Features Navigation

(800) 825-0224 Live Demo
 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
444 Process Yes Efficiency and Cost Reduction Registry

Measure Description

The percentage of patients 5-64 years of age during the measurement year who were identified as having persistent asthma and were dispensed appropriate medications that they remained on for at least 75% of their treatment period

Instructions

This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of persistent asthma seen during 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 the services provided and the measure-specific denominator coding.

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:

The number of patients who achieved a proportion of days (PDC) of at least 75% for their asthma controller medications during the measurement year

Definitions:

PDC – The proportion of days covered by at least one asthma controller medication prescription, divided by the number of days in the treatment period. The treatment period is the period of time beginning on the earliest prescription dispensing date for any asthma controller medication during the measurement year through the last day of the measurement year.

Asthma Controller Medications

Description Prescription
Antiasthmatic combinations
  • Dyphylline-guaifenesin
  • Guaifenesin-theophylline
Antibody inhibitors
  • Omalizumab
Inhaled steroid combinations
  • Budesonide-formoterol
  • Fluticasone-vilanterol
  • Fluticasone-salmeterol
  • Mometasone-formoterol
Inhaled corticosteroids
  • Beclomethasone
  • Budesonide
  • Ciclesonide
  • Flunisolide
  • Fluticasone CFC free
  • Mometasone
Leukotriene modifiers
  • Montelukast
  • Zafirlukast
  • Zileuton
Mast cell stabilizers
  • Cromolyn
Methylxanthines
  • Aminophylline
  • Dyphylline
  • Theophylline
Anti-interleukin-5
  • Mepolizumab
  • Reslizumab

Numerator Quality-Data Coding Options

Performance Met:

Patient achieved a PDC of at least 75% for their asthma controller medication (G9810)

Performance Not Met:

Patient did not achieve a PDC of at least 75% for their asthma controller medication (G9811)

Denominator

Patients 5-64 years of age with persistent asthma and a visit during the measurement period

Denominator Criteria (Eligible Cases):
Patients aged 5-64 years on date of encounter

AND
Diagnosis for persistent asthma (ICD-10-CM): J45.30, J45.31, J45.32, J45.40, J45.41, J45.42, J45.50, J45.51, J45.52

AND
Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381*, 99382*, 99383*, 99384*, 99385*, 99386*, 99387*, 99391*, 99392*, 99393*, 99394*, 99395*, 99396*, 99397*

AND NOT
DENOMINATOR EXCLUSIONS:
Diagnosis of COPD, Emphysema, Obstructive Chronic Bronchitis, Chronic Respiratory Conditions Due to Fumes/Vapors, Cystic Fibrosis, or Acute Respiratory Failure any time during the patient’s history through the end of the measurement year: E84.0, E84.11, E84.19, E84.8, E84.9, J43.0, J43.1, J43.2, J43.8, J43.9, J44.0, J44.1, J44.9, J68.4, J96.00, J96.01, J96.02, J96.20, J96.21, J96.22, J98.2, J98.3

OR
Any patients who had no asthma controller medications dispensed during the measurement year: G9808

OR
Patients who use hospice services any time during the measurement period: G9809

 

 

NOTE: *Signifies that this CPT Category I code is a non-covered service under the Medicare Part B Physician Fee Schedule (PFS). These non-covered services should be counted in the denominator population for MIPS CQMs.

Experience AdvancedMD Software in a Live Demo.

Schedule a short and personalized overview, guided by a live expert.

“The doctor who is not using AdvancedMD right now, is wasting his time.”

Armando Diez
Owner – Florida Pro Health

“Everybody still does basically the same thing; they just do it in a different and better way that’s more efficient.”

Steve Wampler, MD
Greenhill Family Clinic

Read the story  ›

“We have seen approximately a three-fold improvement on a month-to-month basis of increased collections using AdvancedMD technology as compared to our previous technology provider. That has really been a step-change improvement with respect to the economics of the company.”

Michael Paul, CEO
Lineagen, Inc.

“With the new scheduler and EHR, we get a lot of the information up front, so when the patient comes in, unless they have something changed insurance-wise they’re already verified and ready to be taken back right away, it also makes it much easier for billing.”

Nancy Sutter
Office manager