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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
050 0000 Process Yes Person and Caregiver-Centered Experience
and Outcomes
Claims

Measure Description

Percentage of female patients aged 65 years and older with a diagnosis of urinary incontinence with a documented plan of care for urinary incontinence at least once within 12 months

Instructions

This measure is to be submitted a minimum of once per performance period for patients seen during the performance period. This measure is appropriate for use in the ambulatory setting only. It is anticipated that eligible clinicians who provide services for patients with the diagnosis of urinary incontinence will submit this measure.

NOTE: No note related

Measure Submission

The listed denominator criteria is used to identify the intended patient population. The numerator quality-data codes included in this specification are used to submit the quality actions allowed by the measure. All measure-specific coding should be submitted on the claim(s) representing the eligible encounter

Numerator

Patients with a documented plan of care for urinary incontinence at least once within 12 months

Definition

Plan of Care – May include behavioral interventions (e.g., bladder training, pelvic floor muscle training, prompted voiding), referral to specialist, surgical treatment, reassess at follow-up visit, lifestyle interventions, addressing co-morbid factors, modification or discontinuation of medications contributing to urinary incontinence, or pharmacologic therapy

Numerator Quality-Data Coding Options

Performance Met: CPT II 0509F:
Plan of Care for Urinary Incontinence Documented:

Urinary incontinence plan of care documented

Denominator Exception: G9694:
Patient receiving Hospice Services, Patient Not Eligible:

Hospice services utilized by patient any time during the measurement period

Performance Not Met: 0509F with 8P:

Presence or Absence of Urinary Incontinence not Assessed, Reason not Otherwise Specified

Append a submission modifier (8P) to CPT Category II code 0509F to submit circumstances when the action described in the numerator is not performed and the reason is not otherwise specified.

Urinary incontinence plan of care not documented,reason not otherwise specified

NUMERATOR NOTE No notes related

Denominator

All female patients aged 65 years and older with a diagnosis of urinary incontinence

Option 1 – Denominator Criteria (Eligible Cases):

All female patients aged ≥ 65 years on date of encounter

AND

Diagnosis for urinary incontinence (ICD-10-CM): F98.0, N39.3, N39.41, N39.42, N39.43, N39.44, N39.45, N39.46, N39.490, N39.491, N39.492, N39.498, R32


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