CMS 149v8: Dementia: Cognitive Assessment

Measure: Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period
Measure Type High Priority Measure Scoring
Process Yes A higher percentage indicates better quality
Denominator All patients, regardless of age, with a diagnosis of dementia
Numerator Patients for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period
Denominator Exceptions Documentation of patient reason(s) for not assessing cognition
Denominator Exclusions None

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

  • Have an eligible encounter with an active diagnosis of dementia during the Measurement Period finalized by the EC/EP

    AND

  • Have at least one eligible qualifying encounter during the Measurement Period finalized by the EC/EP

CPT: 90791, 90792, 90832, 90834, 90837, 96116, 97165, 97166, 97167, 97168, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350

Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis codes for dementia are:

ICD-9: 094.1, 290.0, 290.10, 290.11, 290.12, 290.13, 290.20, 290.21, 290.3, 290.40, 290.41, 290.42, 290.43, 290.8, 290.9, 294.10, 294.11, 294.20, 294.21, 294.8, 331.0, 331.11, 331.19, 331.82

ICD-10: A52.17, F01.50, F01.51, F02.80, F02.81, F03.90, F03.91, F05, F06.8, G30.0, G30.1, G30.8, G30.9, G31.01, G31.09, G31.83

CPT: 90791, 90792, 90832, 90834, 90837, 96116, 97165, 97166, 97167, 97168, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99441, 99442, 99443, 99421, 99422, 99423, 99024, 99251, 99252, 99253, 99254, 99255

A patient will be counted as an exception for this measure if there is a documented patient reason for not performing a cognitive assessment.

  1. Go to Encounter > Flowsheets/Labs > Standard Flowsheets
  2. Click Add New Flowsheet
  3. Select the Cognitive Assessment flowsheet and click Add
  4. Click Add Column
  5. Select the 'Patient declined...' checkbox for the AD8, Mini-Cog, MMSE, MoCA, or SLUMS assessment
  6. Click OK to save

  1. Go to Encounter > Orders/Procedure > Orders/Referrals
  2. Click Add to add one of the following eligible codes:
    1. SNOMED CT: 113024001, 4719001
  3. Order Status must be Not Performed
  4. Not Performed Reason must be Refusal of treatment by patient
  5. Click Add to save

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 a cognitive assessment using a standardized screening on the day of their eligible dementia encounter or in the 12 months before their eligible dementia encounter.

To document a screening using the Cognitive Assessment flowsheet:

  1. Go to Encounter > Flowsheets/Labs > Standard Flowsheets
  2. Click Add New Flowsheet
  3. Select the Cognitive Assessment flowsheet and click Add
  4. Click Add Column

  5. Populate the patient's score for the AD8, Mini-Cog, MMSE, MoCA, or SLUMS assessment

    or

    Select the Other cognitive assessment performed checkbox

  6. Click OK to save

If Other cognitive assessment performed is selected, the name of the screening tool should be documented in the encounter in which it was performed

https://ecqi.healthit.gov/ecqm/ep/2020/cms149v8

 

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