CMS 156v8: Use of High-Risk Medications in the Elderly

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

• Age is ≥ 65 years at the beginning of the Measurement Period

  AND

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

Encounter Codes Eligible for Denominator

CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99395, 99396, 99397, 99385, 99386, 99387, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 92002, 92004, 92012, 92014, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99315, 99316, 99304, 99305, 99306, 99307, 99308, 99309, 99310

HCPCS: G0438, G0439

Patients who were in hospice care during the Measurement Period 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 Pending or Complete.

Note

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 Numerator 1 if at least one high-risk medication has been ordered for the patient during the Measurement Period.

A patient will be counted in Numerator 2 if at least two of the same high-risk medication have been ordered for the patient on different days during the Measurement Period.

• A high-risk medication is identified as: a prescription for medications classified as high-risk at any dose and for any duration; or as prescriptions for medications classified as high-risk at any dose with greater than a 90-day supply.
• Examples of high-risk medications include muscle relaxants and certain antihistamines. A comprehensive list of eligible high-risk medications can be located here.

https://ecqi.healthit.gov/ecqm/ep/2020/cms156v8