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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
394 1407 Process No Community/Population Health Registry

Measure Description

The percentage of adolescents 13 years of age who had the recommended immunizations by their 13th birthday

Instructions

This measure is to be submitted a minimum of once per performance period for patients seen during the performance period. There is no diagnosis associated with this measure. Performance for this measure is not limited to the performance period. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on services provided and the measure-specific denominator coding.

This measure will be calculated with 4 performance rates:

  1. Patients who had one dose of meningococcal vaccine on or between the patient’s 11th and 13th birthdays
  2. Patients who had one tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) on or between the patient’s 10th and 13th birthdays
  3. Patients who have completed the HPV vaccine series with different dates of service on or between the patient’s 9th and 13th birthdays
  4. All patients who are compliant for Meningococcal, Tdap and HPV during the specified timeframes

Measure Submission

The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The quality-data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data.

Numerator (Submission Criteria 1):

Adolescents who had one dose of meningococcal vaccine on or between the patient’s 11th and 13th birthdays

Numerator Quality-Data Coding Options

Performance Met:

Patient had one dose of meningococcal vaccine on or between the patient’s 11th and 13th birthdays (G9414)

Performance Not Met:

Patient did not have one dose of meningococcal vaccine on or between the patient’s 11th and 13th birthdays (G9415)

Numerator (Submission Criteria 2):

Adolescents who had one tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) on or between the patient’s 10th and 13th birthdays

Numerator Quality-Data Coding Options

Performance Met:

Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) on or between the patient’s 10th and 13th birthdays (G9416)

Performance Not Met:

Patient did not have one tetanus, diphtheria toxoids and acellular pertussis vaccine (Tdap) on or between the patient’s 10th and 13th birthdays (G9417)

Numerator (Submission Criteria 3):

Adolescents who had at least three HPV vaccines on or between the patient’s 9th and 13th birthdays

Numerator Quality-Data Coding Options

Performance Met:

Patient had at least two HPV vaccines (with at least 146 days between the two) OR three HPV vaccines on or between the patient’s 9th and 13th birthdays (G9762)

Performance Not Met:

Patient did not have at least two HPV vaccines (with at least 146 days between the two) OR three HPV vaccines on or between the patient’s 9th and 13th birthdays (G9763)

Numerator (Submission Criteria 4):

Adolescents who are numerator compliant for Rates 1, 2 and 3

Denominator (Submission criteria for all rates)

Adolescents who turn 13 years of age during the measurement period

Denominator Criteria (Eligible Cases):
Patients who turn 13 years of age during the measurement period

AND
Patient encounter during the performance period (CPT or HCPCS): 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337,99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0402

AND NOT
DENOMINATOR EXCLUSIONS:
Meningococcal, Tdap and/or HPV vaccine contraindicated OR patient allergic to the meningococcal, Tdap, and/or HPV vaccine

OR
Patients who use hospice services any time during the measurement period: G9761

 

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