CMS 149v14: 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 the 12 months preceding a dementia encounter during the measurement period
Measure TypeHigh Priority MeasureScoring
ProcessYesA higher percentage indicates better quality
DenominatorAll patients, regardless of age, with a diagnosis of dementia
NumeratorPatients for whom an assessment of cognition is performed and the results reviewed at least once within the 12 months preceding a dementia encounter during the measurement period
Denominator ExceptionsDocumentation of patient reason(s) for not assessing cognition
Denominator ExclusionsNone

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

    AND

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

CPT: 90791, 90792, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 90832, 90834, 90837, 96116, 97165, 97166, 97167, 97168, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99242, 99243, 99244, 99245

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

ICD-10: A52.17, F01.50, F02.80, F03.90, F05, F06.8, G30.0, G30.1, G30.8, G30.9, G31.01, G31.09, G31.83, G31.80, G31.85, G31.84, G31.89

CPT: 90791, 90792, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 90832, 90834, 90837, 96116, 97165, 97166, 97167, 97168, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99242, 99243, 99244, 99245

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 or Chart > Flowsheets/Labs > Standard
  2. Click Add New Flowsheet
  3. Select the Brief Interview for Mental Status (BIMS) flowsheet and click Add
  4. Click Add Column
  5. Select the Patient declined BIMS screeningcheckbox
  6. Click OK to save
  1. Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
  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:

    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.

A cognitive assessment can be documented using the BIMS or Cognitive Assessment standard flowsheets.

  1. Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
  2. Click Add New Flowsheet
  3. Select the Brief Interview for Mental Status (BIMS) flowsheet and click Add
  4. Click Add Column
  5. Select a Value for all questions in the screening
  6. Click OK to save
  1. Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
  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/ec/2026/cms0149v14

 

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