| eCQM / NQF #: | CMS144v7 /0083 |
| Measure: | Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) < 40% who were prescribed beta-blocker therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge. |
| Numerator: | Patients who were prescribed beta-blocker therapy either within a 12 month period when seen in the outpatient setting OR at each hospital discharge. |
| Denominator: | All patients aged 18 years and older with a diagnosis of heart failure with a current or prior LVEF < 40%. |
| Denominator Exceptions: | Documentation of medical reason(s) for not prescribing beta-blocker therapy (eg, low blood pressure, fluid overload, asthma, patients recently treated with an intravenous positive inotropic agent, allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing beta-blocker therapy (eg, patient declined, other patient reasons). Documentation of system reason(s) for not prescribing beta-blocker therapy (eg, other reasons attributable to the healthcare system). |
| Domain: | Effective Clinical Care |
In ChartMaker Clinical:
In order to qualify for this measure, the provider must have seen the patient, age 18 years or older and have the appropriate information documented in the chart:
Required Data Elements for the Denominator*:
• Heart Failure Diagnosis Code (with attached SNOMED) that occurs during or prior to the first encounter during the measurement period
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| ICD-10: | |
| Code | Description |
| I11.0 | Hypertensive heart disease with heart failure |
| I13.0 | Hypertensive heart and chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease |
| I13.2 | Hypertensive heart and chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease |
| I50.1 | Left ventricular failure |
| I50.20 | Unspecified systolic (congestive) heart failure |
| I50.21 | Acute systolic (congestive) heart failure |
| I50.22 | Chronic systolic (congestive) heart failure |
| I50.23 | Acute on chronic systolic (congestive) heart failure |
| I50.30 | Unspecified diastolic (congestive) heart failure |
| I50.31 | Acute diastolic (congestive) heart failure |
| I50.32 | Chronic diastolic (congestive) heart failure |
| I50.33 | Acute on chronic diastolic (congestive) heart failure |
| I50.40 | Unspecified combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.41 | Acute combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.42 | Chronic combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.43 | Acute on chronic combined systolic (congestive) and diastolic (congestive) heart failure |
| I50.9 | Heart failure, unspecified |
| SNOMED: | |
| Code | Description |
| 364006 | Acute left-sided heart failure (disorder) |
| 5053004 | Cardiac insufficiency due to prosthesis (disorder) |
| 5148006 | Hypertensive heart disease with congestive heart failure (disorder) |
| 5375005 | Chronic left-sided congestive heart failure (disorder) |
| 10091002 | High output heart failure (disorder) |
| 10335000 | Chronic right-sided heart failure (disorder) |
| 10633002 | Acute congestive heart failure (disorder) |
| 25544003 | Low output heart failure (disorder) |
| 42343007 | Congestive heart failure (disorder) |
| 43736008 | Rheumatic left ventricular failure (disorder) |
| 44313006 | Right heart failure secondary to left heart failure (disorder) |
| 46113002 | Hypertensive heart failure (disorder) |
| 48447003 | Chronic heart failure (disorder) |
| 56675007 | Acute heart failure (disorder) |
| 60856006 | Cardiac insufficiency following cardiac surgery (disorder) |
| 66989003 | Chronic right-sided congestive heart failure (disorder) |
| 74960003 | Acute left-sided congestive heart failure (disorder) |
| 80479009 | Acute right-sided congestive heart failure (disorder) |
| 82523003 | Congestive rheumatic heart failure (disorder) |
| 83105008 | Malignant hypertensive heart disease with congestive heart failure (disorder) |
| 84114007 | Heart failure (disorder) |
| 85232009 | Left heart failure (disorder) |
| 88805009 | Chronic congestive heart failure (disorder) |
| 90727007 | Pleural effusion due to congestive heart failure (disorder) |
| 92506005 | Biventricular congestive heart failure (disorder) |
| 111283005 | Chronic left-sided heart failure (disorder) |
| 128404006 | Right heart failure (disorder) |
| 194767001 | Benign hypertensive heart disease with congestive cardiac failure (disorder) |
| 194779001 | Hypertensive heart and renal disease with (congestive) heart failure (disorder) |
| 194781004 | Hypertensive heart and renal disease with both (congestive) heart failure and renal failure (disorder) |
| 195111005 | Decompensated cardiac failure (disorder) |
| 195112003 | Compensated cardiac failure (disorder) |
| 195114002 | Acute left ventricular failure (disorder) |
| 206586007 | Congenital cardiac failure (disorder) |
| 233924009 | Heart failure as a complication of care (disorder) |
| 277639002 | Sepsis-associated right ventricular failure (disorder) |
| 314206003 | Refractory heart failure (disorder) |
| 359617009 | Acute right-sided heart failure (disorder) |
| 367363000 | Right ventricular failure (disorder) |
| 410431009 | Cardiorespiratory failure (disorder) |
| 417996009 | Systolic heart failure (disorder) |
| 418304008 | Diastolic heart failure (disorder) |
| 424404003 | Decompensated chronic heart failure (disorder) |
| 426012001 | Right heart failure due to pulmonary hypertension (disorder) |
| 426263006 | Congestive heart failure due to left ventricular systolic dysfunction (disorder) |
| 426611007 | Congestive heart failure due to valvular disease (disorder) |
| 441481004 | Chronic systolic heart failure (disorder) |
| 441530006 | Chronic diastolic heart failure (disorder) |
AND at least one of the following:
• Office Visit, Home Healthcare Service, Care Service in Long-Term Residential Facility, Nursing Facility Visit, Outpatient Consultation, or Face to Face interaction for TWO UNIQUE ENCOUNTERS during the measurement period
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This is captured by adding a procedure with a valid CPT and/or SNOMED code using the procedure widget in a note.
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. |
| 99241 | Office consultation for a new or established 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 self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family. |
| 99242 | Office consultation for a new or established patient, which requires these 3 key components: An expanded problem focused history; An expanded 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, 30 minutes are spent face-to-face with the patient and/or family. |
| 99243 | Office consultation for a new or established patient, which requires these 3 key components: A detailed history; A detailed 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, 40 minutes are spent face-to-face with the patient and/or family. |
| 99244 | Office consultation for a new or established 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 moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family. |
| 99245 | Office consultation for a new or established 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 presenting problem(s) are of moderate to high severity. Typically, 80 minutes are spent face-to-face with the patient and/or family. |
| 99304 | Initial nursing facility care, per day, for the evaluation and management of a patient, which requires these 3 key components: A detailed or comprehensive history; A detailed or comprehensive examination; and Medical decision making that is straightforward or 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 problem(s) requiring admission are of low severity. Typically, 25 minutes are spent at the bedside and on the patient's facility floor or unit. |
| 99305 | Initial nursing facility care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of moderate severity. Typically, 35 minutes are spent at the bedside and on the patient's facility floor or unit. |
| 99306 | Initial nursing facility care, per day, for the evaluation and management of a 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 problem(s) requiring admission are of high severity. Typically, 45 minutes are spent at the bedside and on the patient's facility floor or unit. |
| 99307 | Subsequent nursing facility care, per day, for the evaluation and management of a 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 patient is stable, recovering, or improving. Typically, 10 minutes are spent at the bedside and on the patient's facility floor or unit. |
| 99308 | Subsequent nursing facility care, per day, for the evaluation and management of a 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 patient is responding inadequately to therapy or has developed a minor complication. Typically, 15 minutes are spent at the bedside and on the patient's facility floor or unit. |
| 99309 | Subsequent nursing facility care, per day, for the evaluation and management of a 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 patient has developed a significant complication or a significant new problem. Typically, 25 minutes are spent at the bedside and on the patient's facility floor or unit. |
| 99310 | Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires at least 2 of these 3 key components: A comprehensive interval 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. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 35 minutes are spent at the bedside and on the patient's facility floor or unit. |
| 99324 | Domiciliary or rest 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 with the patient and/or family or caregiver. |
| 99325 | Domiciliary or rest 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 with the patient and/or family or caregiver. |
| 99326 | Domiciliary or rest 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 with the patient and/or family or caregiver. |
| 99327 | Domiciliary or rest 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 with the patient and/or family or caregiver. |
| 99328 | Domiciliary or rest 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 with the patient and/or family or caregiver. |
| 99334 | Domiciliary or rest 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 with the patient and/or family or caregiver. |
| 99335 | Domiciliary or rest 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 with the patient and/or family or caregiver. |
| 99336 | Domiciliary or rest 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 of moderate to high severity. Typically, 40 minutes are spent with the patient and/or family or caregiver. |
| 99337 | Domiciliary or rest 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 with the patient and/or family or caregiver. |
| 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. |
Valid Patient Provider Interaction and Face-to- Face Interaction Codes:
| SNOMED: | |
| Code | Description |
| 4525004 | Emergency department patient visit (procedure) |
| 11797002 | Telephone call by physician to patient or for consultation (procedure) |
| 12843005 | Subsequent hospital visit by physician (procedure) |
| 12843005 | Subsequent hospital visit by physician (procedure) |
| 18170008 | Subsequent nursing facility visit (procedure) |
| 18170008 | Subsequent nursing facility visit (procedure) |
| 19681004 | Nursing evaluation of patient and report (procedure) |
| 19681004 | Nursing evaluation of patient and report (procedure) |
| 87790002 | Follow-up inpatient consultation visit (procedure) |
| 87790002 | Follow-up inpatient consultation visit (procedure) |
| 90526000 | Initial evaluation and management of healthy individual (procedure) |
| 90526000 | Initial evaluation and management of healthy individual (procedure) |
| 185316007 | Indirect encounter (procedure) |
| 185317003 | Telephone encounter (procedure) |
| 185318008 | Third party encounter (procedure) |
| 185320006 | Encounter by computer link (procedure) |
| 185321005 | Letter encounter to patient (procedure) |
| 185349003 | Encounter for "check-up" (procedure) |
| 185349003 | Encounter for "check-up" (procedure) |
| 185463005 | Visit out of hours (procedure) |
| 185463005 | Visit out of hours (procedure) |
| 185465003 | Weekend visit (procedure) |
| 185465003 | Weekend visit (procedure) |
| 207195004 | History and physical examination with evaluation and management of nursing facility patient (procedure) |
| 207195004 | History and physical examination with evaluation and management of nursing facility patient (procedure) |
| 270424005 | Letter encounter from patient (procedure) |
| 270427003 | Patient-initiated encounter (procedure) |
| 270427003 | Patient-initiated encounter (procedure) |
| 270430005 | Provider-initiated encounter (procedure) |
| 270430005 | Provider-initiated encounter (procedure) |
| 308335008 | Patient encounter procedure (procedure) |
| 308335008 | Patient encounter procedure (procedure) |
| 308720009 | Letter encounter (procedure) |
| 386473003 | Telephone follow-up (procedure) |
| 390906007 | Follow-up encounter (procedure) |
| 390906007 | Follow-up encounter (procedure) |
| 401267002 | Telephone triage encounter (procedure) |
| 401271004 | E-mail sent to patient (procedure) |
| 406547006 | Urgent follow-up (procedure) |
| 406547006 | Urgent follow-up (procedure) |
| 438515009 | E-mail encounter from carer (procedure) |
| 438516005 | E-mail encounter to carer (procedure) |
| 439708006 | Home visit (procedure) |
| 439708006 | Home visit (procedure) |
| 445450000 | Encounter by short message service text messaging (procedure) |
| 448337001 | Telemedicine consultation with patient (procedure) |
| 185463005 | Visit out of hours (procedure) |
| 185464004 | Out of hours visit - not night visit (procedure) |
| 185465003 | Weekend visit (procedure) |
| 30346009 | Evaluation and management of established outpatient in office or other outpatient facility (procedure) |
| 3391000175108 | Office visit for pediatric care and assessment (procedure) |
| 37894004 | Evaluation and management of new outpatient in office or other outpatient facility (procedure) |
| 439740005 | 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) |
This is captured by adding a procedure with a valid CPT code using the procedure widget in a note.
| 99238 | Hospital discharge day management; 30 minutes or less |
| 99239 | Hospital discharge day management; more than 30 minutes |
and at least one of the following:
•An active diagnosis of moderate to severe LVSD starting before or during the same visit referenced in the heart failure section of the denominator above
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This can be captured in the following ways:
- Adding a diagnosis of moderate to severe LVSD with a valid SNOMED code using the diagnosis widget in a note.
OR
- Adding a diagnosis of left ventricular systolic dysfunction with a valid SNOMED code and attaching a valid SNOMED code for moderate or severe severity.
| SNOMED: | |
| Code | Description |
| 6736007 | Moderate (severity modifier) (qualifier value) |
| 24484000 | Severe (severity modifier) (qualifier value) |
| 134401001 | Left ventricular systolic dysfunction (disorder) |
| 981000124106 | Moderate left ventricular systolic dysfunction (disorder) |
| 991000124109 | Severe left ventricular systolic dysfunction (disorder) |
--
• An ejection fraction result < 40% occurring before or during the same visit referenced in the heart failure section of the denominator above
Expand
This is captured by adding a numeric result with a valid LOINC code using a numeric control in a note.
| LOINC: | |
| Code | Description |
| 10230-1 | Left ventricular Ejection fraction |
| 18043-0 | Left ventricular Ejection fraction by US |
| 18044-8 | Left ventricular Ejection fraction by US.2D+Calculated by single-plane ellipse method |
| 18045-5 | Left ventricular Ejection fraction by US.2D+Calculated by biplane ellipse method |
| 18046-3 | Left ventricular Ejection fraction by US 2D modified |
| 18047-1 | Left ventricular Ejection fraction by US 2D modified biplane |
| 18048-9 | Left ventricular Ejection fraction by US 2D modified single-plane |
| 18049-7 | Left ventricular Ejection fraction by US.M-mode+Calculated by Teichholz method |
| 77889-4 | Left ventricular Ejection fraction by US.M-mode+Calculated by cube method |
| 77890-2 | Left ventricular Ejection fraction by US.2D+Calculated by cube method |
| 77891-0 | Left ventricular Ejection fraction by US.2D+Calculated by Teichholz method |
| 77892-8 | Left ventricular Ejection fraction by US.2D+Calculated by modified Simpson method |
| 79990-8 | Left ventricular Ejection fraction by US.3D.segmentation |
| 79991-6 | Left ventricular Ejection fraction by US.2D+Calculated by biplane method of disks |
| 79992-4 | Left ventricular Ejection fraction by US.2D.A2C+Calculated by single plane method of disks |
| 79993-2 | Left ventricular Ejection fraction by US.2D.A4C+Calculated by single plane method of disks |
| 8806-2 | Left ventricular Ejection fraction by 2D echo |
| 8807-0 | Left ventricular Ejection fraction by 2D echo.visual estimate |
| 8808-8 | Left ventricular Ejection fraction by Cardiac angiogram |
| 8809-6 | Left ventricular Ejection fraction by Cardiac angiogram.visual estimate |
| 8810-4 | Left ventricular Ejection fraction by Spiral CT |
| 8811-2 | Left ventricular Ejection fraction by MR |
| 8812-0 | Left ventricular Ejection fraction by Nuclear blood pool |
Required Data Elements for the Numerator*:
• Beta Blocker order or Active Medication that occurs on or before the first encounter during the measurement period
Expand
This is captured by prescribing or renewing a medication with a valid RXNORM code using the medication button in a note or the facesheet in a chart.
- 24 HR carvedilol phosphate 10 MG Extended Release Oral Capsule
- 24 HR carvedilol phosphate 20 MG Extended Release Oral Capsule
- 24 HR carvedilol phosphate 40 MG Extended Release Oral Capsule
- 24 HR carvedilol phosphate 80 MG Extended Release Oral Capsule
- 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 100 MG Extended Release Oral Tablet
- 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 25 MG Extended Release Oral Tablet
- 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 50 MG Extended Release Oral Tablet
- 24 HR metoprolol succinate 100 MG Extended Release Oral Tablet
- 24 HR metoprolol succinate 200 MG Extended Release Oral Tablet
- 24 HR metoprolol succinate 25 MG Extended Release Oral Tablet
- 24 HR metoprolol succinate 50 MG Extended Release Oral Tablet
- Bisoprolol Fumarate 10 MG / Hydrochlorothiazide 6.25 MG Oral Tablet
- Bisoprolol Fumarate 10 MG Oral Tablet
- Bisoprolol Fumarate 2.5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet
- Bisoprolol Fumarate 5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet
- Bisoprolol Fumarate 5 MG Oral Tablet
- carvedilol 12.5 MG Oral Tablet
- carvedilol 25 MG Oral Tablet
- carvedilol 3.125 MG Oral Tablet
- carvedilol 6.25 MG Oral Tablet
EXCEPTION DETAILS:
This measure makes an exception for patients who were not prescribed Beta Blocker Therapy due to Medical, Patient or System reasons. In order to meet the requirements for this exception, the appropriate information must be documented in the chart (at least one of the following):
• A medication allergy to an ingredient of beta blocker therapy is captured by adding an allergy with a valid RXNORM code using the allergy button in a note.
OR
• A medication intolerance to beta blocker therapy is captured by discontinuing a beta blocker therapy medication with a valid RXNORM code and selecting a reason of intolerance using the medication button in a note or the facesheet in a chart.
*RXNORM Codes for both cases are listed below:*
Allergy:
| 10600 | Timolol |
| 1202 | Atenolol |
| 149 | Acebutolol |
| 1520 | Betaxolol |
| 19484 | Bisoprolol |
| 20352 | carvedilol |
| 2116 | Carteolol |
| 6185 | Labetalol |
| 6918 | Metoprolol |
| 7226 | Nadolol |
| 8332 | Pindolol |
| 8787 | Propranolol |
Medication Intolerance:
| 1191185 | Penbutolol Sulfate 20 MG Oral Tablet |
| 1297753 | Betaxolol Hydrochloride 10 MG Oral Tablet |
| 1297757 | Betaxolol Hydrochloride 20 MG Oral Tablet |
| 1495058 | Propranolol Hydrochloride 4.28 MG/ML Oral Solution |
| 152916 | Atenolol 50 MG / Chlorthalidone 12.5 MG Oral Tablet |
| 1593725 | Sotalol Hydrochloride 5 MG/ML Oral Solution |
| 1923422 | Sotalol Hydrochloride 120 MG Oral Tablet |
| 1923424 | Sotalol Hydrochloride 160 MG Oral Tablet |
| 1923426 | Sotalol Hydrochloride 80 MG Oral Tablet |
| 197379 | Atenolol 100 MG Oral Tablet |
| 197380 | Atenolol 25 MG Oral Tablet |
| 197381 | Atenolol 50 MG Oral Tablet |
| 197382 | Atenolol 100 MG / Chlorthalidone 25 MG Oral Tablet |
| 197383 | Atenolol 50 MG / Chlorthalidone 25 MG Oral Tablet |
| 198000 | Bendroflumethiazide 5 MG / Nadolol 40 MG Oral Tablet |
| 198001 | Bendroflumethiazide 5 MG / Nadolol 80 MG Oral Tablet |
| 198006 | Nadolol 20 MG Oral Tablet |
| 198007 | Nadolol 40 MG Oral Tablet |
| 198008 | Nadolol 80 MG Oral Tablet |
| 198104 | Pindolol 10 MG Oral Tablet |
| 198105 | Pindolol 5 MG Oral Tablet |
| 198284 | Timolol 10 MG Oral Tablet |
| 198285 | Timolol 20 MG Oral Tablet |
| 198286 | Timolol 5 MG Oral Tablet |
| 199277 | Pindolol 15 MG Oral Tablet |
| 199494 | Oxprenolol 20 MG Oral Tablet |
| 199495 | Oxprenolol 40 MG Oral Tablet |
| 199717 | Clopamide 5 MG / Pindolol 10 MG Oral Tablet |
| 199786 | Oxprenolol 80 MG Oral Tablet |
| 199787 | Oxprenolol 160 MG Extended Release Oral Tablet |
| 200031 | carvedilol 6.25 MG Oral Tablet |
| 200032 | carvedilol 12.5 MG Oral Tablet |
| 200033 | carvedilol 25 MG Oral Tablet |
| 245854 | Hydrochlorothiazide 25 MG / Pindolol 10 MG Oral Tablet |
| 245855 | Hydrochlorothiazide 50 MG / Pindolol 10 MG Oral Tablet |
| 387013 | nebivolol 5 MG Oral Tablet |
| 686924 | carvedilol 3.125 MG Oral Tablet |
| 751612 | nebivolol 10 MG Oral Tablet |
| 751618 | nebivolol 2.5 MG Oral Tablet |
| 827073 | nebivolol 20 MG Oral Tablet |
| 854901 | Bisoprolol Fumarate 10 MG Oral Tablet |
| 854905 | Bisoprolol Fumarate 5 MG Oral Tablet |
| 854908 | Bisoprolol Fumarate 10 MG / Hydrochlorothiazide 6.25 MG Oral Tablet |
| 854916 | Bisoprolol Fumarate 2.5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet |
| 854919 | Bisoprolol Fumarate 5 MG / Hydrochlorothiazide 6.25 MG Oral Tablet |
| 856422 | Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 40 MG Oral Tablet |
| 856429 | Hydrochlorothiazide 25 MG / Propranolol Hydrochloride 80 MG Oral Tablet |
| 856448 | Propranolol Hydrochloride 10 MG Oral Tablet |
| 856457 | Propranolol Hydrochloride 20 MG Oral Tablet |
| 856460 | 24 HR Propranolol Hydrochloride 120 MG Extended Release Oral Capsule |
| 856481 | 24 HR Propranolol Hydrochloride 160 MG Extended Release Oral Capsule |
| 856519 | Propranolol Hydrochloride 40 MG Oral Tablet |
| 856535 | 24 HR Propranolol Hydrochloride 60 MG Extended Release Oral Capsule |
| 856556 | Propranolol Hydrochloride 60 MG Oral Tablet |
| 856569 | 24 HR Propranolol Hydrochloride 80 MG Extended Release Oral Capsule |
| 856578 | Propranolol Hydrochloride 80 MG Oral Tablet |
| 856713 | Propranolol Hydrochloride 160 MG Oral Tablet |
| 856724 | Propranolol Hydrochloride 4 MG/ML Oral Solution |
| 856733 | Propranolol Hydrochloride 8 MG/ML Oral Solution |
| 860510 | 24 HR carvedilol phosphate 10 MG Extended Release Oral Capsule |
| 860516 | 24 HR carvedilol phosphate 20 MG Extended Release Oral Capsule |
| 860522 | 24 HR carvedilol phosphate 40 MG Extended Release Oral Capsule |
| 860532 | 24 HR carvedilol phosphate 80 MG Extended Release Oral Capsule |
| 866412 | 24 HR metoprolol succinate 100 MG Extended Release Oral Tablet |
| 866419 | 24 HR metoprolol succinate 200 MG Extended Release Oral Tablet |
| 866427 | 24 HR metoprolol succinate 25 MG Extended Release Oral Tablet |
| 866436 | 24 HR metoprolol succinate 50 MG Extended Release Oral Tablet |
| 866452 | 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 100 MG Extended Release Oral Tablet |
| 866461 | 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 25 MG Extended Release Oral Tablet |
| 866472 | 24 HR Hydrochlorothiazide 12.5 MG / metoprolol succinate 50 MG Extended Release Oral Tablet |
| 866479 | Hydrochlorothiazide 25 MG / Metoprolol Tartrate 100 MG Oral Tablet |
| 866482 | Hydrochlorothiazide 25 MG / Metoprolol Tartrate 50 MG Oral Tablet |
| 866491 | Hydrochlorothiazide 50 MG / Metoprolol Tartrate 100 MG Oral Tablet |
| 866511 | Metoprolol Tartrate 100 MG Oral Tablet |
| 866514 | Metoprolol Tartrate 50 MG Oral Tablet |
| 866924 | Metoprolol Tartrate 25 MG Oral Tablet |
| 896758 | Labetalol hydrochloride 100 MG Oral Tablet |
| 896762 | Labetalol hydrochloride 200 MG Oral Tablet |
| 896766 | Labetalol hydrochloride 300 MG Oral Tablet |
| 896983 | Labetalol hydrochloride 400 MG Oral Tablet |
| 896987 | Labetalol hydrochloride 50 MG Oral Tablet |
| 904561 | Sotalol Hydrochloride 100 MG Oral Tablet |
| 904589 | Sotalol Hydrochloride 240 MG Oral Tablet |
| 998685 | Acebutolol Hydrochloride 400 MG Oral Capsule |
| 998689 | Acebutolol Hydrochloride 200 MG Oral Capsule |
| 998693 | Acebutolol Hydrochloride 100 MG Oral Capsule |
| 998694 | Acebutolol Hydrochloride 200 MG / Hydrochlorothiazide 12.5 MG Oral Tablet |
| 998695 | Acebutolol Hydrochloride 400 MG Oral Tablet |
• Applicable Diagnosis (ICD-10 or SNOMED) Code for Arrhythmia, Hypotension, Asthma, Allergy to Beta Blocker Therapy, Intolerance to Beta Blocker Therapy, Bradycardia, or Atrioventricular Block (without Cardiac Pacer)
Expand
This is captured by adding a diagnosis with a valid ICD10 and/or SNOMED code using the diagnosis widget in a note. (Applies to the following: An active diagnosis of allergy to beta blocker therapy, intolerance to beta blocker therapy, arrhythmia, hypotension, asthma, or bradycardia.)
Valid Diagnosis Codes for Arrhythmia Exception:
| ICD-10: | |
| Code | Description |
| I49.8 | Other specified cardiac arrhythmias |
| I49.9 | Cardiac arrhythmia, unspecified |
| SNOMED: | |
| Code | Description |
| 184004 | Withdrawal arrhythmia (disorder) |
| 10164001 | Parasystole (disorder) |
| 10626002 | Multifocal premature ventricular complexes (disorder) |
| 11157007 | Ventricular bigeminy (disorder) |
| 11849007 | Atrioventricular junctional rhythm (disorder) |
| 13640000 | Fusion beats (disorder) |
| 17338001 | Ventricular premature beats (disorder) |
| 17366009 | Atrial arrhythmia (disorder) |
| 17869006 | Anomalous atrioventricular excitation (disorder) |
| 26950008 | Chronic ectopic atrial tachycardia (disorder) |
| 27337007 | Unifocal premature ventricular complexes (disorder) |
| 29320008 | Ectopic rhythm (disorder) |
| 33413000 | Ectopic beats (disorder) |
| 36083008 | Sick sinus syndrome (disorder) |
| 38274001 | Interpolated ventricular premature complexes (disorder) |
| 39260000 | Nonparoxysmal atrioventricular nodal tachycardia (disorder) |
| 39357005 | Paroxysmal atrial tachycardia with block (disorder) |
| 40593004 | Fibrillation (disorder) |
| 44808001 | Conduction disorder of the heart (disorder) |
| 47830009 | Junctional escape beats (disorder) |
| 49982000 | Multifocal atrial tachycardia (disorder) |
| 55475008 | Lown-Ganong-Levine syndrome (disorder) |
| 59272004 | Ventricular parasystole (disorder) |
| 60423000 | Sinus node dysfunction (disorder) |
| 61277005 | Accelerated idioventricular rhythm (disorder) |
| 63232000 | Multifocal premature beats (disorder) |
| 63593006 | Supraventricular premature beats (disorder) |
| 69730002 | Idiojunctional tachycardia (disorder) |
| 71908006 | Ventricular fibrillation (disorder) |
| 72654001 | Supraventricular arrhythmia (disorder) |
| 74390002 | Wolff-Parkinson-White pattern (disorder) |
| 74615001 | Tachycardia-bradycardia (disorder) |
| 75532003 | Ventricular escape beat (disorder) |
| 81681009 | Junctional premature beats (disorder) |
| 81898007 | Ventricular escape rhythm (disorder) |
| 88412007 | Atrio-ventricular node arrhythmia (disorder) |
| 195060002 | Ventricular pre-excitation (disorder) |
| 195069001 | Paroxysmal atrial tachycardia (disorder) |
| 195071001 | Paroxysmal junctional tachycardia (disorder) |
| 195072008 | Paroxysmal nodal tachycardia (disorder) |
| 195083004 | Ventricular fibrillation and flutter (disorder) |
| 233891009 | Sinoatrial node tachycardia (disorder) |
| 233892002 | Ectopic atrial tachycardia (disorder) |
| 233893007 | Re-entrant atrial tachycardia (disorder) |
| 233894001 | Incessant atrial tachycardia (disorder) |
| 233895000 | Ectopic atrioventricular node tachycardia (disorder) |
| 233904005 | Permanent junctional reciprocating tachycardia (disorder) |
| 233915000 | Paroxysmal familial ventricular fibrillation (disorder) |
| 233922008 | Concealed accessory pathway (disorder) |
| 233923003 | Unidirectional retrograde accessory pathway (disorder) |
| 234172002 | Electromechanical dissociation (disorder) |
| 251161003 | Slow ventricular response (disorder) |
| 251162005 | Atrio-ventricular-junctional (nodal) bradycardia (disorder) |
| 251163000 | Atrio-ventricular junctional (nodal) arrest (disorder) |
| 251164006 | Junctional premature complex (disorder) |
| 251165007 | Atrioventricular junctional (nodal) tachycardia (disorder) |
| 251166008 | Atrioventricular nodal re-entry tachycardia (disorder) |
| 251167004 | Aberrant premature complexes (disorder) |
| 251168009 | Supraventricular bigeminy (disorder) |
| 251170000 | Blocked premature atrial contraction (disorder) |
| 251172008 | Run of atrial premature complexes (disorder) |
| 251173003 | Atrial bigeminy (disorder) |
| 251174009 | Atrial trigeminy (disorder) |
| 251175005 | Ventricular premature complex (disorder) |
| 251176006 | Multiple premature ventricular complexes (disorder) |
| 251177002 | Run of ventricular premature complexes (disorder) |
| 251178007 | Ventricular interpolated complexes (disorder) |
| 251179004 | Multiple ventricular interpolated complexes (disorder) |
| 251180001 | Ventricular trigeminy (disorder) |
| 251181002 | Ventricular quadrigeminy (disorder) |
| 251182009 | Paired ventricular premature complexes (disorder) |
| 251186007 | Ventricular escape complex (disorder) |
| 251187003 | Atrial escape complex (disorder) |
| 251188008 | Atrial parasystole (disorder) |
| 276796006 | Atrial tachycardia (disorder) |
| 284470004 | Premature atrial contraction (disorder) |
| 287057009 | Atrial premature complex (disorder) |
| 309809007 | Electromechanical dissociation with successful resuscitation (disorder) |
| 406461004 | Ectopic atrial beats (disorder) |
| 418341009 | Atrioventricular conduction disorder (disorder) |
| 418818005 | Brugada syndrome (disorder) |
| 419752005 | Sinoatrial nodal reentrant tachycardia (disorder) |
| 421869004 | Bradyarrhythmia (disorder) |
| 422348008 | Andersen Tawil syndrome (disorder) |
| 429243003 | Sustained ventricular fibrillation (disorder) |
Valid Diagnosis Codes for Hypotension Exception:
| ICD-10: | |
| Code | Description |
| I95.0 | Idiopathic hypotension |
| I95.1 | Orthostatic hypotension |
| I95.2 | Hypotension due to drugs |
| I95.3 | Hypotension of hemodialysis |
| I95.81 | Postprocedural hypotension |
| I95.89 | Other hypotension |
| I95.9 | Hypotension, unspecified |
| SNOMED: | |
| Code | Description |
| 45007003 | Low blood pressure (disorder) |
| 61933008 | Hyperadrenergic postural hypotension (disorder) |
| 70247006 | Hypoadrenergic postural hypotension (disorder) |
| 75181005 | Chronic orthostatic hypotension (disorder) |
| 77545000 | Chronic hypotension (disorder) |
| 88887003 | Maternal hypotension syndrome (disorder) |
| 195506001 | Idiopathic hypotension (disorder) |
| 200113008 | Maternal hypotension syndrome with antenatal problem (disorder) |
| 200114002 | Maternal hypotension syndrome with postnatal problem (disorder) |
| 230664009 | Sympathotonic orthostatic hypotension (disorder) |
| 234171009 | Drug-induced hypotension (disorder) |
| 271870002 | Low blood pressure reading (disorder) |
| 286963007 | Chronic hypotension - idiopathic (disorder) |
| 371073003 | Postural orthostatic tachycardia syndrome (disorder) |
| 408667000 | Hemodialysis-associated hypotension (disorder) |
| 408668005 | Iatrogenic hypotension (disorder) |
| 429561008 | Exertional hypotension (disorder) |
Valid Diagnosis Codes for Asthma Exception:
| ICD-10: | |
| Code | Description |
| J45.20 | Mild intermittent asthma, uncomplicated |
| J45.21 | Mild intermittent asthma with (acute) exacerbation |
| J45.22 | Mild intermittent asthma with status asthmaticus |
| J45.30 | Mild persistent asthma, uncomplicated |
| J45.31 | Mild persistent asthma with (acute) exacerbation |
| J45.32 | Mild persistent asthma with status asthmaticus |
| J45.40 | Moderate persistent asthma, uncomplicated |
| J45.41 | Moderate persistent asthma with (acute) exacerbation |
| J45.42 | Moderate persistent asthma with status asthmaticus |
| J45.50 | Severe persistent asthma, uncomplicated |
| J45.51 | Severe persistent asthma with (acute) exacerbation |
| J45.52 | Severe persistent asthma with status asthmaticus |
| J45.901 | Unspecified asthma with (acute) exacerbation |
| J45.902 | Unspecified asthma with status asthmaticus |
| J45.909 | Unspecified asthma, uncomplicated |
| J45.990 | Exercise induced bronchospasm |
| J45.991 | Cough variant asthma |
| J45.998 | Other asthma |
| SNOMED: | |
| Code | Description |
| 11641008 | Millers' asthma (disorder) |
| 12428000 | Intrinsic asthma without status asthmaticus (disorder) |
| 13151001 | Flax-dressers' disease (disorder) |
| 195949008 | Chronic asthmatic bronchitis (disorder) |
| 195967001 | Asthma (disorder) |
| 195977004 | Mixed asthma (disorder) |
| 225057002 | Brittle asthma (disorder) |
| 233672007 | Byssinosis grade 3 (disorder) |
| 233678006 | Childhood asthma (disorder) |
| 233679003 | Late onset asthma (disorder) |
| 233683003 | Hay fever with asthma (disorder) |
| 233688007 | Sulfite-induced asthma (disorder) |
| 266361008 | Non-allergic asthma (disorder) |
| 281239006 | Exacerbation of asthma (disorder) |
| 30352005 | Allergic-infective asthma (disorder) |
| 304527002 | Acute asthma (disorder) |
| 31387002 | Exercise-induced asthma (disorder) |
| 370218001 | Mild asthma (disorder) |
| 370219009 | Moderate asthma (disorder) |
| 370220003 | Occasional asthma (disorder) |
| 370221004 | Severe asthma (disorder) |
| 389145006 | Allergic asthma (disorder) |
| 405944004 | Asthmatic bronchitis (disorder) |
| 407674008 | Aspirin-induced asthma (disorder) |
| 409663006 | Cough variant asthma (disorder) |
| 423889005 | Non-immunoglobulin E mediated allergic asthma (disorder) |
| 424199006 | Substance induced asthma (disorder) |
| 424643009 | Immunoglobulin E-mediated allergic asthma (disorder) |
| 425969006 | Exacerbation of intermittent asthma (disorder) |
| 426656000 | Severe persistent asthma (disorder) |
| 426979002 | Mild persistent asthma (disorder) |
| 427295004 | Moderate persistent asthma (disorder) |
| 427603009 | Intermittent asthma (disorder) |
| 427679007 | Mild intermittent asthma (disorder) |
| 442025000 | Acute exacerbation of chronic asthmatic bronchitis (disorder) |
| 55570000 | Asthma without status asthmaticus (disorder) |
| 56968009 | Wood asthma (disorder) |
| 59786004 | Weavers' cough (disorder) |
| 63088003 | Extrinsic asthma without status asthmaticus (disorder) |
| 707445000 | Exacerbation of mild persistent asthma (disorder) |
| 707446004 | Exacerbation of moderate persistent asthma (disorder) |
| 707447008 | Exacerbation of severe persistent asthma (disorder) |
| 708038006 | Acute exacerbation of asthma (disorder) |
| 708090002 | Acute severe exacerbation of asthma (disorder) |
| 708093000 | Acute exacerbation of immunoglobulin E-mediated allergic asthma (disorder) |
| 708094006 | Acute exacerbation of intrinsic asthma (disorder) |
| 708095007 | Acute severe exacerbation of immunoglobin E-mediated allergic asthma (disorder) |
| 708096008 | Acute severe exacerbation of intrinsic asthma (disorder) |
| 85761009 | Byssinosis (disorder) |
| 92807009 | Chemical-induced asthma (disorder) |
| 93432008 | Drug-induced asthma (disorder) |
Valid Beta Blocker Therapy Allergy Exclusion Codes:
| SNOMED: | |
| Code | Description |
| 293962009 | Beta-adrenoceptor blocking drug allergy (disorder) |
| 293963004 | Cardioselective beta-blocker allergy (disorder) |
| 293964005 | Acebutolol allergy (disorder) |
| 293965006 | Atenolol allergy (disorder) |
| 293966007 | Betaxolol allergy (disorder) |
| 293967003 | Bisoprolol allergy (disorder) |
| 293968008 | Celiprolol allergy (disorder) |
| 293969000 | Esmolol allergy (disorder) |
| 293970004 | Metoprolol allergy (disorder) |
| 293971000 | Non-cardioselective beta-blocker allergy (disorder) |
| 293972007 | Nadolol allergy (disorder) |
| 293973002 | Pindolol allergy (disorder) |
| 293974008 | Carvedilol allergy (disorder) |
| 293975009 | Metipranolol allergy (disorder) |
| 293976005 | Carteolol allergy (disorder) |
| 293977001 | Labetalol allergy (disorder) |
| 293978006 | Levobunolol allergy (disorder) |
| 293979003 | Oxprenolol allergy (disorder) |
| 293980000 | Penbutolol allergy (disorder) |
| 293981001 | Practolol allergy (disorder) |
| 293982008 | Propranolol allergy (disorder) |
| 293983003 | Sotalol allergy (disorder) |
| 293984009 | Timolol allergy (disorder) |
Valid Beta Blocker Therapy Intolerance Exclusion Codes:
| SNOMED: | |
| Code | Description |
| 292419005 | Beta-adrenoceptor blocking drug adverse reaction (disorder) |
| 292420004 | Cardioselective beta-blocker adverse reaction (disorder) |
| 292421000 | Acebutolol adverse reaction (disorder) |
| 292424008 | Betaxolol adverse reaction (disorder) |
| 292425009 | Bisoprolol adverse reaction (disorder) |
| 292426005 | Celiprolol adverse reaction (disorder) |
| 292427001 | Esmolol adverse reaction (disorder) |
| 292428006 | Metoprolol adverse reaction (disorder) |
| 292429003 | Non-cardioselective beta-blocker adverse reaction (disorder) |
| 292430008 | Nadolol adverse reaction (disorder) |
| 292431007 | Pindolol adverse reaction (disorder) |
| 292432000 | Carvedilol adverse reaction (disorder) |
| 292433005 | Metipranolol adverse reaction (disorder) |
| 292434004 | Carteolol adverse reaction (disorder) |
| 292435003 | Labetalol adverse reaction (disorder) |
| 292436002 | Levobunolol adverse reaction (disorder) |
| 292437006 | Oxprenolol adverse reaction (disorder) |
| 292438001 | Penbutolol adverse reaction (disorder) |
| 292439009 | Practolol adverse reaction (disorder) |
| 292440006 | Propranolol adverse reaction (disorder) |
| 292441005 | Sotalol adverse reaction (disorder) |
| 292442003 | Timolol adverse reaction (disorder) |
| 418370000 | Atenolol adverse reaction (disorder) |
Valid Diagnosis Codes for Bradycardia Exception:
| ICD-10: | |
| Code | Description |
| I49.5 | Sick sinus syndrome |
| I49.8 | Other specified cardiac arrhythmias |
| R00.1 | Bradycardia, unspecified |
| SNOMED: | |
| Code | Description |
| 29894000 | Vagal autonomic bradycardia (disorder) |
| 44602002 | Persistent sinus bradycardia (disorder) |
| 49044005 | Severe sinus bradycardia (disorder) |
| 49710005 | Sinus bradycardia (disorder) |
| 251162005 | Atrio-ventricular-junctional (nodal) bradycardia (disorder) |
| 397841007 | Drug-induced bradycardia (disorder) |
Valid Diagnosis Codes for Atrioventricular Block Exception:
This can be captured in the following ways:
- Adding a diagnosis of cardiac pacer in situ with a valid ICD10 and/or SNOMED code using the diagnosis widget in a note.
OR
- Adding a procedure for implanting a cardiac pacer with a valid SNOMED code using the procedure widget in a note.
| ICD-10: | |
| Code | Description |
| I44.1 | Atrioventricular block, second degree |
| I44.2 | Atrioventricular block, complete |
| SNOMED: | |
| Code | Description |
| 27885002 | Complete atrioventricular block (disorder) |
| 28189009 | Mobitz type II atrioventricular block (disorder) |
| 54016002 | Mobitz type I incomplete atrioventricular block (disorder) |
| 93130009 | Lenegre's disease (disorder) |
| 195042002 | Second degree atrioventricular block (disorder) |
| 233917008 | Atrioventricular block (disorder) |
| 233918003 | Postoperative complete heart block (disorder) |
| 251114004 | Intermittent second degree atrioventricular block (disorder) |
| 283645003 | Lev's syndrome (disorder) |
Valid Diagnosis Codes for Cardiac Pacer that will negate the Atrioventricular Block Exception:
| ICD-10: | |
| Code | Description |
| Z95.0 | Presence of cardiac pacemaker |
| SNOMED: | |
| Code | Description |
| 14106009 | Cardiac pacemaker, device (physical object) |
| 56961003 | Cardiac transvenous pacemaker, device (physical object) |
| 360127006 | Intravenous cardiac pacemaker system (physical object) |
| 360128001 | Intravenous triggered cardiac pacemaker system (physical object) |
| 424921004 | Permanent cardiac pacemaker, device (physical object) |
| 441509002 | Cardiac pacemaker in situ (finding) |
• Medical, Patient or System Reason for Not Prescribing Beta Blocker Therapy that occurs during the first encounter of the measurement period
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Entered via the Medication button in the note for the first encounter of the measurement period for the patient.
- This is captured by adding a medication not ordered with a valid RXNORM code and attaching a valid SNOMED code for the reason not done using the medication button in a note.
Medical Reason
| SNOMED | Description |
| 183932001 | Procedure contraindicated (situation) |
| 183964008 | Treatment not indicated (situation) |
| 183966005 | Drug treatment not indicated (situation) |
| 216952002 | Failure in dosage (event) |
| 266721009 | Absent response to treatment (situation) |
| 269191009 | Late effect of medical and surgical care complication (disorder) |
| 274512008 | Medication discontinued (situation) |
| 31438003 | Drug resistance (disorder) |
| 35688006 | Complication of medical care (disorder) |
| 371133007 | Treatment modification (procedure) |
| 397745006 | Medical contraindication (finding) |
| 407563006 | Treatment not tolerated (situation) |
| 410534003 | Not indicated (qualifier value) |
| 410536001 | Contraindicated (qualifier value) |
| 416098002 | Drug allergy (disorder) |
| 416406003 | Procedure discontinued (situation) |
| 428119001 | Procedure not indicated (situation) |
| 445528004 | Treatment changed (situation) |
| 59037007 | Drug intolerance (disorder) |
| 62014003 | Adverse reaction to drug (disorder) |
| 79899007 | Medication interaction (finding) |
Patient Reason
| SNOMED | Description |
| 105480006 | Refusal of treatment by patient (situation) |
| 134397009 | Angiotensin converting enzyme inhibitor declined (situation) |
| 401084003 | Angioensin II receptor antagonist declined (situation) |
| 160932005 | Financial problem (finding) |
| 160934006 | Financial circumstances change (finding) |
| 182890002 | Patient requests alternative treatment (finding) |
| 182895007 | Drug declined by patient (situation) |
| 182897004 | Drug declined by patient - side effects (situation) |
| 182900006 | Drug declined by patient - patient beliefs (situation) |
| 182902003 | Medication declined by patient - cannot pay script (situation) |
| 183944003 | Procedure refused (situation) |
| 183945002 | Procedure refused for religious reason (situation) |
| 184081006 | Patient has moved away (finding) |
| 185479006 | Patient dissatisfied with result (finding) |
| 185481008 | Dissatisfied with doctor (finding) |
| 224187001 | Variable income (finding) |
| 225928004 | Patient self-discharge against medical advice (procedure) |
| 713247000 | Procedure discontinued by patient (situation) |
| 266710000 | Drugs not taken/completed (situation) |
| 266966009 | Family illness (situation) |
| 275694009 | Patient defaulted from follow-up (finding) |
| 275936005 | Patient noncompliance - general (situation) |
| 281399006 | Did not attend (finding) |
| 310343007 | Further opinion sought (finding) |
| 373787003 | Treatment delay - patient choice (finding) |
| 406149000 | Medication refused (situation) |
| 408367005 | Patient forgets to take medication (finding) |
| 413310006 | Patient non-compliant - refused access to services (situation) |
| 413311005 | Patient non-compliant - refused intervention / support (situation) |
| 413312003 | Patient non-compliant - refused service (situation) |
| 416432009 | Procedure discontinued by patient (situation) |
| 423656007 | Income insufficient to buy necessities (finding) |
| 424739004 | Income sufficient to buy only necessities (finding) |
| 443390004 | Refused (qualifier value) |
System Reason
| SNOMED | Description |
| 107724000 | Patient transfer (procedure) |
| 182856006 | Drug not available - out of stock (finding) |
| 182857002 | Drug not available-off market (finding) |
| 185335007 | Appointment canceled by hospital (finding) |
| 224194003 | Not entitled to benefits (finding) |
| 224198000 | Delay in receiving benefits (finding) |
| 224199008 | Loss of benefits (finding) |
| 242990004 | Drug not available for administration (event) |
| 266756008 | Medical care unavailable (situation) |
| 270459005 | Patient on waiting list (finding) |
| 309017000 | Referred to doctor (finding) |
| 309846006 | Treatment not available (situation) |
| 419808006 | Finding related to health insurance issues (finding) |
| 424553001 | Uninsured medical expenses (finding) |
*ADDITIONAL INFORMATION:
• The appropriate LOINC code for the LVEF result can be linked to the matching condition created from an electronic lab interface, to a numeric template field or to a procedure code.
• Whenever documenting a result using a procedure code, be sure to enter it in the Result field.
• The patient must be at least 18 years of age prior to the start of the measurement period
• A "Medication Not Ordered" may be undone using the "Undo Medication Not Ordered" option in the Medication button. It must be done in the same note in which it was originally indicated.
• 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.