CMS 156v9: Use of High-Risk Medications in Older Adults

Measure: Percentage of patients 65 years of age and older who were ordered at least two of the same high-risk medications

Measure Type High Priority Measure Scoring
Process Yes A lower percentage indicates better quality
Denominator Patients 65 years and older who had a visit during the measurement period
Numerator

Patients with at least two orders for the same high-risk medication on different days during the measurement period

Denominator Exceptions None
Denominator Exclusions Exclude patients whose hospice care overlaps the measurement period

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

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, 99318, 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.

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 the patient has two or more orders for the same high-risk medication, made 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/2021/cms156v9

 

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