| Measure Type | High Priority Measure? | NQS Domain |
|---|---|---|
| Process | No | Effective Clinical Care |
| Data Submission Method(s) | ||
| Registry | ||
Measure Description
Percentage of visits for patients aged 18 years and older with a diagnosis of obstructive sleep apnea that includes documentation of an assessment of sleep symptoms, including presence or absence of snoring and daytime sleepiness
Instructions
This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of sleep apnea seen 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-based submissions; however, these codes may be submitted for those registries that utilize claims data.
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, 95, POS 02
Numerator
Patient visits with an assessment of sleep symptoms documented, including presence or absence of snoring and daytime sleepiness
Numerator Options:
Performance Met:
Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness (G8839)
OR
Denominator Exception:
Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn’t have initial daytime sleepiness, patient visited between initial testing and initiation of therapy) (G8840)
OR
Performance Not Met:
Sleep apnea symptoms not assessed, reason not given (G8841)