(2024) Electronic Clinical Quality Measures
Description
Percentage of patients 18 years of age and older with heart failure who completed initial and follow-up patient-reported functional status assessments.
Guidance
Initial functional status assessment (FSA) and encounter: The initial FSA is an FSA that occurs within two weeks before or during an encounter, in the 180 days or more before the end of the measurement period.
Follow-up FSA: The follow-up FSA must be completed at least 30 days but no more than 180 days after the initial FSA.
The same FSA instrument must be used for the initial and follow-up assessment.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.6. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
Initial Population
Patients 18 years of age and older who had two outpatient encounters during the measurement period and a diagnosis of heart failure that starts any time before and continues into the measurement period.
Date of birth information can be entered in DrChrono in the patient chart under the Demographics tab with the Patient's Date of Birth.
AND
2 Qualifying Encounter During the Measurement Period
Relevant CPT or HCPCS codes for encounters: 98966, 98967, 98968, 98969, 98970, 98971, 98972, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99421, 99423, 99441, 99442, 99443, 99458, G2061, G2062, G2063, G0071, G2010, G2012
CPT and HCPCS codes can be entered in the billing section of the encounter. Below is an example from the appointment window.
AND
A diagnosis of heart failure.
ICD-10 Codes
I11.0, I13.0, I13.2, I50.1, I50.20, I50.21, I50.22, I50.23, I50.30, I50.31, I50.32, I50.33, I50.40, I50.41, I50.42, I50.43, I50.814, I50.82, I50.83, I50.84, I50.89, I50.9
ICD-10 Codes can be entered in any of the billing or assessment sections for the patient's visit. Below is an example from the appointment window.
A diagnosis can also be entered in the patient's chart in the problem list using the ICD-10 or SNOMED CT code. You can search or enter the code. Select an appointment and Save.
SNOMED Codes
| 10091002 | High output heart failure (disorder) |
| 101281000119107 | Congestive heart failure due to cardiomyopathy (disorder) |
| 10633002 | Acute congestive heart failure (disorder) |
| 111283005 | Chronic left-sided heart failure (disorder) |
| 120851000119104 | Systolic heart failure stage D (disorder) |
| 120861000119102 | Systolic heart failure stage C (disorder) |
| 120871000119108 | Systolic heart failure stage B (disorder) |
| 120881000119106 | Diastolic heart failure stage D (disorder) |
| 120891000119109 | Diastolic heart failure stage C (disorder) |
| 120901000119108 | Diastolic heart failure stage B (disorder) |
| 153931000119109 | Acute combined systolic and diastolic heart failure (disorder) |
| 153941000119100 | Chronic combined systolic and diastolic heart failure (disorder) |
| 153951000119103 | Acute on chronic combined systolic and diastolic heart failure (disorder) |
| 15629541000119106 | Congestive heart failure stage C due to ischemic cardiomyopathy (disorder) |
| 15629591000119103 | Congestive heart failure stage B due to ischemic cardiomyopathy (disorder) |
| 15629641000119107 | Systolic heart failure stage B due to ischemic cardiomyopathy (disorder) |
| 15629741000119102 | Systolic heart failure stage C due to ischemic cardiomyopathy (disorder) |
| 15781000119107 | Hypertensive heart AND chronic kidney disease with congestive heart failure (disorder) |
| 15964701000119109 | Acute cor pulmonale co-occurrent and due to saddle embolus of pulmonary artery (disorder) |
| 194767001 | Benign hypertensive heart disease with congestive cardiac failure (disorder) |
| 194779001 | Hypertensive heart and renal disease with (congestive) heart failure (disorder) |
| 194781004 | Hypertensive heart and renal disease with both (congestive) heart failure and renal failure (disorder) |
| 195111005 | Decompensated cardiac failure (disorder) |
| 195112003 | Compensated cardiac failure (disorder) |
| 195114002 | Acute left ventricular failure (disorder) |
| 206586007 | Congenital cardiac failure (disorder) |
| 23341000119109 | Congestive heart failure with right heart failure (disorder) |
| 233924009 | Heart failure as a complication of care (disorder) |
| 25544003 | Low output heart failure (disorder) |
| 314206003 | Refractory heart failure (disorder) |
| 364006 | Acute left-sided heart failure (disorder) |
| 410431009 | Cardiorespiratory failure (disorder) |
| 417996009 | Systolic heart failure (disorder) |
| 418304008 | Diastolic heart failure (disorder) |
| 42343007 | Congestive heart failure (disorder) |
| 424404003 | Decompensated chronic heart failure (disorder) |
| 426263006 | Congestive heart failure due to left ventricular systolic dysfunction (disorder) |
| 426611007 | Congestive heart failure due to valvular disease (disorder) |
| 43736008 | Rheumatic left ventricular failure (disorder) |
| 44088000 | Low cardiac output syndrome (disorder) |
| 441481004 | Chronic systolic heart failure (disorder) |
| 441530006 | Chronic diastolic heart failure (disorder) |
| 44313006 | Right heart failure secondary to left heart failure (disorder) |
| 443253003 | Acute on chronic systolic heart failure (disorder) |
| 443254009 | Acute systolic heart failure (disorder) |
| 443343001 | Acute diastolic heart failure (disorder) |
| 443344007 | Acute on chronic diastolic heart failure (disorder) |
| 46113002 | Hypertensive heart failure (disorder) |
| 471880001 | Heart failure due to end stage congenital heart disease (disorder) |
| 48447003 | Chronic heart failure (disorder) |
| 5148006 | Hypertensive heart disease with congestive heart failure (disorder) |
| 5375005 | Chronic left-sided congestive heart failure (disorder) |
| 56675007 | Acute heart failure (disorder) |
| 67431000119105 | Congestive heart failure stage D (disorder) |
| 67441000119101 | Congestive heart failure stage C (disorder) |
| 698594003 | Symptomatic congestive heart failure (disorder) |
| 703272007 | Heart failure with reduced ejection fraction (disorder) |
| 703273002 | Heart failure with reduced ejection fraction due to coronary artery disease (disorder) |
| 703274008 | Heart failure with reduced ejection fraction due to myocarditis (disorder) |
| 703275009 | Heart failure with reduced ejection fraction due to cardiomyopathy (disorder) |
| 703276005 | Heart failure with reduced ejection fraction due to heart valve disease (disorder) |
| 717840005 | Congestive heart failure stage B (disorder) |
| 72481000119103 | Congestive heart failure as early postoperative complication (disorder) |
| 74960003 | Acute left-sided congestive heart failure (disorder) |
| 82523003 | Congestive rheumatic heart failure (disorder) |
| 83105008 | Malignant hypertensive heart disease with congestive heart failure (disorder) |
| 84114007 | Heart failure (disorder) |
| 85232009 | Left heart failure (disorder) |
| 871617000 | Low output heart failure due to and following Fontan operation (disorder) |
| 88805009 | Chronic congestive heart failure (disorder) |
| 90727007 | Pleural effusion due to congestive heart failure (disorder) |
| 92506005 | Biventricular congestive heart failure (disorder) |
Denominator
Equals Initial Population.
Denominator Exclusions:
Exclude patients with severe cognitive impairment in any part of the measurement period.
Exclude patients who are in hospice care for any part of the measurement period.
Denominator Exceptions:
None
Numerator
Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12]; VR-36; Kansas City Cardiomyopathy Questionnaire [KCCQ]; KCCQ-12; Minnesota Living with Heart Failure Questionnaire [MLHFQ]; Patient-Reported Outcomes Measurement Information System [PROMIS]-10 Global Health, PROMIS-29) present in the EHR within two weeks before or during the initial FSA encounter and results for the follow-up FSA at least 30 days but no more than 180 days after the initial FSA.
Assessments can be entered in the patient's chart in the Assessment section of the CQMs tab. Click +New.
You can enter the code or search by keyword. Select an appointment and then click Create.
Assessment LOINC Codes
- Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12] LOINC Code (86923-0)
- Overall summary score [KCCQ-12] LOINC Code (86924-8)
- Overall summary score [KCCQ] LOINC Code (71940-1)
- Physical limitation score [KCCQ] LOINC Code (72195-1)
- Quality of life score [KCCQ] LOINC Code (72189-4)
- Self-efficacy score [KCCQ] LOINC Code (72190-2)
- Social limitation score [KCCQ] LOINC Code (72196-9)
- Symptom stability score [KCCQ] LOINC Code (72194-4)
- Total symptom score [KCCQ] LOINC Code (72191-0)
- Physical score [MLHFQ] LOINC Code (85618-7)
- Emotional score [MLHFQ] LOINC Code (85609-6)
- PROMIS-10 Global Mental Health (GMH) score T-score LOINC Code (71969-0)
- PROMIS-10 Global Physical Health (GPH) score T-score LOINC Code (71971-6)
- PROMIS-29 Anxiety score T-score LOINC Code (71967-4)
- PROMIS-29 Depression score T-score LOINC Code (71965-8)
- PROMIS-29 Fatigue score T-score LOINC Code (71963-3)
- PROMIS-29 Pain interference score T-score LOINC Code (71961-7)
- PROMIS-29 Physical function score T-score LOINC Code (71959-1)
- PROMIS-29 Satisfaction with participation in social roles score T-score LOINC Code (71957-5)
- PROMIS-29 Sleep disturbance score T-score LOINC Code (71955-9)
- VR-12 Mental component summary (MCS) score - oblique method T-score LOINC Code (72026-8)
- VR-12 Mental component summary (MCS) score - orthogonal method T-score LOINC Code (72028-4)
- VR-12 Physical component summary (PCS) score - oblique method T-score LOINC Code (72025-0)
- VR-12 Physical component summary (PCS) score - orthogonal method T-score LOINC Code (72027-6)
- VR-36 Mental component summary (MCS) score - oblique method T-score LOINC Code (71990-6)
- VR-36 Mental component summary (MCS) score - orthogonal method T-score LOINC Code (72008-6)
- VR-36 Physical component summary (PCS) score - oblique method T-score LOINC Code (71989-8)
- VR-36 Physical component summary (PCS) score - orthogonal method T-score LOINC Code (72007-8)
Numerator Exclusions:
None.