CQM Measure CMS156v5 Use of High Risk Medications in the Elderly

CQM Measure CMS156v5 Use of High Risk Medications in the Elderly

NQS Domain: Patient Safety

Description: Percentage of patients 66 years of age and older who were ordered high-risk medications. Two rates are reported.
a. Percentage of patients who were ordered at least one high-risk medication.
b. Percentage of patients who were ordered at least two different high-risk medications.

Group I - At least one high-risk medication

Denominator Logic

Patient was >= 66 years old on or before the start of measurement period.

AND Patient had one or more appointment scheduled during measurement period, with CPT code in [92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397] or HCPCS code in [G0439, G0438] entered.

Numerator Logic

Patient had one or more medication of High Risk Medications for the Elderly (CQM ValueSet: 2.16.840.1.113883.3.464.1003.196.12.1253) or High-Risk Medications With Days Supply Criteria (CQM ValueSet: 2.16.840.1.113883.3.464.1003.196.12.1254) ordered during measurement period.

Group II - At least two high-risk medications

Denominator Logic

Patient was >= 66 years old on or before the start of measurement period.

AND Patient had one or more appointment scheduled during measurement period, with CPT code in [92002, 92004, 92012, 92014, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397] or HCPCS code in [G0439, G0438] entered.

Numerator Logic

Patient had two or more medications of High Risk Medications for the Elderly (CQM ValueSet: 2.16.840.1.113883.3.464.1003.196.12.1253) or High-Risk Medications With Days Supply Criteria (CQM ValueSet: 2.16.840.1.113883.3.464.1003.196.12.1254) ordered during measurement period.

For more information, please visit the CMS website here. 

How To (Website)

Step 1: Access the patient record and click Medication List

Step 2: As applicable, click “Add Medication” to add medications for the patient

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