CMS 153v6: Chlamydia Screening for Women

Measure: Percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period
Measure TypeHigh Priority MeasureScoring
ProcessNoA higher percentage indicates better quality
DenominatorWomen 16 to 24 years of age who are sexually active and who had a visit in the measurement period
NumeratorWomen with at least one chlamydia test during the measurement period
Denominator ExceptionsNone
Denominator Exclusions

Women who:

  • Are only eligible for the initial population due to a pregnancy test and who had an x-ray or an order for a specified medication within 7 days of the pregnancy test
  • Were in hospice care during the measurement year

This eCQM requires a lab interface to be met. Customers interested in a lab interface should contact Sevocity Support to begin the process of a new interface setup. Interface setup requirements and fees vary per request.

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

  • Have a birth sex of female

    AND

  • Age must be ≥ 16 years and < 24 years at the beginning of the Measurement Period

    AND

  • Must be identified as sexually active

    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

A patient can be identified as sexually active if they meet any of the following criteria during the Measurement Period:

  • Has an active diagnosis of genital herpes, syphilis, chlamydia, HIV, inflammatory diseases of the female reproductive organs, gonococcal infection, venereal disease, or other female reproductive conditions
  • Has an active diagnosis of complications of pregnancy, childbirth, and the puerperium
  • Has a current prescription for contraceptive medication
  • Received a prescription for contraceptive medication
  • Has an order for a pregnancy test, pap test, or sexually transmitted infection test
  • Has an order for a lab test or diagnostic study during pregnancy
  • Has a completed procedure involving contraceptive devices or a procedure during pregnancy
  • Has a completed procedure for a live delivery
  • Responded Yes to having vaginal sex

Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for sexual activity characteristics can be located here.

To prescribe a medication, go to Encounter > Medications > Manage/Prescribe Meds > Prescribe a Medication. A comprehensive list of eligible contraceptive medications can be located here.

To document a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below. The Order Status for procedures involving contraceptive devices, procedures during pregnancy, and delivery live births must be marked as Complete in order to count toward the denominator.

Pregnancy Test

CPT: 81025, 84702, 84703, 84704

Pap Test

CPT: 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88155, 88164, 88165, 88166, 88167, 88174, 88175

HCPCS: G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, P3000, P3001, Q0091

Sexually Transmitted Infection Test

CPT: 86592, 86593, 86631, 86632, 87110, 87164, 87166, 87270, 87320, 87490, 87491, 87492, 87590,

87591, 87592, 87620, 87621, 87622, 87660, 87800, 87801, 87808, 87810, 87850, 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88155, 88164, 88165, 88166, 88167, 88174, 88175, 88235, 88267, 88269

Lab Test During Pregnancy

CPT: 59020, 59025, 59030, 59050, 59051, 59070, 59072, 59074, 59076, 59200, 59400, 59409, 59410, 59412, 59414, 59425, 59426, 59430, 59510, 59610, 59612, 59614, 59618, 59620, 59622, 80055, 82105, 82106, 82143, 82731, 83632, 83661, 83662, 83663, 83664

Diagnostic Study During Pregnancy

CPT: 76801, 76802, 76805, 76810, 76811, 76812, 76813, 76814, 76815, 76816, 76817, 76818, 76819, 76820, 76821, 76825, 76827, 93325, 93976

Procedures Involving Contraceptive Devices

CPT: 11976, 58301, 58300

HCPCS: S4981

Procedures During Pregnancy

CPT: 58970, 58974, 58976, 59000, 59001, 59012, 59015, 59020, 59025, 59030, 59050, 59051, 59070, 59072, 59074, 59076, 59100, 59120, 59121, 59130, 59135, 59136, 59140, 59150, 59151, 59160, 59200, 59300, 59320, 59325, 59350, 59412, 59414, 59430, 59525, 59812, 59820, 59821, 59830, 59840, 59841, 59850, 59851, 59852, 59855, 59856, 59857, 59866, 59870, 59871, 59897, 59898, 59899

Delivery Live Births

CPT: 59400, 59409, 59410, 59412, 59414, 59425, 59426, 59430, 59510, 59514, 59515, 59525, 59610, 59612, 59614, 59618, 59620, 59622

  1. Go to Encounter > Past History > Structured > Social History
  2. Select the hardcoded Sexual Activity node
  3. Select Type of sexual activity and Vaginal

A patient will be excluded from the measure if they were only included in the denominator due to a completed pregnancy test but received a prescription for isotretinoin or an x-ray study within 7 days of receiving the pregnancy test result. Patients who were in hospice care during the measurement year will also be excluded from the measure.

To prescribe a medication, go to Encounter > Medications > Manage/Prescribe Meds > Prescribe a Medication. A comprehensive list of eligible isotretinoin medications can be located here.

To document the order of an x-ray study, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

CPT: 79999

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 received at least one chlamydia screening during the Measurement Period.

To document that a chlamydia screening was performed, an e-Lab result for the test must be stored to the patient chart.

  1. From the Clinic Inbox, select the lab result to be stored and click View
  2. Click Select to search for and select a patient
  3. Verify patient displayed matches the lab result and select the I have verified the following lab results belong to the above patient checkbox
  4. Click Sign/Route
  5. Select the Sign checkbox and click OK

Stored e-Lab results can be viewed in the Flowsheets/Labs > Scanned/E-Labs tab of the patient chart.

https://ecqi.healthit.gov/ecqm/ep/2018/cms153v6

 

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