Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (2022)

eCQMs / NQF #: CMS138v10 / 0028e
Measure: Percentage of patients aged 18 years and older who were screened for tobacco use one or more times during the measurement period AND who received tobacco cessation intervention if identified as a tobacco user

Three rates are reported:

a. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times during the measurement period.

b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention.

c. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times during the measurement period AND who received tobacco cessation intervention if identified as a tobacco user.

Numerator: Population 1: Patients who were screened for tobacco use at least once within 12 months.

Population 2: Patients who received tobacco cessation intervention.

Population 3: Patients who were screened for tobacco use at least once within 12 months AND who received tobacco cessation intervention if identified as a tobacco user.

Denominator: Population 1: All patients aged 18 years and older seen for at least two visits or at least one preventive visit during the measurement period.

Population 2: All patients aged 18 years and older seen for at least two visits or at least one preventive visit during the measurement period who were screened for tobacco use and identified as a tobacco user.

Population 3: All patients aged 18 years and older seen for at least two visits or at least one preventive visit during the measurement period.

Denominator Exceptions:   Population 1: Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason).

Population 2: Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g., limited life expectancy, other medical reason).

Population 3: Documentation of medical reason(s) for not screening for tobacco use OR for not providing tobacco cessation intervention for patients identified as tobacco users (e.g., limited life expectancy, other medical reason).

Domain: Community/Population Health

 

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient, who is at least 18 years old, for at least 2 visits OR at least 1 preventive visit during the reporting period and have the appropriate information documented in the chart:

Required Data Elements for the Denominator: 

At least one of the following:  

This is captured by adding a procedure with a valid CPT or SNOMED code using the Procedure widget in a note.

CPT:  
Code Description
99385 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 18-39 years
99386 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 40-64 years
99387 Initial comprehensive preventive medicine evaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, new patient; 65 years and older
99395 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 18-39 years
99396 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 40-64 years
99397 Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; 65 years and older
99401 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 15 minutes
99402 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 30 minutes
99403 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 45 minutes
99404 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to an individual (separate procedure); approximately 60 minutes
99411 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 30 minutes
99412 Preventive medicine counseling and/or risk factor reduction intervention(s) provided to individuals in a group setting (separate procedure); approximately 60 minutes
99420 Administration and interpretation of health risk assessment instrument (eg, health hazard appraisal)
99429 Unlisted preventive medicine service
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit

 

SNOMED:  
Code Description
12843005 Subsequent hospital visit by physician (procedure)
18170008 Subsequent nursing facility visit (procedure)
19681004 Nursing evaluation of patient and report (procedure)
87790002 Follow-up inpatient consultation visit (procedure)
90526000 Initial evaluation and management of healthy individual (procedure)
185349003 Encounter for “check-up” (procedure)
185463005 Visit out of hours (procedure)
185465003 Weekend visit (procedure)
207195004 History and physical examination with evaluation and management of nursing facility patient (procedure)
270427003 Patient-initiated encounter (procedure)
270430005 Provider-initiated encounter (procedure)
308335008 Patient encounter procedure (procedure)
390906007 Follow-up encounter (procedure)
406547006 Urgent follow-up (procedure)
439708006 Home visit (procedure)
444971000124105 Annual wellness visit (procedure)
456201000124103 Medicare Annual Wellness Visit (procedure)

This is captured by adding a procedure with a valid CPT, HCPCS, or SNOMED code using the Procedure widget in a note.

CPT/HCPCS:  
Code Description
90791 Psychiatric diagnostic evaluation
90792 Psychiatric diagnostic evaluation with medical services
90832 Psychotherapy, 30 minutes with patient
90834 Psychotherapy, 45 minutes with patient
90837 Psychotherapy, 60 minutes with patient
90845 Psychoanalysis
92002 Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; intermediate, new patient
92004 Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits
92012 Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; intermediate, established patient
92014 Ophthalmological services: medical examination and evaluation, with initiation or continuation of diagnostic and treatment program; comprehensive, established patient, 1 or more visits
98966 Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
98967 Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
98968 Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion
98969 Online assessment and management service provided by a qualified nonphysician health care professional to an established patient or guardian, not originating from a related assessment and management service provided within the previous 7 days, using the Internet or similar electronic communications network
98970 Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
98971 Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes
98972 Qualified nonphysician health care professional online digital assessment and management, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes
99201 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99202 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99203 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99204 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99205 Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99212 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99213 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99214 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99215 Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99341 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of low severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99342 Home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99343 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99344 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99345 Home visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the patient is unstable or has developed a significant new problem requiring immediate physician attention. Typically, 75 minutes are spent face-to-face with the patient and/or family.
99347 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused interval history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are self limited or minor. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99348 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused interval history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99349 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed interval history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
99350 Home visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive interval history; A comprehensive examination; Medical decision making of moderate to high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are of moderate to high severity. The patient may be unstable or may have developed a significant new problem requiring immediate physician attention. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99421 Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
99422 Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes
99423 Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes
99441 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
99442 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion
99443 Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management services provided to an established patient, parent, or guardian not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion
99458 Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; each additional 20 minutes (List separately in addition to code for primary procedure)
97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family.
97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family.
97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.
97165 Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; An assessment(s) that identifies 1-3 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of low complexity, which includes an analysis of the occupational profile, analysis of data from problem-focused assessment(s), and consideration of a limited number of treatment options. Patient presents with no comorbidities that affect occupational performance. Modification of tasks or assistance (eg, physical or verbal) with assessment(s) is not necessary to enable completion of evaluation component. Typically, 30 minutes are spent face-to-face with the patient and/or family.
97166 Occupational therapy evaluation, moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 3-5 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of moderate analytic complexity, which includes an analysis of the occupational profile, analysis of data from detailed assessment(s), and consideration of several treatment options. Patient may present with comorbidities that affect occupational performance. Minimal to moderate modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. Typically, 45 minutes are spent face-to-face with the patient and/or family.
97167 Occupational therapy evaluation, high complexity, requiring these components: An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 5 or more performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of high analytic complexity, which includes an analysis of the patient profile, analysis of data from comprehensive assessment(s), and consideration of multiple treatment options. Patient presents with comorbidities that affect occupational performance. Significant modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. Typically, 60 minutes are spent face-to-face with the patient and/or family.
97168 Re-evaluation of occupational therapy established plan of care, requiring these components: An assessment of changes in patient functional or medical status with revised plan of care; An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals; and A revised plan of care. A formal reevaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required. Typically, 30 minutes are spent face-to-face with the patient and/or family.
G0071 Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only
G2010 Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion
G2061 Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes
G2062 Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes
G2063 Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes

 

SNOMED:  
Code Description
10197000 Psychiatric interview and evaluation (procedure)
165172002 Diagnostic psychiatric interview (procedure)
183381005 General psychotherapy (regime/therapy)
183382003 Psychotherapy – behavioral (regime/therapy)
183383008 Psychotherapy – cognitive (regime/therapy)
18512000 Individual psychotherapy (regime/therapy)
185317003 Telephone encounter (procedure)
185463005 Visit out of hours (procedure)
185464004 Out of hours visit – not night visit (procedure)
185465003 Weekend visit (procedure)
225929007 Joint home visit (procedure)
28988002 Psychoanalysis in depth (procedure)
302242004 Long-term psychodynamic psychotherapy (regime/therapy)
30346009 Evaluation and management of established outpatient in office or other outpatient facility (procedure)
304820009 Developmental psychodynamic psychotherapy (regime/therapy)
304822001 Psychodynamic-interpersonal psychotherapy (regime/therapy)
314034001 Psychodynamic psychotherapy (regime/therapy)
314849005 Telephone contact by consultant (procedure)
315205008 Bank holiday home visit (procedure)
33849009 Diagnostic physical therapy procedure (regime/therapy)
3391000175108 Office visit for pediatric care and assessment (procedure)
359960003 Ophthalmologic examination and evaluation under general anesthesia, limited (procedure)
36228007 Ophthalmic examination and evaluation (procedure)
37894004 Evaluation and management of new outpatient in office or other outpatient facility (procedure)
386472008 Telephone consultation (procedure)
386473003 Telephone follow-up (procedure)
38678006 Client-centered psychotherapy (regime/therapy)
401157001 Brief solution focused psychotherapy (regime/therapy)
401267002 Telephone triage encounter (procedure)
410155007 Occupational therapy assessment (procedure)
410157004 Occupational therapy management (procedure)
439708006 Home visit (procedure)
439740005 Postoperative follow-up visit (procedure)
443730003 Interpersonal psychotherapy (regime/therapy)
61436009 Psychoanalysis (procedure)
66902005 Ophthalmic examination and evaluation, follow-up (procedure)
68338001 Interactive medical psychiatric diagnostic interview (procedure)
698704008 Home visit for rheumatology service (procedure)
704126008 Home visit for anticoagulant drug monitoring (procedure)
75516001 Psychotherapy (regime/therapy)
78831002 Comprehensive eye examination (procedure)
79094001 Initial psychiatric interview with mental status and evaluation (procedure)
90102008 Social psychotherapy (regime/therapy)

Denominator Exceptions:

This measure makes an exception for patients who were not screened for tobacco use due to a documented medical reason.  In order to meet the requirements for this exception, the appropriate information must be documented in the chart (at least one of the following):

SNOMED:   
Code Description
27143004 Patient status determination, pre-terminal (finding)
170969009 Prognosis bad (finding)
162607003 Terminal illness – early stage (finding)
162608008 Terminal illness – late stage (finding)
300936002 Terminal illness (finding)

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:  
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)
397745006 Medical contraindication (finding)
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 Description
105480006 Refusal of treatment 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 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)

Required Data Elements for the Numerator: 

AND, if the patient is a tobacco user, at least ONE of the following must also be documented:

This is captured by prescribing or renewing a medication with a valid RXNORM code.

RXNORM:  
Code Description
1232585 24 HR bupropion hydrochloride 450 MG Extended Release Oral Tablet
1302827 24 HR phentermine 7.5 MG / topiramate 46 MG Extended Release Oral Capsule
1302839 24 HR phentermine 3.75 MG / topiramate 23 MG Extended Release Oral Capsule
1302850 24 HR phentermine 15 MG / topiramate 92 MG Extended Release Oral Capsule
1436239 24 HR topiramate 50 MG Extended Release Oral Capsule
1437278 24 HR topiramate 25 MG Extended Release Oral Capsule
1437283 24 HR topiramate 100 MG Extended Release Oral Capsule
1437288 24 HR topiramate 200 MG Extended Release Oral Capsule
1494769 Sprinkle 24 HR topiramate 150 MG Extended Release Oral Capsule
151226 topiramate 50 MG Oral Tablet
1551468 12 HR bupropion hydrochloride 90 MG / naltrexone hydrochloride 8 MG Extended Release Oral Tablet
1797886 nicotine 0.5 MG/ACTUAT Metered Dose Nasal Spray
1801289 Smoking Cessation 12 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet
1812419 Sprinkle 24 HR topiramate 200 MG Extended Release Oral Capsule
1812421 Sprinkle 24 HR topiramate 25 MG Extended Release Oral Capsule
1812425 Sprinkle 24 HR topiramate 50 MG Extended Release Oral Capsule
1812427 Sprinkle 24 HR topiramate 100 MG Extended Release Oral Capsule
198029 24 HR nicotine 0.583 MG/HR Transdermal System
198030 24 HR nicotine 0.875 MG/HR Transdermal System
198031 24 HR nicotine 0.292 MG/HR Transdermal System
198045 nortriptyline 10 MG Oral Capsule
198046 nortriptyline 50 MG Oral Capsule
198047 nortriptyline 75 MG Oral Capsule
199888 topiramate 25 MG Oral Tablet
199889 topiramate 100 MG Oral Tablet
199890 topiramate 200 MG Oral Tablet
205315 topiramate 25 MG Oral Capsule
205316 topiramate 15 MG Oral Capsule
250983 nicotine 4 MG Inhalation Solution
311975 nicotine 4 MG Chewing Gum
312036 nortriptyline 2 MG/ML Oral Solution
314119 nicotine 2 MG Chewing Gum
317136 nortriptyline 25 MG Oral Capsule
359817 nicotine 2 MG Oral Lozenge
359818 nicotine 4 MG Oral Lozenge
636671 varenicline 0.5 MG Oral Tablet
636676 varenicline 1 MG Oral Tablet
749289 {11 (varenicline 0.5 MG Oral Tablet) / 42 (varenicline 1 MG Oral Tablet) } Pack
749788 {56 (varenicline 1 MG Oral Tablet) } Pack
892244 {14 (24 HR nicotine 0.292 MG/HR Transdermal System) / 14 (24 HR nicotine 0.583 MG/HR Transdermal System) / 28 (24 HR nicotine 0.875 MG/HR Transdermal System) } Pack
993503 12 HR bupropion hydrochloride 100 MG Extended Release Oral Tablet
993518 12 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet
993536 12 HR bupropion hydrochloride 200 MG Extended Release Oral Tablet
993541 24 HR bupropion hydrochloride 150 MG Extended Release Oral Tablet
993557 24 HR bupropion hydrochloride 300 MG Extended Release Oral Tablet
993687 bupropion hydrochloride 100 MG Oral Tablet
993691 bupropion hydrochloride 75 MG Oral Tablet
998671 168 HR clonidine 0.00417 MG/HR Transdermal System
998675 168 HR clonidine 0.00833 MG/HR Transdermal System
998679 168 HR clonidine 0.0125 MG/HR Transdermal System

ADDITIONAL INFORMATION: 

  • In order for successful calculation of this measure, the most recent version of ChartMaker Clinical 2018 must be used.
  • The codes used for the numerator must be documented within the last 24 months prior to the measurement END date.
  • The additional fields in the smoking button are optional.
  • 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 on the MIPS Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes.