| Measure Type | High Priority Measure? | NQS Domain |
|---|---|---|
| Process | No | Effective Clinical Care |
| Data Submission Method(s) | ||
| Registry | ||
Measure Description
All patients 18 and older prescribed opiates for longer than six weeks duration who had a follow-up evaluation conducted at least every three months during Opioid Therapy documented in the medical record
Instructions
This measure is to be submitted a minimum of once per performance period for all patients being prescribed opioids for duration longer than six weeks during the performance period. There is no diagnosis associated with this measure. 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.
NOTE: Include only patients that have 6 weeks opioid use through September 30 of the performance period. This will allow the follow-up evaluation of at least 90 days after opioid therapy within the performance period.
Measure Submission
The listed denominator criteria are 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 patients 18 and older prescribed opiates for longer than six weeks duration
Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter
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, 95, POS 02
AND
Patients prescribed opiates for longer than six weeks: G9561
Numerator
Patients who had a follow-up evaluation conducted at least every three months during opioid therapy
Numerator Options:
Performance Met: .
Patients who had a follow-up evaluation conducted at least every three months during opioid therapy (G9562)
OR
Performance Not Met:
Patients who did not have a follow-up evaluation conducted at least every three months during opioid therapy (G9563)