CMS Measure ID 377 (eCQM): Functional Status Assessments for Heart Failure (CMS90v11)

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 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.

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 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.

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ICD-10 Diagnosis 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

Encounter Codes: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, G0071, G2010, G2012, G2061, G2062, G2063, 98966, 98967, 98968, 99441, 99442, 99443

Diagnosis and CPT codes can be entered in the appointment window under the billing tab.

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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 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.

Functional assessments can be entered in the patient's chart under Lab Orders and selecting Manual Entry.

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Select the appointment and date the assessment was performed. You can search for the assessment by name or enter the LOINC code.

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Select +Add Another to add more assessments. You can then enter the scores and save the results.

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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.

CMS Measure Information