a diagnosis of epilepsy
Denominator Criteria (Eligible Cases):
All females age 12-44 years old
AND
Diagnosis for Epilepsy (ICD-10-CM): G40.A09, G40.A19, G40.109, G40.119, G40.209, G40.219, G40.309, G40.409, G40.411, G40.822, G40.824, G40.909
AND
Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215
WITHOUT
Telehealth Modifier: GQ, GT, 95, POS 02
Numerator
Female patients or caregivers counseled at least once a year about how epilepsy and its treatment may affect contraception OR pregnancy
NUMERATOR NOTE: Denominator Exception(s) are determined on the date of the denominator eligible encounter.
Numerator Options:
Performance Met:
Counseling for women of childbearing potential with epilepsy (4340F)
OR
Denominator Exception:
Documentation of medical reason(s) why counseling was not performed for women of childbearing potential with epilepsy (4340F with 1P)
OR
Performance Not Met:
Counseling about epilepsy specific safety issues provided to patient or caregiver was not performed, reason not otherwise specified (4340F with 8P)