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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
268 1814 Process No Effective Clinical Care Registry

Measure Description

All female patients of childbearing potential (12 – 44 years old) diagnosed with epilepsy who were counseled or referred for counseling for how epilepsy and its treatment may affect contraception OR pregnancy at least once a year

Instructions

This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of epilepsy during the performance period. This measure may be submitted by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding

NOTE: No notes 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

Female patients or caregivers counseled at least once a year about how epilepsy and its treatment may affect contraception OR pregnancy

Definition

NUMERATOR NOTE: Denominator Exception(s) are determined on the date of the denominator eligible encounter.

Numerator Quality-Data Coding Options

NUMERATOR 

Denominator Exception: 4340F With 1P:
Counseling for Women of Childbearing Potential with Epilepsy Not Performed for Medical Reasons

Append a modifier (1P) to Category II code 4340F to submit documented circumstances that appropriately exclude patients from the denominator.

Documentation of medical reason(s) why counseling was not performed for women of childbearing potential with epilepsy

 

NUMERATOR 

Performance Met: CPT II 4340F:
Counseling for Women of Childbearing Potential with Epilepsy

 

Counseling for women of childbearing potential with epilepsy

NUMERATOR:

Performance Not Met: 4340F with 8P:
Counseling for Women of Childbearing Potential with Epilepsy Not Performed, Reason Not Otherwise Specified

Append a submission modifier (8P) to CPT Category II code 4340F to submit circumstances when the action
described in the numerator is not performed and the reason is not otherwise specified

Counseling about epilepsy specific safety issues provided to patient or caregiver was not performed, reason not otherwise specified

Numerator Note: No data

Denominator

All females of childbearing potential (12 – 44 years old) with a diagnosis of epilepsy

Eligible cases are determined and must be reported, if either of the following conditions

Option 1 – Denominator Criteria (Eligible Cases):

All females age 12 – 44 years old

AND

Diagnosis for Epilepsy (ICD-10-CM): G40.A09, G40.A19, G40.109, G40.119, G40.209,G40.219, G40.309,
G40.409, G40.411, G40.822, G40.824, G40.909

AND

Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205,99211,
99212, 99213, 99214, 99215

WITHOUT

Telehealth Modifier: GQ, GT, 95, POS 02

 

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