CQM Measure CMS165v5 Controlling High Blood Pressure

CQM Measure CMS165v5 Controlling High Blood Pressure

NQS Domain: Clinical Process/Effectiveness

Description: Percentage of patients 18-85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90mmHg) during the measurement period.

Denominator Logic

Patient was >= 18 years old on or before the start of measurement period
 AND Patient was < 85 years old on or before the start of measurement period


AND Patient had active patient problem Essential Hypertension (CQM ValueSet: 2.16.840.1.113883.3.464.1003.104.12.1011) recorded <= 6 months before or during measurement period.

AND Patient had one or more appointment scheduled during measurement period, with CPT code in [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.

Denominator Exclusions Logic

OR Patient had active patient problem Pregnancy (CQM ValueSet: 2.16.840.1.113883.3.526.3.378) recorded during measurement period.


OR Patient had active patient problem End Stage Renal Disease (CQM ValueSet: 2.16.840.1.113883.3.526.3.353) recorded during measurement period.


OR Patient had active patient problem Chronic Kidney Disease, Stage 5 (CQM ValueSet: 2.16.840.1.113883.3.526.3.1002) recorded during measurement period.

OR Patient had appointment scheduled before end of measurement period with procedure Dialysis Services (CQM ValueSet: 2.16.840.1.113883.3.464.1003.109.12.1013) entered.

OR Patient had appointment scheduled before end of measurement period with procedure Kidney Transplant (CQM ValueSet: 2.16.840.1.113883.3.464.1003.109.12.1012) entered.

OR Patient had appointment scheduled before end of measurement period with procedure Vascular Access for Dialysis (CQM ValueSet: 2.16.840.1.113883.3.464.1003.109.12.1011) entered.

OR Patient had appointment scheduled before end of measurement period with procedure ESRD Monthly Outpatient Services (CQM ValueSet: 2.16.840.1.113883.3.464.1003.109.12.1014) entered.

Numerator Logic

During the most recent appointment with scheduled during measurement period, patient had diastolic blood pressure < 90 mmHg and systolic blood pressure < 140mmHg recorded in vital signs.

 

For more information, please visit the CMS website here.

How To (Website)

Step 1: Access “Schedule Appointment” area of patient record

Step 2: Click on the “Vitals” tab

Step 3: Enter Blood Pressure data for the patient in the Blood Pressure fields as pictured below

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