Description
Percentage of patients 13 years of age and older with a new substance use disorder(SUD) who received the following:
Two rates are reported
a. Percentage of patients who initiated treatment, including either an intervention or medication for the treatment of SUD within 14 days of the diagnosis
b. Percentage of patients who engaged in ongoing treatment, including two additional interventions or short-term medications, or one long-term medication for the treatment of SUD within 34 days of the initiation.
Guidance
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 aged 13 years of age and older as of the start of the measurement period who were diagnosed with a new SUD episode during a visit between January 1 and November 14 of 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
A diagnosis for a new SUD episode.
ICD-10 Codes
F10.10, F10.120, F10.121, F10.129, F10.130, F10.131, F10.132, F10.139, F10.14, F10.150, F10.151, F10.159, F10.180, F10.181, F10.182, F10.188, F10.19, F10.20, F10.220, F10.221, F10.229
F10.230, F10.231, F10.232, F10.239, F10.24, F10.250, F10.251, F10.259, F10.26, F10.27, F10.280, F10.281, F10.282, F10.288, F10.29, F11.10, F11.120, F11.121, F11.122, F11.129, F11.13, F11.14, F11.150,
F11.151, F11.159, F11.181, F11.182, F11.188, F11.19, F11.20, F11.220, F11.221, F11.222, F11.229, F11.23
F11.24, F11.250, F11.251, F11.259, F11.281, F11.282, F11.288, F11.29, F12.10, F12.120, F12.121, F12.122,
F12.129, F12.13, F12.150, F12.151, F12.159, F12.180, F12.188, F12.19, F12.20, F12.220, F12.221, F12.222,
F12.229, F12.23, F12.250, F12.251, F12.259, F12.280, F12.288, F12.29, F13.10, F13.120, F13.121, F13.129, F13.130, F13.131, F13.132, F13.139, F13.14, F13.150, F13.151, F13.159, F13.180, F13.181, F13.182, F13.188, F13.19, F13.20, F13.220, F13.221, F13.229, F13.230, F13.231, F13.232, F13.239, F13.24, , F13.250, F13.251, F13.259, F13.26, F13.27, F13.280, F13.281, F13.282, F13.288, F13.29, F14.10, F14.120, F14.121, F14.122, F14.129, F14.13, F14.14, F14.150, F14.151, F14.159, F14.180, F14.181,
F14.182, F14.188, F14.19, F14.20, F14.220, F14.221, F14.222, F14.229, F14.23, F14.24, F14.250, F14.251,
F14.259, F14.280, F14.281, F14.282, F14.288, F14.29, F15.10, F15.120, F15.121, F15.122, F15.129, F15.13, F15.14, F15.150, F15.151, F15.159, F15.180, F15.181, F15.182, F15.188, F15.19, F15.20, F15.220,
F15.221, F15.222, F15.229, F15.23, F15.24, F15.250, F15.251, F15.259, F15.280, F15.281, F15.282, F15.288, F15.29, F16.10, F16.120, F16.121, F16.122, F16.129, F16.14, F16.150, F16.151, F16.159, F16.180,
F16.183, F16.188, F16.19, F16.20, F16.220, F16.221, F16.229, F16.24, F16.250, F16.251, F16.259, F16.280, F16.283, F16.288, F16.29, F18.10, F18.120, F18.121, F18.129, F18.14, F18.150, F18.151, F18.159,
F18.17, F18.180, F18.188, F18.19, F18.20, F18.220, F18.221, F18.229, F18.24, F18.250, F18.251, F18.259,
F18.27, F18.280, F18.288, F18.29, F19.10, F19.120, F19.121, F19.122, F19.129, F19.130, F19.131, F19.132,
F19.139, F19.14, F19.150, F19.151, F19.159, F19.16, F19.17, F19.180, F19.181, F19.182, F19.188, F19.19, F19.20, F19.220, F19.221, F19.222, F19.229, F19.230, F19.231, F19.232, F19.239, F19.24, F19.250, F19.251, F19.259, F19.26, F19.27, F19.280, F19.281, F19.282, F19.288, F19.29
ICD-10 Codes can be entered in any of the billing or assessment sections for the patient's visit or the problem list in the patient chart.
SNOMEDCT Codes
231475006, 191877009, 361150008, 10028000, 10327003, 10741871000119101, 10755041000119100, 1081000119105, 11047881000119101, 11048011000119103, 11387009, 1142050005, 12398281000119105, 12398651000119100, 125851000119106, 135301000119103, 135311000119100, 135321000119107, 1383008, 144981000119109, 145101000119102, 145121000119106, 145841000119107, 14784000, 15167005, 15277004, 154211000119108, 16236661000119100, 1686006, 18653004, 18689007, 191475009, 191476005, 191478006, 191480000, 191802004, 191804003, 191805002, 191811004, 191812006, 191819002, 191820008, 191825003, 191826002, 191831000, 191832007, 191837001, 191838006, 191843004, 191844005, 191849000, 191850000, 191853003, 191855005, 191856006, 191865004, 191867007, 191868002, 191882002, 191883007, 191891003, 191893000, 191894006, 191899001, 191900006, 191905001, 191906000, 191909007, 191912005, 191913000, 191916008, 191918009, 191919001, 191924003, 191925002, 19445006, 1973000, 20385005, 20876004, 21647008, 22574000, 230443000, 231461004, 231462006, 231468005, 231469002, 231470001, 231472009, 231473004, 231474005, 231477003, 231478008, 231479000, 231480002, 23601000119102, 2403008, 25753007, 26714005, 268640002, 268645007, 268646008, 268647004, 268648009, 275471001, 27956007, 281004, 284591009, 288021000119107, 288031000119105, 288461000119105, 28864000, 288851000119106, 288861000119108, 29212009, 29733004, 301643003, 30491001, 308742005, 312098001, 312936002, 31956009, 32009006, 32358001, 32875003, 34111000119108, 34938008, 361151007, 37344009, 38247002, 39807006, 39951001, 40571009, 41083005, 416714005, 417143004, 42344001, 425339005, 425885002, 426001001, 426095000, 426873000, 427205009, 427229002, 427327003, 428370001, 429692000, 43497001, 441527004, 442406005, 46975003, 47664006, 5002000, 50320000, 50933003, 51443000, 51493001, 52866005, 53050002, 53936005, 5444000, 5602001, 57588009, 59651006, 61104008, 61144001, 6348008, 63649001, 63983005, 64386003,66590003, 699449003, 70328006, 70340006, 703845008, 703846009, 703847000, 703848005, 703849002, 703850002, 7052005, 70701004, 7071007, 70932007, 71328000, 713583005, 713862009, 714829008, 7200002, 723926008, 723927004, 723928009, 723929001, 723930006, 723933008, 723936000, 723937009, 724653003, 724655005,, 724656006, 724657002, 724658007, 724659004, 724660009, 724661008, 724662001, 724663006, 724664000, 724665004, 724666003, 724667007, 724668002, 724669005, 724670006, 724671005, 724672003, 724675001, 724688003, 724689006, 724690002, 724691003, 724692005, 724693000, 724695007, 724696008, 724700000, 724701001, 724702008, 724704009, 724706006, 724712001, 724714000, 724715004, 724720004, 724724008, 724725009, 724726005, 724727001, 724728006, 724732000, 73097000, 735750005, 737338002, 74851005, 74934004, 75122001, 75544000, 762320004, 762321000, 762322007, 762324008, 762325009, 762326005, 762327001, 762333005, 762334004, 762335003, 762336002, 762337006, 762338001, 762339009, 762340006, 762344002, 762345001, 762346000, 762517008, 762672001, 77355000, 78267003, 78358001, 785277001, 80868005, 817962007, 82339009, 83367009, 838527002, 84758004, 85005007, 85561006, 86325007, 8635005, 86391000119101, 86401000119104, 87132004, 87810006, 8837000, 88926005, 89451009, 91388009, 95661003, 97571000119109
Both SNOMEDCT and ICD-10 codes can be entered into a patient's chart under the Problem List section.
You can search by the ICD-10 or SNOMEDCT code. Select the code and the appointment and save.
During a Visit
CPT and HCPCS Codes: 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 98966, 98967, 98968, 99201, 99202,99203,99204,99025, 991212, 99123, 99214, 99215, 99221, 99222, 99223, 99238, 99239, 99234, 99235, 99236, 99281, 99282, 99283, 99284, 99285, 99441, 99442, 99443 G2061, G2062, G2063, G0071, G2010, G2012
CPT and HCPCS codes can be entered into the billing section for the encounter. Below is an example from the appointment window.
Denominator
Equals Initial Population
Denominator Exclusions
Exclude patients who are in hospice care for any part of the measurement period
Denominator Exceptions
None
Numerator
Numerator 1: Initiation of treatment includes either an intervention or medication for the treatment of SUD within 14 days of the new SUD episode.
Numerator 2: Engagement in ongoing SUD treatment within 34 days of initiation includes:
- A long-acting SUD medication on the day after the initiation through 34 days after the initiation of treatment
- One of the following options on the day after the initiation of treatment through 34 days after the initiation of treatment: a) two engagement visits, b) two engagement medication treatment events, c) one engagement visit and one engagement medication treatment event
Encounter Codes: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99218, 99219, 99220, 99221, 99222, 99223, 99234, 99235, 99236, 99238, 99239, 99281, 99282, 99283, 99284, 99285
Online Assessments: 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, G0071, G2010, G2012, G2061, G2062, G2063
Telephone Visit Codes: 98966, 98967, 98968, 99441, 99442, 99443
Psychotherapy Visit Codes: 90832, 90834, 90837
Medication Assisted Treatment HCPCS Codes: G2067, G2068, G2069, G2070, G2071, G2072, G2073, G2074, G2075, G2076, G2077, G2080, G2086, G2087, H0020, H0033
Psychotherapy Visit Codes: 90832, 90834, 90837
SNOMEDCT Codes
| 171047005 | Drugs of addiction education (procedure) |
| 20093000 | Alcohol rehabilitation and detoxification (regime/therapy) |
| 23915005 | Combined alcohol and drug rehabilitation and detoxification (regime/therapy) |
| 24165007 | Alcoholism counseling (procedure) |
| 266707007 | Drug addiction therapy (regime/therapy) |
| 310653000 | Drug addiction therapy using methadone (regime/therapy) |
| 313071005 | Counseling for substance abuse (procedure) |
| 370881007 | Abuse prevention assessment (procedure) |
| 370884004 | Abuse prevention management (procedure) |
| 385989002 | Substance use therapy (regime/therapy) |
| 386448003 | Substance use prevention (procedure) |
| 386449006 | Substance use treatment: alcohol withdrawal (regime/therapy) |
| 386450006 | Substance use treatment: drug withdrawal (regime/therapy) |
| 386451005 | Substance use treatment: overdose (regime/therapy) |
| 408933008 | Substance abuse prevention (procedure) |
| 408934002 | Substance abuse prevention assessment (procedure) |
| 408935001 | Substance abuse prevention education (procedure) |
| 408936000 | Substance abuse prevention management (procedure) |
| 408941008 | Drug abuse prevention (procedure) |
| 408942001 | Drug abuse prevention assessment (procedure) |
| 408943006 | Drug abuse prevention education (procedure) |
| 408944000 | Drug abuse prevention management (procedure) |
| 408945004 | Alcohol abuse prevention (procedure) |
| 408947007 | Alcohol abuse prevention education (procedure) |
| 408948002 | Alcohol abuse prevention management (procedure) |
| 410419007 | Substance use surveillance (regime/therapy) |
| 413473000 | Counseling about alcohol consumption (procedure) |
| 423416000 | Substance use cessation case management (procedure) |
| 424148004 | Substance use cessation surveillance (regime/therapy) |
| 424407005 | Substance use cessation education, guidance, and counseling (procedure) |
| 424589009 | Substance use treatment: cessation (regime/therapy) |
| 426928008 | Prevention of opioid abuse (procedure) |
| 429291000124102 | Alcohol brief intervention (procedure) |
| 56876005 | Drug rehabilitation and detoxification (regime/therapy) |
| 60112009 | Drug addiction counseling (procedure) |
| 707166002 | Alcohol reduction program (regime/therapy) |
| 720174008 | Drug harm reduction program (regime/therapy) |
| 720175009 | Alcohol harm reduction program (regime/therapy) |
| 720176005 | Alcohol relapse prevention program (regime/therapy) |
| 720177001 | Drug relapse prevention program (regime/therapy) |
| 737363002 | Alcohol abuse surveillance (regime/therapy) |
| 792901003 | Drug addiction therapy using buprenorphine (regime/therapy) |
| 792902005 | Drug addiction therapy using buprenorphine and naloxone (regime/therapy) |
SNOMEDCT codes can be entered in the patient's chart in the Intervention section of the CQMs tab.
Next, enter the code directly or search for it. Select the appointment, ordered or performed, and click Create.
Medications can be prescribed in the patient's chart in the Send eRx tab.
| 1 ML buprenorphine 0.3 MG/ML Cartridge |
| buprenorphine 74.2 MG Drug Implant |
| 0.5 ML buprenorphine 200 MG/ML Prefilled Syringe |
| 1.5 ML buprenorphine 200 MG/ML Prefilled Syringe |
| 1 ML buprenorphine 0.3 MG/ML Injection |
| naltrexone 380 MG Injection |
| buprenorphine 2 MG / naloxone 0.5 MG Sublingual Film |
| buprenorphine 8 MG / naloxone 2 MG Sublingual Film |
| buprenorphine 4 MG / naloxone 1 MG Sublingual Film |
| buprenorphine 12 MG / naloxone 3 MG Sublingual Film |
| buprenorphine 1.4 MG / naloxone 0.36 MG Sublingual Tablet |
| buprenorphine 5.7 MG / naloxone 1.4 MG Sublingual Tablet |
| naltrexone hydrochloride 50 MG Oral Tablet |
| buprenorphine 2.1 MG / naloxone 0.3 MG Buccal Film |
| buprenorphine 4.2 MG / naloxone 0.7 MG Buccal Film |
| buprenorphine 6.3 MG / naloxone 1 MG Buccal Film |
| buprenorphine 11.4 MG / naloxone 2.9 MG Sublingual Tablet |
| buprenorphine 8.6 MG / naloxone 2.1 MG Sublingual Tablet |
| buprenorphine 2.9 MG / naloxone 0.71 MG Sublingual Tablet |
| buprenorphine 0.7 MG / naloxone 0.18 MG Sublingual Tablet |
| disulfiram 250 MG Oral Tablet |
| disulfiram 500 MG Oral Tablet |
| buprenorphine 2 MG Sublingual Tablet |
| buprenorphine 8 MG Sublingual Tablet |
| buprenorphine 2 MG / naloxone 0.5 MG Sublingual Tablet |
| buprenorphine 8 MG / naloxone 2 MG Sublingual Tablet |
| acamprosate calcium 333 MG Delayed Release Oral Tablet |
Numerator Exclusions
Not applicable