Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) (2024)
| eCQMs / NQF #: | CMS144v12 / 0083e |
| 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 or already taking beta-blocker therapy during the measurement period. |
| Numerator: | Patients who were prescribed or already taking beta-blocker therapy during the measurement period. |
| Denominator: | All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure with a current or prior LVEF <= 40%. |
| Denominator Exclusions: | Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD. |
| Denominator Exceptions: | Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons).
Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons). |
| 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:
This is captured by adding a procedure with a valid CPT or SNOMED code using the Procedure widget in a note.
Office Visit
| 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 a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 15-29 minutes of total time is spent on the date of the encounter. |
| 99203 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 30-44 minutes of total time is spent on the date of the encounter. |
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 45-59 minutes of total time is spent on the date of the encounter. |
| 99205 | Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 60-74 minutes of total time is spent on the date of the encounter. |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using time for code selection, 10-19 minutes of total time is spent on the date of the encounter. |
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using time for code selection, 20-29 minutes of total time is spent on the date of the encounter. |
| 99214 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code selection, 30-39 minutes of total time is spent on the date of the encounter. |
| 99215 | Office or other outpatient visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using time for code selection, 40-54 minutes of total time is spent on the date of the encounter. |
| SNOMED: | |
| Code | Description |
| 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) |
Outpatient Consultation
| SNOMED: | |
| Code | Description |
| 281036007 | Follow-up consultation (procedure) |
| 77406008 | Confirmatory medical consultation (procedure) |
| CPT: | |
| Code | Description |
| 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 or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded. |
| 99243 | Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. |
| 99244 | Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded. |
| 99245 | Office or other outpatient consultation for a new or established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 55 minutes must be met or exceeded. |
Nursing Facility Visit
| SNOMED: | |
| Code | Description |
| 18170008 | Subsequent nursing facility visit (procedure) |
| 207195004 | History and physical examination with evaluation and management of nursing facility patient (procedure) |
| CPT: | |
| Code | Description |
| 99304 | Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. When using total time on the date of the encounter for code selection, 25 minutes must be met or exceeded. |
| 99305 | Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 35 minutes must be met or exceeded. |
| 99306 | Initial nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded. |
| 99307 | Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 10 minutes must be met or exceeded. |
| 99308 | Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded. |
| 99309 | Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. |
| 99310 | Subsequent nursing facility care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded. |
| 99315 | Nursing facility discharge management; 30 minutes or less total time on the date of the encounter |
| 99316 | Nursing facility discharge management; more than 30 minutes total time on the date of the encounter |
| 99318 | Evaluation and management of a patient involving an annual nursing facility assessment, which requires these 3 key components: A detailed interval history; A comprehensive examination; and Medical decision making that is of low to 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 is stable, recovering, or improving. Typically, 30 minutes are spent at the bedside and on the patient’s facility floor or unit. |
Care Services in Long Term Residential Facility
| SNOMED: | |
| Code | Description |
| 209099002 | History and physical examination with management of domiciliary or rest home patient (procedure) |
| 210098006 | Domiciliary or rest home patient evaluation and management (procedure) |
| CPT: | |
| Code | Description |
| 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. |
Home Healthcare Services
| CPT: | |
| Code | Description |
| 99341 | Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded. |
| 99342 | Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. |
| 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 or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded. |
| 99345 | Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 75 minutes must be met or exceeded. |
| 99347 | Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 20 minutes must be met or exceeded. |
| 99348 | Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded. |
| 99349 | Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 40 minutes must be met or exceeded. |
| 99350 | Home or residence visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded. |
| SNOMED: | |
| Code | Description |
| 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) |
Patient Provider Interaction
| SNOMED: | |
| Code | Description |
| 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) |
| 185463005 | Visit out of hours (procedure) |
| 185465003 | Weekend visit (procedure) |
| 270424005 | Letter encounter from patient (procedure) |
| 270427003 | Patient-initiated encounter (procedure) |
| 270430005 | Provider-initiated encounter (procedure) |
| 308335008 | Patient encounter procedure (procedure) |
| 308720009 | Letter encounter (procedure) |
| 386473003 | Telephone follow-up (procedure) |
| 390906007 | Follow-up encounter (procedure) |
| 401267002 | Telephone triage encounter (procedure) |
| 401271004 | Email sent to patient (procedure) |
| 406547006 | Urgent follow-up (procedure) |
| 438515009 | Email encounter from caregiver (procedure) |
| 438516005 | Email encounter to caregiver (procedure) |
| 445450000 | Encounter by short message service text messaging (procedure) |
| 448337001 | Telemedicine consultation with patient (procedure) |
| 87790002 | Follow-up inpatient consultation visit (procedure) |
| 90526000 | Initial evaluation and management of healthy individual (procedure) |
Heart Failure
This is captured by adding a diagnosis with a valid SNOMED or ICD10 code using the Diagnosis widget in a note.
| SNOMED: | |
| Code | Description |
| 10091002 | High output heart failure (disorder) |
| 101281000119107 | Congestive heart failure due to cardiomyopathy (disorder) |
| 10633002 | Acute congestive heart failure (disorder) |
| 111283005 | Chronic left-sided heart failure (disorder) |
| 1204200007 | Left ventricular failure with normal ejection fraction due to valvular heart disease (disorder) |
| 1204203009 | Left ventricular failure with normal ejection fraction due to coronary arteriosclerosis (disorder) |
| 1204204003 | Left ventricular failure with normal ejection fraction due to myocarditis (disorder) |
| 1204206001 | Left ventricular failure with normal ejection fraction due to cardiomyopathy (disorder) |
| 1204462004 | Left ventricular failure with sepsis (disorder) |
| 120851000119104 | Systolic heart failure stage D (disorder) |
| 120861000119102 | Systolic heart failure stage C (disorder) |
| 120871000119108 | Systolic heart failure stage B (disorder) |
| 120881000119106 | Diastolic heart failure stage D (disorder) |
| 120891000119109 | Diastolic heart failure stage C (disorder) |
| 120901000119108 | Diastolic heart failure stage B (disorder) |
| 153931000119109 | Acute combined systolic and diastolic heart failure (disorder) |
| 153941000119100 | Chronic combined systolic and diastolic heart failure (disorder) |
| 153951000119103 | Acute on chronic combined systolic and diastolic heart failure (disorder) |
| 15629541000119106 | Congestive heart failure stage C due to ischemic cardiomyopathy (disorder) |
| 15629591000119103 | Congestive heart failure stage B due to ischemic cardiomyopathy (disorder) |
| 15629641000119107 | Systolic heart failure stage B due to ischemic cardiomyopathy (disorder) |
| 15629741000119102 | Systolic heart failure stage C due to ischemic cardiomyopathy (disorder) |
| 15781000119107 | Hypertensive heart AND chronic kidney disease with congestive heart failure (disorder) |
| 15964701000119109 | Acute cor pulmonale co-occurrent and due to saddle embolus of pulmonary artery (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) |
| 23341000119109 | Congestive heart failure with right heart failure (disorder) |
| 233924009 | Heart failure as a complication of care (disorder) |
| 25544003 | Low output heart failure (disorder) |
| 314206003 | Refractory heart failure (disorder) |
| 364006 | Acute left-sided heart failure (disorder) |
| 410431009 | Cardiorespiratory failure (disorder) |
| 417996009 | Systolic heart failure (disorder) |
| 418304008 | Diastolic heart failure (disorder) |
| 42343007 | Congestive heart failure (disorder) |
| 424404003 | Decompensated chronic heart failure (disorder) |
| 426263006 | Congestive heart failure due to left ventricular systolic dysfunction (disorder) |
| 426611007 | Congestive heart failure due to valvular disease (disorder) |
| 43736008 | Rheumatic left ventricular failure (disorder) |
| 44088000 | Low cardiac output syndrome (disorder) |
| 441481004 | Chronic systolic heart failure (disorder) |
| 441530006 | Chronic diastolic heart failure (disorder) |
| 44313006 | Right heart failure secondary to left heart failure (disorder) |
| 443253003 | Acute on chronic systolic heart failure (disorder) |
| 443254009 | Acute systolic heart failure (disorder) |
| 443343001 | Acute diastolic heart failure (disorder) |
| 443344007 | Acute on chronic diastolic heart failure (disorder) |
| 46113002 | Hypertensive heart failure (disorder) |
| 471880001 | Heart failure due to end stage congenital heart disease (disorder) |
| 48447003 | Chronic heart failure (disorder) |
| 5148006 | Hypertensive heart disease with congestive heart failure (disorder) |
| 5375005 | Chronic left-sided congestive heart failure (disorder) |
| 56675007 | Acute heart failure (disorder) |
| 67431000119105 | Congestive heart failure stage D (disorder) |
| 67441000119101 | Congestive heart failure stage C (disorder) |
| 698594003 | Symptomatic congestive heart failure (disorder) |
| 703272007 | Heart failure with reduced ejection fraction (disorder) |
| 703273002 | Heart failure with reduced ejection fraction due to coronary artery disease (disorder) |
| 703274008 | Heart failure with reduced ejection fraction due to myocarditis (disorder) |
| 703275009 | Heart failure with reduced ejection fraction due to cardiomyopathy (disorder) |
| 703276005 | Heart failure with reduced ejection fraction due to heart valve disease (disorder) |
| 717840005 | Congestive heart failure stage B (disorder) |
| 72481000119103 | Congestive heart failure as early postoperative complication (disorder) |
| 74960003 | Acute left-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) |
| 871617000 | Low output heart failure due to and following Fontan operation (disorder) |
| 88805009 | Chronic congestive heart failure (disorder) |
| 90727007 | Pleural effusion due to congestive heart failure (disorder) |
| 92506005 | Biventricular congestive heart failure (disorder) |
| ICD10: | |
| 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, unspecified |
| 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 |
| I50.814 | Right heart failure due to left heart failure |
| I50.82 | Biventricular heart failure |
| I50.83 | High output heart failure |
| I50.84 | End stage heart failure |
| I50.89 | Other heart failure |
| I50.9 | Heart failure, unspecified |
and at least one of the following that occurs before or during the measurement period:
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 |
| 93644-3 | Left ventricular Ejection fraction by US.2D.A2C+Calc by single plane area-length method |
| 93645-0 | Left ventricular Ejection fraction by US.2D.A4C+Calc by single plane area-length method |
| 93646-8 | Left ventricular Ejection fraction by US.2D+Calculated by biplane area-length method |
| SNOMED: | |
| Code | Description |
| 134401001 | Left ventricular systolic dysfunction (disorder) |
| 981000124106 | Moderate left ventricular systolic dysfunction (disorder) |
| 991000124109 | Severe left ventricular systolic dysfunction (disorder) |
Denominator Exclusions:
Denominator exclusions include patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD.
If one of the following is documented in the chart, the patient will not be included in the denominator:
Heart Transplant Procedure prior to the end of the outpatient encounter with Moderate or Severe LVSD
This is captured by adding a procedure with a valid SNOMED or CPT code using the Procedure widget in a note.
| SNOMED: | |
| Code | Description |
| 174803001 | Revision of transplantation of heart and lung (procedure) |
| 32413006 | Transplantation of heart (procedure) |
| 32477003 | Heart-lung transplant with recipient cardiectomy-pneumonectomy (procedure) |
| 450816007 | Revision of transplantation of heart (procedure) |
| 47058000 | Heart transplant with recipient cardiectomy (procedure) |
| CPT: | |
| Code | Description |
| 33935 | Heart-lung transplant with recipient cardiectomy-pneumonectomy |
| 33945 | Heart transplant, with or without recipient cardiectomy |
| 450816007 | Revision of transplantation of heart (procedure) |
| 47058000 | Heart transplant with recipient cardiectomy (procedure) |
This is captured by adding a diagnosis with a valid SNOMED or ICD10 code using the Diagnosis widget in a note.
| SNOMED: | |
| Code | Description |
| 122511000119103 | Lymphoproliferative disorder following heart transplantation (disorder) |
| 15960341000119104 | Unstable angina due to arteriosclerosis of coronary artery bypass graft of transplanted heart (disorder) |
| 213151004 | Heart transplant failure and rejection (disorder) |
| 213152006 | Heart-lung transplant failure and rejection (disorder) |
| 233844002 | Accelerated coronary artery disease in transplanted heart (disorder) |
| 429257001 | Disorder of transplanted heart (disorder) |
| 444855007 | Arteriosclerosis of coronary artery bypass graft of transplanted heart (disorder) |
| 471851005 | Disorder of myocardium associated with rejection of cardiac transplant (disorder) |
| 792842004 | Coronary arteriosclerosis in artery of transplanted heart (disorder) |
| SNOMED: | |
| Code | Description |
| I25.750 | Atherosclerosis of native coronary artery of transplanted heart with unstable angina |
| I25.751 | Atherosclerosis of native coronary artery of transplanted heart with angina pectoris with documented spasm |
| I25.758 | Atherosclerosis of native coronary artery of transplanted heart with other forms of angina pectoris |
| I25.759 | Atherosclerosis of native coronary artery of transplanted heart with unspecified angina pectoris |
| I25.760 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with unstable angina |
| I25.761 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with angina pectoris with documented spasm |
| I25.768 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with other forms of angina pectoris |
| I25.769 | Atherosclerosis of bypass graft of coronary artery of transplanted heart with unspecified angina pectoris |
| I25.811 | Atherosclerosis of native coronary artery of transplanted heart without angina pectoris |
| I25.812 | Atherosclerosis of bypass graft of coronary artery of transplanted heart without angina pectoris |
| T86.20 | Unspecified complication of heart transplant |
| T86.21 | Heart transplant rejection |
| T86.22 | Heart transplant failure |
| T86.23 | Heart transplant infection |
| T86.298 | Other complications of heart transplant |
| T86.30 | Unspecified complication of heart-lung transplant |
| T86.31 | Heart-lung transplant rejection |
| T86.32 | Heart-lung transplant failure |
| T86.33 | Heart-lung transplant infection |
| T86.39 | Other complications of heart-lung transplant |
This is captured by adding a procedure with a valid SNOMED or CPT code using the Procedure widget in a note.
| SNOMED: | |
| Code | Description |
| 232967006 | Implantation of left cardiac ventricular assist device (procedure) |
| 232968001 | Implantation of cardiac biventricular assist device (procedure) |
| 700151002 | Temporary implantation of left cardiac ventricular assist device (procedure) |
| CPT: | |
| Code | Description |
| 33976 | Insertion of ventricular assist device; extracorporeal, biventricular |
| 33981 | Replacement of extracorporeal ventricular assist device, single or biventricular, pump(s), single or each pump |
| 33990 | Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, arterial access only |
| 33991 | Insertion of ventricular assist device, percutaneous, including radiological supervision and interpretation; left heart, both arterial and venous access, with transseptal puncture |
| 33993 | Repositioning of percutaneous right or left heart ventricular assist device with imaging guidance at separate and distinct session from insertion |
This is captured by adding a diagnosis with a valid SNOMED code using the Diagnosis widget in a note.
| SNOMED: | |
| Code | Description |
| 764680009 | Infection of left ventricular assist device driveline (disorder) |
| 765181003 | Thrombosis caused by left ventricular assist device (disorder) |
| 765465004 | Thrombosis associated with left ventricular assist device (disorder) |
Denominator Exceptions:
Denominator exceptions include documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates <50, allergy, intolerance, other medical reasons); as well as documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).
If one of the following is documented in the chart, the patient will not be included in the denominator:
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 for the first encounter of the measurement period for the patient.
Medical Reason
| SNOMED: | |
| Code | Description |
| 183932001 | Procedure contraindicated (situation) |
| 183964008 | Treatment not indicated (situation) |
| 183966005 | Drug treatment not indicated (situation) |
| 266721009 | Absent response to treatment (situation) |
| 269191009 | Late effect of medical and surgical care complication (disorder) |
| 31438003 | Drug resistance (disorder) |
| 35688006 | Complication of medical care (disorder) |
| 407563006 | Treatment not tolerated (situation) |
| 410534003 | Not indicated (qualifier value) |
| 410536001 | Contraindicated (qualifier value) |
| 416098002 | Allergy to drug (finding) |
| 428119001 | Procedure not indicated (situation) |
| 59037007 | Intolerance to drug (finding) |
| 62014003 | Adverse reaction caused by drug (disorder) |
| 79899007 | Drug interaction (finding) |
Patient Reason
| SNOMED: | |
| Code | Description |
| 105480006 | Procedure declined by patient (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 | Drug declined by patient – cannot pay script (situation) |
| 183945002 | Procedure declined 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) |
| 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 declined (situation) |
| 408367005 | Patient forgets to take medication (finding) |
| 413311005 | Patient non-compliant – declined intervention / support (situation) |
| 416432009 | Procedure not wanted (situation) |
| 423656007 | Income insufficient to buy necessities (finding) |
| 424739004 | Income sufficient to buy only necessities (finding) |
| 443390004 | Refused (qualifier value) |
| 713247000 | Procedure discontinued by patient (situation) |
This is captured by adding a diagnosis with a valid SNOMED or ICD10 code using the Diagnosis widget in a note.
Arrhythmia
| SNOMED: | |
| Code | Description |
| 1010405004 | Paroxysmal atrial fibrillation with rapid ventricular response (disorder) |
| 10164001 | Parasystole (disorder) |
| 10626002 | Multifocal premature ventricular complexes (disorder) |
| 11157007 | Ventricular bigeminy (disorder) |
| 1142040009 | Right atrial non-cavotricuspid isthmus dependent macro re-entrant atrial tachycardia (disorder) |
| 1142041008 | Non-scar mediated right atrial non-cavotricuspid isthmus dependent macro re-entrant atrial tachycardia (disorder) |
| 1142057008 | Anticlockwise cavotricuspid isthmus dependent macroreentry tachycardia (disorder) |
| 1142064005 | Antidromic atrioventricular reciprocating tachycardia utilizing atrio-ventricular accessory pathway with antegrade unidirectional conduction (disorder) |
| 1142066007 | Antidromic atrioventricular reciprocating tachycardia utilizing atrio-fascicular accessory pathway with antegrade unidirectional conduction (disorder) |
| 1142067003 | Non scar mediated left atrial non-cavotricuspid isthmus dependent macro re-entrant atrial tachycardia (disorder) |
| 1142068008 | Antidromic atrioventricular reciprocating tachycardia utilizing accessory pathway with antegrade unidirectional conduction (disorder) |
| 1142069000 | Scar mediated left atrial non-cavotricuspid isthmus dependent macro re-entrant atrial tachycardia (disorder) |
| 1142082008 | Idiopathic junctional ectopic tachycardia (disorder) |
| 1142086006 | Congenital junctional ectopic tachycardia (disorder) |
| 1142090008 | Clockwise cavotricuspid isthmus dependent macroreentry tachycardia (disorder) |
| 1142093005 | Left atrial non-cavotricuspid isthmus dependent macro re-entrant atrial tachycardia (disorder) |
| 1142098001 | Junctional ectopic tachycardia following surgical procedure on heart (disorder) |
| 1142103004 | Antidromic atrioventricular reciprocating tachycardia utilizing nodo-fascicular accessory pathway with antegrade unidirectional conduction (disorder) |
| 1142105006 | Typical atrioventricular nodal re-entry tachycardia (disorder) |
| 1142114001 | Scar mediated right atrial non-cavotricuspid isthmus dependent macro re-entrant atrial tachycardia (disorder) |
| 1142117008 | Atypical slow slow atrioventricular nodal re-entry tachycardia (disorder) |
| 1142118003 | Atypical atrioventricular nodal re-entry tachycardia (disorder) |
| 1142119006 | Atypical fast slow atrioventricular nodal re-entry tachycardia (disorder) |
| 1142120000 | Orthodromic atrioventricular reciprocating tachycardia utilizing manifest accessory pathway (disorder) |
| 1142121001 | Atrioventricular nodal reentry tachycardia with twin atrioventricular nodes (disorder) |
| 1142122008 | Antidromic atrioventricular reciprocating tachycardia utilizing accessory pathway with bidirectional conduction (disorder) |
| 1142204001 | Orthodromic atrioventricular reciprocating tachycardia utilizing concealed accessory pathway (disorder) |
| 11849007 | Atrioventricular junctional rhythm (disorder) |
| 1208832006 | Pacemaker mediated tachycardia (disorder) |
| 1220643007 | Regular wide QRS complex tachycardia (disorder) |
| 13640000 | Fusion beats (disorder) |
| 16415081000119104 | Supraventricular tachycardia following acute myocardial infarction (disorder) |
| 17366009 | Atrial arrhythmia (disorder) |
| 17869006 | Anomalous atrioventricular excitation (disorder) |
| 184004 | Withdrawal 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) |
| 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) |
| 26950008 | Chronic ectopic atrial tachycardia (disorder) |
| 27337007 | Unifocal premature ventricular complexes (disorder) |
| 276796006 | Atrial tachycardia (disorder) |
| 284470004 | Premature atrial contraction (disorder) |
| 287057009 | Atrial premature complex (disorder) |
| 29320008 | Ectopic rhythm (disorder) |
| 309809007 | Electromechanical dissociation with successful resuscitation (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) |
| 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) |
| 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) |
| 762534000 | Supraventricular bradyarrhythmia (disorder) |
| 81681009 | Junctional premature beats (disorder) |
| 81898007 | Ventricular escape rhythm (disorder) |
| 88412007 | Atrio-ventricular node arrhythmia (disorder) |
| ICD10: | |
| Code | Description |
| I49.8 | Other specified cardiac arrhythmias |
| I49.9 | Cardiac arrhythmia, unspecified |
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) |
| 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 | Asthma caused by wood dust (disorder) |
| 59786004 | Weavers’ cough (disorder) |
| 63088003 | Allergic 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) |
| 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) |
| 762521001 | Exacerbation of allergic asthma (disorder) |
| 782520007 | Exacerbation of allergic asthma due to infection (disorder) |
| 85761009 | Byssinosis (disorder) |
| 92807009 | Chemical-induced asthma (disorder) |
| 93432008 | Drug-induced asthma (disorder) |
| ICD10: | |
| 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 |
Hypotension
| SNOMED: | |
| Code | Description |
| 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 | Idiopathic chronic hypotension (disorder) |
| 371073003 | Postural orthostatic tachycardia syndrome (disorder) |
| 408667000 | Hemodialysis-associated hypotension (disorder) |
| 408668005 | Iatrogenic hypotension (disorder) |
| 429561008 | Exertional hypotension (disorder) |
| 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) |
| ICD10: | |
| 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 |
| O26.50 | Maternal hypotension syndrome, unspecified trimester |
| O26.51 | Maternal hypotension syndrome, first trimester |
| O26.52 | Maternal hypotension syndrome, second trimester |
| O26.53 | Maternal hypotension syndrome, third trimester |
Bradycardia
| SNOMED: | |
| Code | Description |
| 1142110005 | Sinus bradycardia caused by drug (disorder) |
| 1142111009 | Sinus bradycardia due to metabolic disease (disorder) |
| 251162005 | Atrio-ventricular-junctional (nodal) bradycardia (disorder) |
| 29894000 | Vagal autonomic bradycardia (disorder) |
| 397841007 | Drug-induced bradycardia (disorder) |
| 44602002 | Persistent sinus bradycardia (disorder) |
| 49044005 | Severe sinus bradycardia (disorder) |
| 49710005 | Sinus bradycardia (disorder) |
| ICD10: | |
| Code | Description |
| I49.5 | Sick sinus syndrome |
| I49.8 | Other specified cardiac arrhythmias |
| R00.1 | Bradycardia, unspecified |
Allergy to Beta Blocker Therapy
| SNOMED: | |
| Code | Description |
| 293962009 | Allergy to beta adrenergic receptor antagonist (finding) |
| 293963004 | Allergy to beta-1 adrenergic receptor antagonist (finding) |
| 293964005 | Allergy to acebutolol (finding) |
| 293965006 | Allergy to atenolol (finding) |
| 293966007 | Allergy to betaxolol (finding) |
| 293967003 | Allergy to bisoprolol (finding) |
| 293968008 | Allergy to celiprolol (finding) |
| 293969000 | Allergy to esmolol (finding) |
| 293970004 | Allergy to metoprolol (finding) |
| 293972007 | Allergy to nadolol (finding) |
| 293973002 | Allergy to pindolol (finding) |
| 293974008 | Allergy to carvedilol (finding) |
| 293975009 | Allergy to metipranolol (finding) |
| 293976005 | Allergy to carteolol (finding) |
| 293977001 | Allergy to labetalol (finding) |
| 293978006 | Allergy to levobunolol (finding) |
| 293979003 | Allergy to oxprenolol (finding) |
| 293980000 | Allergy to penbutolol (finding) |
| 293981001 | Allergy to practolol (finding) |
| 293982008 | Allergy to propranolol (finding) |
| 293983003 | Allergy to sotalol (finding) |
| 293984009 | Allergy to timolol (finding) |
Intolerance to Beta Blocker Therapy
| 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) |
| 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) |
| 772020009 | Adverse reaction caused by nebivolol (disorder) |
This is captured by entering a medication ingredient with a valid RXNORM code in the Allergy widget in a note prior to or during the first encounter of the measurement period for the patient.
| RXNORM: | |
| Code | Description |
| 10600 | timolol |
| 1202 | atenolol |
| 149 | acebutolol |
| 1520 | betaxolol |
| 19484 | bisoprolol |
| 20352 | carvedilol |
| 2116 | carteolol |
| 31555 | nebivolol |
| 6185 | labetalol |
| 6918 | metoprolol |
| 7226 | nadolol |
| 8332 | pindolol |
| 8787 | propranolol |
| 9947 | sotalol |
Atrioventricular Block
This is captured by adding a diagnosis with a valid SNOMED or ICD10 code using the Diagnosis widget in a note.
| SNOMED: | |
| Code | Description |
| 102451000119107 | Complete atrioventricular block as complication of atrioventricular nodal ablation (disorder) |
| 195042002 | Second degree atrioventricular block (disorder) |
| 204383001 | Congenital complete atrioventricular heart block (disorder) |
| 233917008 | Atrioventricular block (disorder) |
| 233918003 | Postoperative complete heart block (disorder) |
| 251114004 | Intermittent second degree atrioventricular block (disorder) |
| 27885002 | Complete atrioventricular block (disorder) |
| 28189009 | Mobitz type II atrioventricular block (disorder) |
| 283645003 | Lev’s syndrome (disorder) |
| 284941000119107 | High degree second degree atrioventricular block (disorder) |
| 54016002 | Mobitz type I incomplete atrioventricular block (disorder) |
| 733125004 | Acquired complete atrioventricular block (disorder) |
| ICD10: | |
| Code | Description |
| I44.0 | Atrioventricular block, first degree |
| I44.1 | Atrioventricular block, second degree |
| I44.2 | Atrioventricular block, complete |
| I44.30 | Unspecified atrioventricular block |
| I44.39 | Other atrioventricular block |
And does not have:
Cardiac Pacer in Situ Diagnosis
| SNOMED: | |
| 441509002 | Cardiac pacemaker in situ (finding) |
| 441769002 | Cardiac defibrillator in situ (finding) |
| 443325000 | Automatic implantable cardiac defibrillator in situ (finding) |
| 703396000 | Combination internal cardiac defibrillator and pacemaker in situ (finding) |
| 86041000119107 | Normally functioning cardiac pacemaker in situ (finding) |
| ICD10: | |
| Code | Description |
| Z95.0 | Presence of cardiac pacemaker |
| Z95.810 | Presence of automatic (implantable) cardiac defibrillator |
And does not have:
Cardiac Pacer Procedure
| SNOMED: | |
| 1279006 | Repair of cardiac pacemaker pocket in skin AND/OR subcutaneous tissue (procedure) |
| 175135009 | Introduction of cardiac pacemaker system via vein (procedure) |
| 175142009 | Implantation of permanent intravenous cardiac pacemaker (procedure) |
| 175143004 | Implantation of intravenous fixed-rate cardiac pacemaker (procedure) |
| 175144005 | Implantation of intravenous triggered cardiac pacemaker (procedure) |
| 20453006 | Relocation of cardiac pacemaker pocket to new site in subcutaneous tissue (procedure) |
| 230588002 | Reposition of cardiac pacemaker pocket (procedure) |
| 233174007 | Cardiac pacemaker procedure (procedure) |
| 233175008 | Temporary cardiac pacemaker procedure (procedure) |
| 233182007 | Permanent cardiac pacemaker procedure (procedure) |
| 233183002 | Insertion of permanent epicardial cardiac pacemaker system (procedure) |
| 23325006 | Repair of cardiac pacemaker (procedure) |
| 23999003 | Implantation of rate-responsive cardiac single-chamber device (procedure) |
| 25267002 | Insertion of intracardiac pacemaker (procedure) |
| 265482008 | Implantation of emergency intravenous cardiac pacemaker (procedure) |
| 307280005 | Implantation of cardiac pacemaker (procedure) |
| 308805008 | Reimplantation of cardiac pacemaker electrode (procedure) |
| 309405007 | Implantation of simple one wire intravenous cardiac pacemaker (procedure) |
| 309407004 | Implantation of complex one wire intravenous cardiac pacemaker (procedure) |
| 309408009 | Implantation of complex two wire intravenous cardiac pacemaker (procedure) |
| 309471004 | Implantation of temporary intravenous cardiac pacemaker (procedure) |
| 310582005 | Implantation of intravenous dual chamber permanent cardiac pacemaker (procedure) |
| 384683008 | Replacement of cardiac pacemaker device with dual-chamber device (procedure) |
| 429064006 | Implantation of biventricular cardiac pacemaker system (procedure) |
| 429528001 | Implantation of intravenous single chamber cardiac pacemaker system (procedure) |
| 429542009 | Implantation of intravenous biventricular cardiac pacemaker system (procedure) |
| 430294007 | Reposition of permanent cardiac pacemaker using fluoroscopic guidance (procedure) |
| 431846007 | Replacement of permanent cardiac pacemaker using fluoroscopic guidance (procedure) |
| 432113002 | Insertion of temporary cardiac pacemaker using fluoroscopic guidance (procedure) |
| 443753002 | Insertion of single chamber cardiac pacemaker pulse generator (procedure) |
| 444179007 | Insertion of dual chamber cardiac pacemaker pulse generator (procedure) |
| 444566006 | Replacement of cardiac pacemaker (procedure) |
| 448242007 | Repositioning of cardiac pacemaker lead using fluoroscopic guidance (procedure) |
| 448841009 | Replacement of cardiac biventricular implantable cardioverter defibrillator using fluoroscopic guidance (procedure) |
| 448869001 | Replacement of cardiac biventricular permanent pacemaker using fluoroscopic guidance (procedure) |
| 449397007 | Insertion of permanent cardiac pacemaker pulse generator and electrode (procedure) |
| 450820006 | Replacement of pulse generator of permanent cardiac pacemaker using fluoroscopic guidance (procedure) |
| 58863009 | Initial implantation of cardiac dual-chamber device (procedure) |
| 65219008 | Subcutaneous implantation of cardiac pacemaker (procedure) |
| 699125007 | Insertion of programmable cardiac pacemaker (procedure) |
| 699135001 | Implantation of cardiac defibrillator lead (procedure) |
| 703073006 | Cardiac pacemaker procedure using fluoroscopic guidance (procedure) |
| 704115002 | Revision of cardiac pacemaker electrode using fluoroscopic guidance (procedure) |
| 736700005 | Revision of internal cardiac defibrillator lead using fluoroscopic guidance (procedure) |
| 737011002 | Revision of cardiac biventricular implantable cardioverter defibrillator lead using fluoroscopic guidance (procedure) |
| 771557007 | Replacement of cardiac biventricular implantable cardioverter defibrillator (procedure) |
| 77453006 | Revision of permanent cardiac pacemaker device (procedure) |
| 8072003 | Replacement of cardiac pacemaker with single chamber pacemaker not specified as rate responsive (procedure) |
| ICD10: | |
| Code | Description |
| 33206 | Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial |
| 33207 | Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular |
| 33208 | Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial and ventricular |
| 33210 | Insertion or replacement of temporary transvenous single chamber cardiac electrode or pacemaker catheter (separate procedure) |
| 33211 | Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure) |
| 33212 | Insertion of pacemaker pulse generator only; with existing single lead |
| 33213 | Insertion of pacemaker pulse generator only; with existing dual leads |
| 33214 | Upgrade of implanted pacemaker system, conversion of single chamber system to dual chamber system (includes removal of previously placed pulse generator, testing of existing lead, insertion of new lead, insertion of new pulse generator) |
| 33216 | Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator |
| 33217 | Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator |
| 33221 | Insertion of pacemaker pulse generator only; with existing multiple leads |
| 33224 | Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, with attachment to previously placed pacemaker or implantable defibrillator pulse generator (including revision of pocket, removal, insertion, and/or replacement of existing generator) |
| 33225 | Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, at time of insertion of implantable defibrillator or pacemaker pulse generator (eg, for upgrade to dual chamber system) (List separately in addition to code for primary procedure) |
| 33274 | Transcatheter insertion or replacement of permanent leadless pacemaker, right ventricular, including imaging guidance (eg, fluoroscopy, venous ultrasound, ventriculography, femoral venography) and device evaluation (eg, interrogation or programming), when performed |
Required Data Elements for the Numerator:
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.
| RXNORM: | |
| Code | Description |
| 1999031 | 24 HR metoprolol succinate 100 MG Extended Release Oral Capsule |
| 1999033 | 24 HR metoprolol succinate 200 MG Extended Release Oral Capsule |
| 1999035 | 24 HR metoprolol succinate 25 MG Extended Release Oral Capsule |
| 1999037 | 24 HR metoprolol succinate 50 MG Extended Release Oral Capsule |
| 200031 | carvedilol 6.25 MG Oral Tablet |
| 200032 | carvedilol 12.5 MG Oral Tablet |
| 200033 | carvedilol 25 MG Oral Tablet |
| 686924 | carvedilol 3.125 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 |
| 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 |
*ADDITIONAL INFORMATION:
- The Ejection Fraction result LOINC code can be linked to a numeric template 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 ChartMaker Clinical. If a patient encounter was not entered into Clinical, that encounter is not included in the denominator for the statistical calculations in the MIPS Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes.