NQF 0036: Use of Appropriate Medications for Asthma

Measure: Record percentage of patients 5 - 64 years of age who were identified as having Persistent Asthma and were appropriately prescribed medication during the measurement year. Report four age stratifications (5-11 years, 12-18 years, 19-50 and 51-64).
Numerator:  Patients who meet the denominator criteria for each age group who were dispensed at least once prescription for a preferred therapy during the measurement period.
Denominator (Same for all groups):           (Ages 5 – 11), (Ages 12 – 18),
(Ages 19 - 50),
(Ages 51-64)
All patients for each age group, with Persistent Asthma and with at least one encounter during the measurement period.
Exclusion: Patients with Emphysema, COPD, Cystic Fibrosis or Acute Respiratory Failure during or prior to the measurement period.
NQS Domain: Clinical Process / Effectiveness

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient (age 5 to 64) at least one time during the reporting period and have the appropriate information documented in the chart:

Required Data Element for the Denominator*:

• Office Visit (CPT) OR Face-to-Face Encounter (SNOMED) Code during the measurement period
Valid Office Encounter Codes:
CPT:
Code Description
99201 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99202 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99203 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99205 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99213 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99214 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99215 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99341 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99342 Home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99343 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99344 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99345 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician attention. Typically, 75 minutes are spent face-to-face with the patient and/or family.
99347 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99348 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99349 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99350 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99381 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; infant (age younger than 1 year)
99382 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; early childhood (age 1 through 4 years)
99383 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5 through 11 years)
99384 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12 through 17 years)
99385 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years
99386 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years
99387 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older
99391 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; infant (age younger than 1 year)
99392 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; early childhood (age 1 through 4 years)
99393 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; late childhood (age 5 through 11 years)
99394 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)
99395 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years
99396 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years
99397 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older

Valid Face-to-Face Interaction Codes:

SNOMED:  
Code Description
12843005 Subsequent hospital visit by physician (procedure)
18170008 Subsequent nursing facility visit (procedure)
19681004 Nursing evaluation of patient and report (procedure)
87790002 Follow-up inpatient consultation visit (procedure)
90526000 Initial evaluation and management of healthy individual (procedure)
185349003 Encounter for "check-up" (procedure)
185463005 Visit out of hours (procedure)
185465003 Weekend visit (procedure)
207195004 History and physical examination with evaluation and management of nursing facility patient (procedure)
270427003 Patient-initiated encounter (procedure)
270430005 Provider-initiated encounter (procedure)
308335008 Patient encounter procedure (procedure)
390906007 Follow-up encounter (procedure)
406547006 Urgent follow-up (procedure)
439708006 Home visit (procedure)
• Persistent Asthma Diagnosis Code (with attached SNOMED) in which the initial occurrence starts before or during and does not end before or during the measurement period
ICD-10:   
CodeDescription
J45.30Mild persistent asthma, uncomplicated
J45.31Mild persistent asthma with (acute) exacerbation
J45.32Mild persistent asthma with status asthmaticus
J45.40Moderate persistent asthma, uncomplicated
J45.41Moderate persistent asthma with (acute) exacerbation
J45.42Moderate persistent asthma with status asthmaticus
J45.50Severe persistent asthma, uncomplicated
J45.51Severe persistent asthma with (acute) exacerbation
J45.52Severe persistent asthma with status asthmaticus
SNOMED: 
CodeDescription
426656000Severe persistent asthma (disorder)
426979002Mild persistent asthma (disorder)
427295004Moderate persistent asthma (disorder)
5281000124103Persistent asthma (disorder)

Required Data Elements for the Numerator*:

• Medication for Preferred Asthma Therapy dispensed during the measurement period
  • 100 ACTUAT Beclomethasone Dipropionate 0.04 MG/ACTUAT Metered Dose Inhaler
  • 100 ACTUAT Beclomethasone Dipropionate 0.08 MG/ACTUAT Metered Dose Inhaler
  • 100 ACTUAT flunisolide 0.25 MG/ACTUAT Metered Dose Inhaler
  • 12 HR Aminophylline 225 MG Extended Release Oral Tablet
  • 12 HR zileuton 600 MG Extended Release Oral Tablet
  • 120 ACTUAT Beclomethasone Dipropionate 0.04 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Beclomethasone Dipropionate 0.08 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Beclomethasone Dipropionate 0.084 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Budesonide 0.08 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Budesonide 0.16 MG/ACTUAT Dry Powder Inhaler
  • 120 ACTUAT ciclesonide 0.05 MG/ACTUAT Nasal Inhaler
  • 120 ACTUAT flunisolide 0.08 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Fluticasone propionate 0.044 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Fluticasone propionate 0.045 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Fluticasone propionate 0.11 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Fluticasone propionate 0.115 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Fluticasone propionate 0.22 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT Fluticasone propionate 0.23 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.1 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT formoterol fumarate 0.005 MG/ACTUAT / mometasone furoate 0.2 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT mometasone furoate 0.1 MG/ACTUAT Metered Dose Inhaler
  • 120 ACTUAT mometasone furoate 0.2 MG/ACTUAT Dry Powder Inhaler
  • 120 ACTUAT mometasone furoate 0.2 MG/ACTUAT Metered Dose Inhaler
  • 14 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler
  • 14 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler
  • 14 ACTUAT Fluticasone propionate 0.5 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler
  • 14 ACTUAT mometasone furoate 0.2 MG/ACTUAT Dry Powder Inhaler
  • 200 ACTUAT Beclomethasone Dipropionate 0.042 MG/ACTUAT Metered Dose Inhaler
  • 200 ACTUAT Beclomethasone Dipropionate 0.084 MG/ACTUAT Metered Dose Inhaler
  • 200 ACTUAT Budesonide 0.16 MG/ACTUAT Dry Powder Inhaler
  • 28 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler
  • 28 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT Dry Powder Inhaler
  • 30 ACTUAT mometasone furoate 0.1 MG/ACTUAT Dry Powder Inhaler
  • 30 ACTUAT mometasone furoate 0.2 MG/ACTUAT Dry Powder Inhaler
  • 50 ACTUAT Beclomethasone Dipropionate 0.08 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT Budesonide 0.08 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT Budesonide 0.08 MG/ACTUAT Dry Powder Inhaler
  • 60 ACTUAT Budesonide 0.16 MG/ACTUAT / formoterol fumarate 0.0045 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT ciclesonide 0.037 MG/ACTUAT Nasal Inhaler
  • 60 ACTUAT ciclesonide 0.08 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT ciclesonide 0.16 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT flunisolide 0.08 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT Fluticasone propionate 0.045 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT Fluticasone propionate 0.05 MG/ACTUAT Dry Powder Inhaler
  • 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler
  • 60 ACTUAT Fluticasone propionate 0.1 MG/ACTUAT Dry Powder Inhaler
  • 60 ACTUAT Fluticasone propionate 0.115 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT Fluticasone propionate 0.23 MG/ACTUAT / salmeterol 0.021 MG/ACTUAT Metered Dose Inhaler
  • 60 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler
  • 60 ACTUAT Fluticasone propionate 0.25 MG/ACTUAT Dry Powder Inhaler
  • 60 ACTUAT Fluticasone propionate 0.5 MG/ACTUAT / salmeterol 0.05 MG/ACTUAT Dry Powder Inhaler
  • 60 ACTUAT mometasone furoate 0.2 MG/ACTUAT Dry Powder Inhaler
  • 7 ACTUAT mometasone furoate 0.1 MG/ACTUAT Dry Powder Inhaler
  • 80 ACTUAT Beclomethasone Dipropionate 0.042 MG/ACTUAT Metered Dose Inhaler
  • Aminophylline 100 MG Delayed Release Oral Tablet
  • Aminophylline 100 MG Oral Tablet
  • Aminophylline 130 MG / Guaifenesin 100 MG Oral Tablet
  • Aminophylline 16.7 MG/ML Oral Solution
  • Aminophylline 200 MG Delayed Release Oral Tablet
  • Aminophylline 200 MG Oral Tablet
  • Aminophylline 21 MG/ML Oral Solution
  • Aminophylline 300 MG Extended Release Oral Tablet
  • Aminophylline 350 MG Extended Release Oral Tablet
  • Budesonide 0.032 MG/ACTUAT Inhalant Powder
  • Budesonide 0.08 MG/ACTUAT / formoterol 0.0045 MG/ACTUAT Inhalant Powder
  • Budesonide 0.09 MG/ACTUAT Inhalant Powder
  • Budesonide 0.1 MG/ACTUAT Inhalant Powder
  • Budesonide 0.125 MG/ML Inhalant Solution
  • Budesonide 0.16 MG/ACTUAT / formoterol 0.0045 MG/ACTUAT Inhalant Powder
  • Budesonide 0.18 MG/ACTUAT Inhalant Powder
  • Budesonide 0.2 MG/ACTUAT Inhalant Powder
  • Budesonide 0.25 MG/ML Inhalant Solution
  • Budesonide 0.4 MG/ACTUAT Inhalant Powder
  • Budesonide 0.5 MG/ML Inhalant Solution
  • Budesonide 3 MG Delayed Release Oral Capsule
  • ciclesonide 0.08 MG/ACTUAT Inhalant Solution
  • ciclesonide 0.16 MG/ACTUAT Inhalant Solution
  • Cromolyn Sodium 0.8 MG/ACTUAT Inhalant Powder
  • Cromolyn Sodium 10 MG/ML Inhalant Solution
  • Cromolyn Sodium 5 MG/ACTUAT Inhalant Powder
  • Dyphylline 10.7 MG/ML Oral Solution
  • Dyphylline 20 MG/ML / Guaifenesin 10 MG/ML Oral Solution
  • Dyphylline 20 MG/ML / Guaifenesin 20 MG/ML Oral Solution
  • Dyphylline 20 MG/ML / Guaifenesin 40 MG/ML Oral Solution
  • Dyphylline 200 MG / Guaifenesin 400 MG Oral Tablet
  • Dyphylline 200 MG Oral Tablet
  • Dyphylline 400 MG Oral Tablet
  • Dyphylline 6.67 MG/ML Oral Solution
  • flunisolide 0.08 MG/ACTUAT Inhalant Solution
  • Fluticasone propionate 0.22 MG/ACTUAT Inhalant Powder
  • Guaifenesin 100 MG / Theophylline 125 MG Oral Tablet
  • Guaifenesin 100 MG / Theophylline 137 MG Oral Tablet
  • Guaifenesin 180 MG / Theophylline 300 MG Oral Capsule
  • Guaifenesin 20 MG/ML / Theophylline 20 MG/ML Oral Solution
  • Guaifenesin 200 MG / Theophylline 250 MG Oral Tablet
  • Guaifenesin 6 MG/ML / Theophylline 10 MG/ML Oral Solution
  • Guaifenesin 6.67 MG/ML / Theophylline 20 MG/ML Oral Solution
  • Guaifenesin 6.67 MG/ML / Theophylline 6.67 MG/ML Oral Solution
  • mometasone furoate 0.1 MG/ACTUAT Inhalant Powder
  • mometasone furoate 0.1 MG/ML Inhalant Powder
  • mometasone furoate 0.2 MG/ACTUAT Inhalant Powder
  • montelukast 10 MG Oral Tablet
  • montelukast 4 MG Chewable Tablet
  • montelukast 4 MG Oral Granules
  • montelukast 5 MG Chewable Tablet
  • omalizumab 125 MG/ML Injectable Solution
  • Theophylline 10 MG/ML Oral Solution
  • Theophylline 10.7 MG/ML Oral Solution
  • Theophylline 100 MG Extended Release Oral Capsule
  • Theophylline 100 MG Extended Release Oral Tablet
  • Theophylline 100 MG Oral Capsule
  • Theophylline 125 MG Extended Release Oral Capsule
  • Theophylline 125 MG Oral Tablet
  • Theophylline 130 MG Extended Release Oral Capsule
  • Theophylline 175 MG Extended Release Oral Tablet
  • Theophylline 20 MG/ML Oral Suspension
  • Theophylline 200 MG Extended Release Oral Capsule
  • Theophylline 200 MG Extended Release Oral Tablet
  • Theophylline 22 MG/ML Oral Solution
  • Theophylline 250 MG Extended Release Oral Tablet
  • Theophylline 250 MG Oral Capsule
  • Theophylline 250 MG Oral Tablet
  • Theophylline 3.2 MG/ML Injectable Solution
  • Theophylline 300 MG Extended Release Oral Capsule
  • Theophylline 300 MG Extended Release Oral Tablet
  • Theophylline 300 MG Oral Tablet
  • Theophylline 330 MG Oral Tablet
  • Theophylline 400 MG Extended Release Oral Capsule
  • Theophylline 400 MG Extended Release Oral Tablet
  • Theophylline 450 MG Extended Release Oral Tablet
  • Theophylline 5.33 MG/ML Oral Solution
  • Theophylline 50 MG Extended Release Oral Capsule
  • Theophylline 50 MG Oral Capsule
  • Theophylline 50 MG Oral Tablet
  • Theophylline 500 MG Extended Release Oral Tablet
  • Theophylline 60 MG Extended Release Oral Capsule
  • Theophylline 600 MG Extended Release Oral Tablet
  • Theophylline 65 MG Extended Release Oral Capsule
  • Theophylline 7.5 MG/ML Oral Solution
  • Theophylline 75 MG Extended Release Oral Capsule
  • zafirlukast 10 MG Oral Tablet
  • zafirlukast 20 MG Oral Tablet
  • zileuton 600 MG Oral Tablet
  • EXCLUSION DETAILS:

    Exclusion includes patients with a diagnosis of Emphysema, COPD, Cystic Fibrosis or Acute Respiratory Failure during or prior to the measurement period.  In order to meet the requirements for this exclusion, the appropriate information must be documented in the chart:

    At least one of the following:

    • Initial Emphysema Diagnosis (with attached SNOMED) before or during and active throughout the measurement period
    ICD-9: 
    CodeDescription
    492.0Emphysematous bleb
    492.8Other emphysema
    506.4Chronic respiratory conditions due to fumes and vapors
    518.1Interstitial emphysema
    518.2Compensatory emphysema
    ICD-10: 
    CodeDescription
    J43.0Unilateral pulmonary emphysema [MacLeod's syndrome]
    J43.1Panlobular emphysema
    J43.2Centrilobular emphysema
    J43.8Other emphysema
    J43.9Emphysema, unspecified
    J68.4Chronic respiratory conditions due to chemicals, gases, fumes and vapors
    J98.2Interstitial emphysema
    J98.3Compensatory emphysema
    SNOMED: 
    CodeDescription
    2912004Cystic-bullous disease of the lung (disorder)
    4981000Panacinar emphysema (disorder)
    16003001Giant bullous emphysema (disorder)
    16838000Mediastinal emphysema (disorder)
    16846004Obstructive emphysema (disorder)
    21072009Gas bubble disease (disorder)
    23958009Vanishing lung (disorder)
    31898008Paraseptal emphysema (disorder)
    33325001Compensatory emphysema (disorder)
    47895001Congenital emphysema (disorder)
    57686001Emphysematous bleb of lung (disorder)
    60805002Hemolytic anemia with emphysema AND cutis laxa (disorder)
    66110007Chronic diffuse emphysema due to inhalation of chemical fumes AND/OR vapors (disorder)
    66987001Congenital lobar emphysema (disorder)
    68328006Centriacinar emphysema (disorder)
    70756004Bronchial atresia with segmental pulmonary emphysema (disorder)
    77690003Interstitial emphysema of lung (disorder)
    86680006Ruptured emphysematous bleb of lung (disorder)
    87433001Pulmonary emphysema (disorder)
    195957006Chronic bullous emphysema (disorder)
    195958001Segmental bullous emphysema (disorder)
    195959009Zonal bullous emphysema (disorder)
    195963002Acute vesicular emphysema (disorder)
    196026004Chronic emphysema due to chemical fumes (disorder)
    233674008Pulmonary emphysema in alpha-1 primary immunodeficiency deficiency (disorder)
    233675009Toxic emphysema (disorder)
    233677001Scar emphysema (disorder)
    266355005Bullous emphysema with collapse (disorder)
    266356006Atrophic (senile) emphysema (disorder)
    • Initial Cystic Fibrosis Diagnosis (with attached SNOMED) before or during and active throughout the measurement period
    ICD-9: 
    CodeDescription
    277.00Cystic fibrosis without mention of meconium ileus
    277.01Cystic fibrosis with meconium ileus
    277.02Cystic fibrosis with pulmonary manifestations
    277.03Cystic fibrosis with gastrointestinal manifestations
    277.09Cystic fibrosis with other manifestations
    ICD-10: 
    CodeDescription
    E84.0Cystic fibrosis with pulmonary manifestations
    E84.11Meconium ileus in cystic fibrosis
    E84.19Cystic fibrosis with other intestinal manifestations
    E84.8Cystic fibrosis with other manifestations
    E84.9Cystic fibrosis, unspecified
    SNOMED: 
    CodeDescription
    81423003Cystic fibrosis without meconium ileus (disorder)
    86092005Cystic fibrosis with meconium ileus (disorder)
    86555001Cystic fibrosis of the lung (disorder)
    190905008Cystic fibrosis (disorder)
    190909002Cystic fibrosis with intestinal manifestations (disorder)
    235978006Cystic fibrosis of pancreas (disorder)
    • Initial Acute Respiratory Failure Diagnosis (with attached SNOMED) before or during and remains active throughout the measurement period
    ICD-9: 
    CodeDescription
    518.81Acute respiratory failure
    ICD-10: 
    CodeDescription
    J96.00Acute respiratory failure, unspecified whether with hypoxia or hypercapnia
    J96.01Acute respiratory failure with hypoxia
    J96.02Acute respiratory failure with hypercapnia
    J96.20Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia
    J96.21Acute and chronic respiratory failure with hypoxia
    J96.22Acute and chronic respiratory failure with hypercapnia
    SNOMED:  
    CodeDescription
    65710008Acute respiratory failure (disorder)
    67905004Acute-on-chronic respiratory failure (disorder)
    397767007Acute respiratory failure requiring reintubation (disorder)
    • Initial Chronic Obstructive Pulmonary Disease Diagnosis (with attached SNOMED) before or during and active throughout the measurement period
    ICD-9: 
    CodeDescription
    493.20Chronic obstructive asthma, unspecified
    493.21Chronic obstructive asthma with status asthmaticus
    493.22Chronic obstructive asthma with (acute) exacerbation
    496Chronic airway obstruction, not elsewhere classified
    ICD-10: 
    CodeDescription
    J44.0Chronic obstructive pulmonary disease with acute lower respiratory infection
    J44.1Chronic obstructive pulmonary disease with (acute) exacerbation
    J44.9Chronic obstructive pulmonary disease, unspecified
    SNOMED:  
    CodeDescription
    195951007Acute exacerbation of chronic obstructive airways disease (disorder)
    285381006Acute infective exacerbation of chronic obstructive airways disease (disorder)
    13645005Chronic obstructive lung disease (disorder)
    196001008Chronic obstructive pulmonary disease with acute lower respiratory infection (disorder)
    135836000End stage chronic obstructive airways disease (disorder)
    313296004Mild chronic obstructive pulmonary disease (disorder)
    313297008Moderate chronic obstructive pulmonary disease (disorder)
    313299006Severe chronic obstructive pulmonary disease (disorder)

    *ADDITIONAL INFORMATION:

    •  The valid office visit (CPT) codes listed for the denominator should not have a SNOMED code attached.  As an alternative, if an office code is used that is NOT listed in the valid CPT codes, a face-to-face SNOMED code can be attached to that non-valid office visit (CPT) code in order to count it for the denominator.  

    • Example of using a valid office (CPT) code vs Face-to Face Interaction (SNOMED) code

    Using a Valid Office (CPT) Code (Listed in the denominator requirements above):  

    NQF 0036 valid office code

    Using a Valid Face-to-Face Encounter (SNOMED) Code  (Listed in the denominator requirements above) with  NON-VALID office visit (CPT) Code:  

    NQF 0036 non valid office code

    • There are no valid ICD-9 codes for Persistent Asthma, therefore a valid ICD-10 and SNOMED code should be used instead.

    • When converting an existing problem list ICD-9 code to ICD-10, use the crosswalk in order to maintain the status of "Initial Diagnosis".  If the crosswalk is not used, the ICD-10 will not be counted as part of the "Initial Diagnosis".  

    • This measure will be reported in different age strata.  However, the patient should be at least 5 years and up to 64 years of age before the start of the measurement period. 

    • The only data used to determine the denominator is data from the ChartMaker Clinical Module. If a patient encounter was not entered into the ChartMaker Clinical Module, that encounter is not included in the denominator for the statistical calculations on the Meaningful Use Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes

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