| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Registry | Process | No | Effective Clinical Care | Gastroenterology |
Measure Description
Percentage of patients aged 18 years and older with a diagnosis of inflammatory bowel disease (IBD) who had Hepatitis B Virus (HBV) status assessed and results interpreted within one year prior to receiving a first course of anti-TNF (tumor necrosis factor) therapy
Instruction
This measure is to be reported a minimum of once per performance period for all patients with a diagnosis of inflammatory bowel disease 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 and older with a diagnosis of inflammatory bowel disease
Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter
AND
Diagnosis for inflammatory bowel disease (ICD-10-CM): K50.00, K50.011, K50.012, K50.013, K50.014, K50.018, K50.019, K50.10, K50.111, K50.112, K50.113, K50.114, K50.118, K50.119, K50.80, K50.811, K50.812, K50.813, K50.814, K50.818, K50.819, K50.90, K50.911, K50.912, K50.913, K50.914, K50.918, K50.919, K51.00, K51.011, K51.012, K51.013, K51.014, K51.018, K51.019, K51.20, K51.211, K51.212, K51.213, K51.214, K51.218, K51.219, K51.30, K51.311, K51.312, K51.313, K51.314, K51.318, K51.319, K51.40, K51.411, K51.412, K51.413, K51.414, K51.418, K51.419, K51.50, K51.511, K51.512, K51.513, K51.514, K51.518, K51.519, K51.80, K51.811, K51.812, K51.813, K51.814, K51.818, K51.819, K51.90,
K51.911, K51.912, K51.913, K51.914, K51.918, K51.919
AND
Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 12,99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99406, 99407
Numerator
Patients who had HBV status assessed and results interpreted within one year prior to receiving a first course of anti- TNF therapy
Numerator Instructions: HBV status must be assessed by one of the following: HBsAG, HBsAG neutralization, HBcAb total, HBcAB IgM, HBsAB.
Definition:
First Course of anti-TNF therapy – the first (ever) course of anti-TNF therapy
Numerator Options:
Performance Met: Hepatitis B Virus (HBV) status assessed and results interpreted within one year prior to receiving a first course of anti-TNF (tumor necrosis factor) therapy (3517F)
OR
Performance Met: Patient has documented immunity to hepatitis B and is receiving a first course of anti-TNF therapy (G8869)
OR
Denominator Exception: Documented reason for not assessing Hepatitis B Virus (HBV) status (e.g. patient not receiving a first course of anti-TNF therapy, patient declined) within one year prior to first course of anti-TNF therapy (G9504)
OR
Performance Not Met: Hepatitis B Virus (HBV) status not assessed and results interpreted within one year prior to receiving a first course of anti-TNF (tumor necrosis factor) therapy, reason not otherwise specified (3517F with 8P)