CMS 127v6: Pneumococcal Vaccination Status for Older Adults

Measure: Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Measure TypeHigh Priority MeasureScoring
ProcessNoA higher percentage indicates better quality
DenominatorPatients 65 years of age and older with a visit during the measurement period
NumeratorPatients who have ever received a pneumococcal vaccination
Denominator ExceptionsNone
Denominator ExclusionsExclude patients who were in hospice care during the measurement year

Patients who meet the following criteria will be included in the denominator:

  • Age must be ≥ 65 years at the beginning of the Measurement Period

    AND

  • Must have at least one encounter during the Measurement Period finalized by the EC/EP

CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397, 99221, 99222, 99223, 99231, 99232, 99233, 99241, 99242, 99243, 99244, 99245, 99281, 99282, 99283, 99284, 99285, 99305, 99306, 99307, 99308, 99309, 99310, 99251, 99252, 99253, 99254, 99255, 99381, 99382, 99383, 99384, 99024, 99391, 99392, 99393, 99394, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337

HCPCS: G0402, G0438, G0439

Patients who were in hospice care during the measurement year will be excluded from the measure.

To document hospice care services as a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

SNOMED CT: 385763009, 385765002

Order Status must be marked as Complete.

SNOMED CT codes must be added as a Favorite in Preferences > Form Data > Orders to be accessible from the Orders/Referrals tab.

A patient will be counted in the numerator if they receive a pneumococcal immunization before the end of the Measurement Period or if they report previously receiving a pneumococcal immunization.

  1. Go to Encounters > Immunizations > Adult tab
  2. Click the Add button for Pneumococcal
  3. Complete the fields in the Serum section
  4. Complete the applicable fields of the Administration section
  5. Click Save

To document the administration of a vaccine as a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

CPT: 90670, 90732

Order Status must be marked as Complete in order to count toward the numerator.

  1. Go to Encounters > Immunizations > Adult tab
  2. Click the Add button for Pneumococcal
  3. Select the Historic checkbox
  4. Document the date the immunization was given in the Date field of the Administration section
  5. Click Save
  1. Go to Encounter > Past History > Structured > Medical History
  2. Select the hardcoded Pneumococcal vaccine node
  3. Populate the Date Given for the vaccine
  4. Click OK to save

https://ecqi.healthit.gov/ecqm/ep/2018/cms127v6

 

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