CMS 127v10: Pneumococcal Vaccination Status for Older Adults

Measure: Percentage of patients 66 years of age and older who have ever received a pneumococcal vaccine
Measure Type High Priority Measure Scoring
Process No A higher percentage indicates better quality
Denominator Patients 66 years of age and older with a visit during the measurement period
Numerator Patients who received a pneumococcal vaccination on or after their 60th birthday and before the end of the measurement period; or ever had an adverse reaction to the vaccine before the end of the measurement period
Denominator Exceptions None
Denominator Exclusions Exclude patients who are in hospice care for any part of the measurement period

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

  • Age is ≥ 66 years at the beginning of the Measurement Period

    AND

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

CPT: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 98966, 98967, 98968, 99441, 99442, 99443

HCPCS: G0438, G0439, G0071, G2010, G2012, G2061, G2062, G2063

Patients who were in hospice care for any part of 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 they received a pneumococcal vaccination on or after their 60th birthday and before the end of the Measurement Period OR if they ever had an adverse reaction to the vaccine before the end of the Measurement Period.

A pneumococcal vaccination can be documented when the vaccine is administered or documented as previously received if administered outside of the clinic.

  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 the eligible code listed below:

CPT: 90732

Order Status must be marked as Complete.

  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

A patient’s allergic reaction to a vaccine can be documented in the Assessment tab of an encounter using the following code:

SNOMED CT: 293116002

SNOMED codes can be added in the Assessment tab by mapping the codes to an active ICD-10 using the Map SNO button.

https://ecqi.healthit.gov/ecqm/ep/2022/cms127v10

 

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