Measure: Percentage of patients aged 12 years and older who were screened for tobacco use one or more times during the measurement period AND who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period if identified as a tobacco user. Three rates are reported:
| ||
| Measure Type | High Priority Measure | Scoring |
| Process | No | A higher percentage indicates better quality |
| Denominator | Denominator 1: All patients aged 12 years and older seen for at least two visits or at least one preventive visit during the measurement period Denominator 2: All patients aged 12 years and older seen for at least two visits or at least one preventive visit during the measurement period who were screened for tobacco use during the measurement period and identified as a tobacco user Denominator 3: All patients aged 12 years and older seen for at least two visits or at least one preventive visit during the measurement period |
| Numerator | Numerator 1: Patients who were screened for tobacco use at least once during the measurement period Numerator 2: Patients who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period Numerator 3: Patients who were screened for tobacco use at least once during the measurement period AND who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period if identified as a tobacco user |
| Denominator Exceptions | None |
| Denominator Exclusions | Exclude patients who are in hospice care for any part of the measurement period |
Denominator
Denominator 1
Patients who meet the following criteria will be included in the denominator:
Age is ≥ 12 years at the beginning of the Measurement Period
AND
- Have at least two eligible encounters or at least one preventive care encounter during the Measurement Period finalized by the EC
Encounter Codes Eligible for Denominator 1
CPT: 96156, 96158, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 97165, 97166, 97167, 97168, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 92002, 92004, 92012, 92014, 90791, 90792, 90832, 90834, 90837, 90845, 92521, 92522, 92524, 92540, 92557, 92625, 97161, 97162, 97163, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 98966, 98967, 98968, 99441, 99442, 99443, 98980, 98981, 99444, 99457
HCPCS: G0071, G2010, G2012, G2250, G2251, G2252
Preventive Care Encounter Codes Eligible for Denominator 1
CPT: 99395, 99396, 99397, 99411, 99412, 99429, 99401, 99402, 99403, 99404, 99385, 99386, 99387, 99024, 97802, 97803, 97804, 99381, 99382, 99383, 99384, 99391, 99392, 99393, 99394
HCPCS: G0402, G0438, G0439, G0270, G0271, G0447, S9449, S9452, S9470
Denominator 2
Patients who meet the following criteria will be included in the denominator:
Age is ≥ 12 years at the beginning of the Measurement Period
AND
Have at least two eligible encounters or at least one preventive care encounter during the Measurement Period finalized by the EC
AND
- Were screened for tobacco use and identified as a tobacco user
Encounter Codes Eligible for Denominator 2
CPT: 96156, 96158, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 97165, 97166, 97167, 97168, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 92002, 92004, 92012, 92014, 90791, 90792, 90832, 90834, 90837, 90845, 92521, 92522, 92524, 92540, 92557, 92625, 97161, 97162, 97163, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 98966, 98967, 98968, 99441, 99442, 99443, 98980, 98981, 99444, 99457
HCPCS: G0071, G2010, G2012, G2250, G2251, G2252
Preventive Care Encounter Codes Eligible for Denominator 2
CPT: 99395, 99396, 99397, 99411, 99412, 99429, 99401, 99402, 99403, 99404, 99385, 99386, 99387, 99024, 97802, 97803, 97804, 99381, 99382, 99383, 99384, 99391, 99392, 99393, 99394
HCPCS: G0402, G0438, G0439, G0270, G0271, G0447, S9449, S9452, S9470
Screening and Identification as a Tobacco User
Screening for tobacco use is documented in the Past History tab of the patient encounter. The patient must be screened during the Measurement Period.
- Go to Encounter > Past History > Structured > Social History
- Select the hardcoded Smoking status node or the hardcoded Smokeless Tobacco Use node
- Select the appropriate patient status from the Smoking Status list or select Y or N for Smokeless Tobacco Use
- If populating the Smoking status field, click OK to save
- Selecting Current every day smoker, Current some day smoker, Heavy tobacco smoker, or Light tobacco smoker from Smoking Status identifies a patient as a tobacco user
- Selecting Y for Smokeless Tobacco Use identifies a patient as a tobacco user
Denominator 3
Patients who meet the following criteria will be included in the denominator:
Age is ≥ 12 years at the beginning of the Measurement Period
AND
- Have at least two eligible encounters or at least one preventive care encounter during the Measurement Period finalized by the EC
Encounter Codes Eligible for Denominator 3
CPT: 96156, 96158, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 97165, 97166, 97167, 97168, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 92002, 92004, 92012, 92014, 90791, 90792, 90832, 90834, 90837, 90845, 92521, 92522, 92524, 92540, 92557, 92625, 97161, 97162, 97163, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 98966, 98967, 98968, 99441, 99442, 99443, 98980, 98981, 99444, 99457
HCPCS: G0071, G2010, G2012, G2250, G2251, G2252
Preventive Care Encounter Codes Eligible for Denominator 3
CPT: 99395, 99396, 99397, 99411, 99412, 99429, 99401, 99402, 99403, 99404, 99385, 99386, 99387, 99024, 97802, 97803, 97804, 99381, 99382, 99383, 99384, 99391, 99392, 99393, 99394
HCPCS: G0402, G0438, G0439, G0270, G0271, G0447, S9449, S9452, S9470
Denominator Exclusions
Patients who were in hospice care during any part of the Measurement Period will be excluded from the measure.
Hospice Care Services
Document Hospice Services as a Procedure
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: 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.
Document Hospice Services in the Assessment Tab
The eligible diagnosis codes for Hospice Services are only available as SNOMED CT codes.
SNOMED CT: 305911006, 170935008, 170935009
SNOMED codes can be added in the Assessment tab by mapping the code to an active ICD-10 using the Map SNO button.
Numerator
Numerator 1
A patient will be counted in Numerator 1 if they were screened for tobacco use at least once during the Measurement Period. If a patient received multiple screenings, the most recent screening will be counted toward the numerator.
Tobacco Use Screening
- Go to Encounter > Past History > Structured > Social History
- Select the hardcoded Smoking status node or the hardcoded Smokeless Tobacco Use node
- Select the appropriate patient status from the Smoking Status list or select Y or N for Smokeless Tobacco Use
- If populating the Smoking status field, click OK to save
Note
Selecting a Smoking Status of Unknown if ever smoked is equivalent to not performing a screening, and patients with this status will not be counted in the numerator
Tip
If a tobacco use screening was already documented during a previous visit, and there have been no changes to the patient’s tobacco use status, selecting the Social History checkbox from Areas Reviewed in Past History will continue to count the patient toward the numerator on subsequent eligible encounters.
Numerator 2
A patient will be counted in Numerator 2 if they received tobacco cessation intervention during the Measurement Period or in the six months prior to the Measurement Period.
Tobacco Cessation Interventions
Document an Intervention from the Tobacco Cessation Intervention Flowsheet
- Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
- Click Add New Flowsheet
- Select the Tobacco Cessation Intervention flowsheet and click Add
- Click Add Column
- Select Done for Tobacco use cessation education or Referral for cessation counseling
- Click OK to save
Tobacco Cessation Counseling
To document tobacco cessation counseling as a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
CPT: 99406, 99407
Order Status must be marked as Complete.
To document tobacco cessation counseling as a diagnosis, go to Encounter > Assessment and add the following code:
ICD-10: Z71.6
Medication
To prescribe a medication for pharmacological therapy, go to Encounter > Medications > Manage/Prescribe Meds > New Prescription or Chart > Medications/Assessments > Modify. A comprehensive list of eligible tobacco use cessation medications can be located here.
Numerator 3
A patient will be counted in Numerator 3 if they were screened for tobacco use at least once during the Measurement Period AND if they received tobacco cessation intervention during the Measurement Period or in the six months prior to the Measurement Period if identified as a tobacco user.
Numerator 3 can be met by completing the Tobacco Use Screening outlined in Numerator 1 and documenting one of theTobacco Cessation Interventions outlined in Numerator 2.
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