CMS 139v12: Falls: Screening for Future Fall Risk

Measure: Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Measure Type High Priority Measure Scoring
Process Yes A higher percentage indicates better quality
Denominator Patients aged 65 years and older at the start of the measurement period with a visit during the measurement period
Numerator Patients who were screened for future fall risk at least once within the measurement period
Denominator Exceptions None
Denominator Exclusions 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 ≥ 65 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, 99212, 99213, 99214, 99215, 99395, 99396, 99397, 99385, 99386, 99387, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 92002, 92004, 92012, 92014, 99401, 99402, 99403, 99404, 99315, 99316, 99318, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 92540, 92541, 92542, 92548, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 97161, 97162, 97163, 97164, 97165, 97166, 97167, 97168, 98980, 98981, 99444, 99457

HCPCS: G0438, G0439, G0071, G2010, G2012, G2061, G2062, G2063, G2250, G2251, G2252

Patients who were in hospice care during any part of the Measurement Period will be excluded from the measure.

To document hospice care ambulatory services, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

CPT: 99377, 99378

HCPCS: G0182

Order Status must be marked as Pending or Complete.

To document hospice care encounter services, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

HCPCS: G9996, G9473, G9474, G9475, G9476, G9477, G9478, G9479, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5010, S9126, T2042, T2043, T2044, T2045, T2046

Order Status must be marked as Complete.

The eligible diagnosis codes for Hospice Services are only available as SNOMED CT codes.

SNOMED CT: 305911006, 170935008

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

A patient will be counted in the numerator if they received a fall risk screening using the Morse Fall Scale assessment tool or through another screening method during the Measurement Period.

To document a screening using the Morse Fall Scale:

  1. Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
  2. Click Add New Flowsheet
  3. Select the Fall Risk Screening flowsheet and click Add
  4. Click Add Column
  5. Select a Value for all questions in the screening
  6. Click OK to save

To document the performance of a fall risk screening with a different screening tool:

  1. Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
  2. Click Add New Flowsheet
  3. Select the Fall Risk Screening flowsheet and click Add
  4. Click Add Column
  5. Select the Done checkbox for Other fall risk assessment performed
  6. Click OK to save

If Other fall risk 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/ec/2024/cms0139v12

 

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