Description:
Percentage of patients 13 years of age and older with a new episode of alcohol or other drug abuse or (AOD) dependence 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 AOD abuse or dependence within 14 days of the diagnosis
b. Percentage of patients who engaged in ongoing treatment including two additional interventions or a medication for the treatment of AOD abuse or dependence within 34 days of the initiation visit. For patients who initiated treatment with a medication, at least one of the two engagement events must be a treatment intervention.
Guidance:
The new episode of alcohol and other drug dependence should be the first episode of the measurement period that is not preceded in the 60 days prior by another episode of alcohol or other drug dependence.
Initial Population:
Patients aged 13 years of age and older who were diagnosed with a new episode of alcohol, opioid, or other drug abuse or dependency 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.
ICD-10 Diagnosis 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
Denominator
Equals Initial Population.
Denominator Exclusions:
Exclude patients with a negative diagnosis history, defined as an encounter or medication treatment for a diagnosis of alcohol, opioid, or other drug abuse or dependence in the 60 days prior to the first episode of alcohol or drug dependence.
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 AOD abuse or dependence within 14 days of the diagnosis.
Numerator 2: Engagement in ongoing treatment within 34 days of initiation includes:
1. Patients that initiated treatment with a psychosocial visit, and whose engagement criteria was fulfilled by a dispensed medication.
2. Patients that initiated treatment with a psychosocial visit, and whose engagement criteria was fulfilled by two further psychosocial visits.
3. Patients that initiated treatment with a dispensed medication, and whose engagement criteria was fulfilled by both a further medication dispense and a psychosocial visit.
4. Patients that initiated treatment with a dispensed medication, and whose engagement criteria was fulfilled by two psychosocial visits
Medication Assisted Treatment HCPCS Codes: G2067, G2068, G2069, G2070, G2071, G2072, G2073, G2074, G2075, G2076, G2077, G2080, G2086, G2087, H0020, H0033
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
Codes can be entered in the clinical note under the billing section, in the live claims feed, and in the appointment window under the billing tab.
Medications: Opiate Antagonists
| 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 |
| 12 HR bupropion hydrochloride 90 MG / naltrexone hydrochloride 8 MG Extended Release Oral Tablet |
| buprenorphine 11.4 MG / naloxone 2.9 MG Sublingual Tablet |
| buprenorphine 8.6 MG / naloxone 2.1 MG Sublingual Tablet |
| 1 ML buprenorphine 0.3 MG/ML Cartridge |
| buprenorphine 2.9 MG / naloxone 0.71 MG Sublingual Tablet |
| buprenorphine 74.2 MG Drug Implant |
| buprenorphine 0.7 MG / naloxone 0.18 MG Sublingual Tablet |
| disulfiram 250 MG Oral Tablet |
| disulfiram 500 MG Oral Tablet |
| 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 |
| 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 |
| naltrexone 380 MG Injection |
| acamprosate calcium 333 MG Delayed Release Oral Tablet |
Medications can be prescribed in the patient's chart in the Send eRx tab.
Numerator Exclusions:
None.