| eCQM / NQF #: | CMS149v7 / 2872 |
| Measure: | Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12 month period. |
| Numerator: | Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12 month period. |
| Denominator: | All patients, regardless of age, with a diagnosis of dementia |
| Denominator Exception: | Documentation of patient reason(s) for not assessing cognition |
| Domain: | Effective Clinical Care |
In ChartMaker Clinical:
In order to qualify for this measure, the provider must have seen the patient at least twice during the reporting period and have the appropriate information documented in the chart:
Required Data Elements for the Denominator:
• A Valid Diagnosis (ICD-9, ICD-10 or SNOMED) of Dementia & Mental Degenerations during the measurement period
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ICD-9 Codes:
| 094.1 | General paresis |
| 290.0 | Senile dementia, uncomplicated |
| 290.10 | Presenile dementia, uncomplicated |
| 290.11 | Presenile dementia with delirium |
| 290.12 | Presenile dementia with delusional features |
| 290.13 | Presenile dementia with depressive features |
| 290.20 | Senile dementia with delusional features |
| 290.21 | Senile dementia with depressive features |
| 290.3 | Senile dementia with delirium |
| 290.40 | Vascular dementia, uncomplicated |
| 290.41 | Vascular dementia, with delirium |
| 290.42 | Vascular dementia, with delusions |
| 290.43 | Vascular dementia, with depressed mood |
| 290.8 | Other specified senile psychotic conditions |
| 290.9 | Unspecified senile psychotic condition |
| 294.10 | Dementia in conditions classified elsewhere without behavioral disturbance |
| 294.11 | Dementia in conditions classified elsewhere with behavioral disturbance |
| 294.20 | Dementia, unspecified, without behavioral disturbance |
| 294.21 | Dementia, unspecified, with behavioral disturbance |
| 294.8 | Other persistent mental disorders due to conditions classified elsewhere |
| 331.0 | Alzheimer's disease |
| 331.11 | Pick's disease |
| 331.19 | Other frontotemporal dementia |
| 331.82 | Dementia with lewy bodies |
ICD-10 Codes:
| A52.17 | General paresis |
| F01.50 | Vascular dementia without behavioral disturbance |
| F01.51 | Vascular dementia with behavioral disturbance |
| F02.80 | Dementia in other diseases classified elsewhere without behavioral disturbance |
| F02.81 | Dementia in other diseases classified elsewhere with behavioral disturbance |
| F03.90 | Unspecified dementia without behavioral disturbance |
| F03.91 | Unspecified dementia with behavioral disturbance |
| F05 | Delirium due to known physiological condition |
| F06.8 | Other specified mental disorders due to known physiological condition |
| G30.0 | Alzheimer's disease with early onset |
| G30.1 | Alzheimer's disease with late onset |
| G30.8 | Other Alzheimer's disease |
| G30.9 | Alzheimer's disease, unspecified |
| G31.01 | Pick's disease |
| G31.09 | Other frontotemporal dementia |
| G31.83 | Dementia with Lewy bodies |
SNOMED Codes:
| 10349009 | Multi-infarct dementia with delirium (disorder) |
| 10532003 | Primary degenerative dementia of the Alzheimer type, presenile onset, with depression (disorder) |
| 111480006 | Psychoactive substance-induced organic dementia (disorder) |
| 12348006 | Presenile dementia (disorder) |
| 14070001 | Multi-infarct dementia with depression (disorder) |
| 15662003 | Senile dementia (disorder) |
| 191449005 | Uncomplicated senile dementia (disorder) |
| 191451009 | Uncomplicated presenile dementia (disorder) |
| 191452002 | Presenile dementia with delirium (disorder) |
| 191454001 | Presenile dementia with paranoia (disorder) |
| 191455000 | Presenile dementia with depression (disorder) |
| 191457008 | Senile dementia with depressive or paranoid features (disorder) |
| 191458003 | Senile dementia with paranoia (disorder) |
| 191459006 | Senile dementia with depression (disorder) |
| 191461002 | Senile dementia with delirium (disorder) |
| 191463004 | Uncomplicated arteriosclerotic dementia (disorder) |
| 191464005 | Arteriosclerotic dementia with delirium (disorder) |
| 191465006 | Arteriosclerotic dementia with paranoia (disorder) |
| 191466007 | Arteriosclerotic dementia with depression (disorder) |
| 191493005 | Drug-induced dementia (disorder) |
| 230270009 | Frontotemporal dementia (disorder) |
| 230283005 | Punch drunk syndrome (disorder) |
| 230286002 | Subcortical vascular dementia (disorder) |
| 230287006 | Mixed cortical and subcortical vascular dementia (disorder) |
| 230288001 | Semantic dementia (disorder) |
| 25772007 | Multi-infarct dementia with delusions (disorder) |
| 26852004 | Primary degenerative dementia of the Alzheimer type, senile onset, with depression (disorder) |
| 278857002 | Dementia of frontal lobe type (disorder) |
| 279982005 | Cerebral degeneration presenting primarily with dementia (disorder) |
| 281004 | Dementia associated with alcoholism (disorder) |
| 312991009 | Senile dementia of the Lewy body type (disorder) |
| 32875003 | Inhalant-induced persisting dementia (disorder) |
| 371024007 | Senile dementia with delusion (disorder) |
| 371026009 | Senile dementia with psychosis (disorder) |
| 416780008 | Primary degenerative dementia of the Alzheimer type, presenile onset (disorder) |
| 420614009 | Organic dementia associated with acquired immunodeficiency syndrome (disorder) |
| 421023003 | Presenile dementia associated with acquired immunodeficiency syndrome (disorder) |
| 421529006 | Dementia associated with acquired immunodeficiency syndrome (disorder) |
| 425390006 | Dementia associated with Parkinson's Disease (disorder) |
| 429998004 | Vascular dementia (disorder) |
| 442344002 | Dementia due to Huntington chorea (disorder) |
| 4817008 | Primary degenerative dementia of the Alzheimer type, senile onset, with delirium (disorder) |
| 51928006 | General paresis - neurosyphilis (disorder) |
| 52448006 | Dementia (disorder) |
| 54502004 | Primary degenerative dementia of the Alzheimer type, presenile onset, with delusions (disorder) |
| 55009008 | Primary degenerative dementia of the Alzheimer type, senile onset, with delusions (disorder) |
| 56267009 | Multi-infarct dementia (disorder) |
| 59651006 | Sedative, hypnotic AND/OR anxiolytic-induced persisting dementia (disorder) |
| 62239001 | Parkinson-dementia complex of Guam (disorder) |
| 6475002 | Primary degenerative dementia of the Alzheimer type, presenile onset, uncomplicated (disorder) |
| 65096006 | Primary degenerative dementia of the Alzheimer type, presenile onset, with delirium (disorder) |
| 66108005 | Primary degenerative dementia of the Alzheimer type, senile onset, uncomplicated (disorder) |
| 70936005 | Multi-infarct dementia, uncomplicated (disorder) |
| 82959004 | Dementia paralytica juvenilis (disorder) |
| 90099008 | Subcortical leukoencephalopathy (disorder) |
• 2 or More Office Visits, Psych Visits, Nursing Facility Visits, Care Services in Long-Term Residential Facility, Patient Provider Interaction, Home Healthcare Service, Occupational Therapy, Behavioral/Neuropsych Assessment or Outpatient Consultations during the measurement period
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This is captured by adding a procedure with a valid CPT or SNOMED code using the Procedure widget in a note.
Valid Office Encounter Codes:
| CPT: | |
| Code | Description |
| 92002 | Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient |
| 92004 | Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits |
| 92012 | Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient |
| 92014 | Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits |
| 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. |
| 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) |
| Postoperative follow-up visit (procedure) |
| 185460008 | Home visit request by patient (procedure) |
| 185462000 | Home visit request by relative (procedure) |
| 185466002 | Home visit for urgent condition (procedure) |
| 185467006 | Home visit for acute condition (procedure) |
| 185468001 | Home visit for chronic condition (procedure) |
| 185470005 | Home visit elderly assessment (procedure) |
| 225929007 | Joint home visit (procedure) |
| 315205008 | Bank holiday home visit (procedure) |
| 439708006 | Home visit (procedure) |
| 698704008 | Home visit for rheumatology service (procedure) |
| 704126008 | Home visit for anticoagulant drug monitoring (procedure) |
| 17436001 | Medical consultation with outpatient (procedure) |
| 281036007 | Follow-up consultation (procedure) |
| 77406008 | Confirmatory medical consultation (procedure) |
| 18170008 | Subsequent nursing facility visit (procedure) |
| 207195004 | History and physical examination with evaluation and management of nursing facility patient (procedure) |
| 209099002 | History and physical examination with management of domiciliary or rest home patient (procedure) |
| 210098006 | Domiciliary or rest home patient evaluation and management (procedure) |
Required Data Elements for the Numerator:
Documented Assessment of Cognition is Performed and the Results Reviewed at least once within a 12 month period
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This can be captured by completing the Blessed Orientation Memory Concentration Test (Cognitive Assessment) via the Screening widget.
The questionnaire is accessed by clicking the corresponding button at the top of the dialog. After the questionnaire is accessed, you can configure the answers for the various questions. Do note if the answer to the first question (Screening not done for medical reason), is Yes, the assessment questionnaire sections below will be grayed out and not score will be given. Likewise, if the answer to the second question (Screening not done for patient reason), is anything other than Yes or blank (unanswered), the assessment questionnaire sections below will be grayed out and not score will be given.
The Repeat the memory phrase… link provides access to detailed information on how to score this aspect of the questionnaire.
The various assessment questions have a measured Total Score based on the answered questions allowing you to quickly determine if the patient assessment is consistent with dementia and thereby offer further testing or treatment as needed. If you click the Total Score link, additional information is provided, displaying how the scoring is conducted and providing further information.
In addition, you can determine how this information is outputted to the note. You can choose only to output only the Title, to output the configured information in List format, or to output the configured information in Paragraph format. When information is configured in the Screening dialog, the applicable LOINC and/or SNOMED codes will be attached to the options selected and will be used to access any applicable Meaningful Use quality measures. Likewise, the information will also appear in the History tab for the patient.
DENOMINATOR EXCEPTIONS:
This can be captured in the Screening dialog, by selecting a reason in the Screening not done for patient reason drop-down list of the Blessed Orientation Memory Concentration Test (Cognitive Assessment) screening.
ADDITIONAL INFORMATION:
• Cognition can be assessed by the clinician during the patient's clinical history
• 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.