| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Claims, EHR, CMS Web Interface, Registry | Process | No | Community/Population Health | Allergy/Immunology, Preventive Medicine |
Measure Description
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine.
Instruction
This measure is to be reported a minimum of once per performance period for patients seen during the performance period. There is no diagnosis associated with this measure. Performance for this measure is not limited to the performance period. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on services provided and the measure-specific denominator coding.
Denominator
Patients 65 years of age and older with a visit during the measurement period
DENOMINATOR NOTE: This measure assesses whether patients 65 years of age or older have received one or more pneumococcal vaccinations.
Denominator Criteria (Eligible Cases):
Patients aged ≥ 65 years on date of encounter
AND
Patient encounter during the performance period (CPT or HCPCS): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0402, G0438, G0439
AND NOT
DENOMINATOR EXCLUSION:
Patient received hospice services any time during the measurement period: G9707
Numerator
Patients who have ever received a pneumococcal vaccination
NUMERATOR NOTE: While the measure provides credit for adults 65 years of age and older who have ever received either the PCV13 or PPSV23 vaccine (or both), according to ACIP recommendations, patients should receive both vaccines. The order and timing of the vaccinations depends on certain patient characteristics, and are described in more detail in the ACIP recommendations.
Numerator Options:
Performance Met: Pneumococcal vaccine administered or previously
received (4040F)
OR
Performance Not Met: Pneumococcal vaccine was not administered or previously received, reason not otherwise specified (4040F with 8P)