CMS 153v12: Chlamydia Screening in Women

Measure: Percentage of women 16-24 years of age who were identified as sexually active at any time during the measurement period and who had at least one test for chlamydia during the measurement period
Measure TypeHigh Priority MeasureScoring
ProcessNoA higher percentage indicates better quality
DenominatorWomen 16 to 24 years of age by the end of the measurement period who are sexually active and who had a visit in the measurement period
NumeratorWomen with at least one chlamydia test during the measurement period
Denominator ExceptionsNone
Denominator Exclusions
  • Women who are only eligible for the initial population due to a pregnancy test during the measurement period and who had an order for an x-ray or for a specified medication on the date of the pregnancy test or the six days after the pregnancy test
  • Women who are in hospice care for any part of the measurement period
Setup Note

This eCQM requires a lab interface to be met. Customers interested in a lab interface should contact Sevocity Support to begin the process of a new interface setup. Interface setup requirements and fees vary per request.

Denominator

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

  • Have a birth sex of female

    AND

  • Age is 16 years to 24 years at the end of the Measurement Period

    AND

  • Have been identified as sexually active

    AND

  • Have at least one eligible encounter during the Measurement Period finalized by the EC
Encounter Codes Eligible for Denominator

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, 99384, 99382, 99381, 99383, 99394, 99392, 99391, 99393, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 98966, 98967, 98968, 99441, 99442, 99443, 98980, 98981, 99444, 99457

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

Characteristics of Sexual Activity

A patient is identified as sexually active if they meet any of the following criteria during the Measurement Period:

  • Had a diagnosis indicating sexual activity
  • Had a diagnosis of HIV
  • Had a diagnosis of complications of pregnancy, childbirth, and the puerperium
  • Has a current prescription for contraceptive medication or received a prescription for contraceptive medication
  • Has an order for a pregnancy test, pap test, or sexually transmitted infection test
  • Has an order for a lab test or diagnostic study during pregnancy
  • Has a completed procedure identifying sexual activity
  • Responded Yes to having vaginal sex
Diagnosis

Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for indicators of sexual activity, HIV, and complications of pregnancy, childbirth, and the puerperium can be located here.

Medication

To prescribe a medication, go to Encounter > Medications > Manage/Prescribe Meds > New Prescription or Chart > Medications/Assessments > Modify. A comprehensive list of eligible contraceptive medications can be located here.

Procedure Codes Eligible for Denominator

To document a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below.

The Order Status for Pregnancy Test, Pap Test, Sexually Transmitted Infection Test, Lab Test During Pregnancy, and Diagnostic Study During Pregnancy must be marked as Pending or Complete.

The Order Status for Procedures Identifying Sexual Activity must be marked as Complete.

Pregnancy Test

CPT: 84702, 84704

Pap Test

CPT: 88141, 88142, 88147, 88148, 88150, 88152, 88153, 88155, 88164, 88165, 88166, 88167, 88174, 88175, 87491

HCPCS: G0101, G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, P3000, P3001, Q0091

Sexually Transmitted Infection Test

CPT: 87624, 87623, 87625, 87591, 86780, 86592, 86593, 86780, 87800, 87081, 87591, 88365

Lab Test During Pregnancy

CPT: 82106, 82107, 82104, 82105, 82731

Diagnostic Study During Pregnancy

CPT: 76801, 76805, 76813, 76816, 76818, 76819, 76820, 76821, 76941, 76945, 76811, 76817, 76814, 76830, 76815, 76705, 76825, 76826, 76827, 76828, 76942, 76946, 76948

Procedures Identifying Sexual Activity

CPT: 11976, 57022, 57170, 58300, 58301, 58600, 58605, 58615, 58970, 58974, 58976, 59000, 59001, 59012, 59015, 59020, 59025, 59030, 59050, 59051, 59070, 59072, 59074, 59076, 59100, 59120, 59121, 59130, 59135, 59136, 59140, 59150, 59151, 59160, 59200, 59300, 59320, 59325, 59350, 59400, 59409, 59410, 59412, 59414, 59425, 59426, 59430, 59510, 59514, 59515, 59525, 59610, 59612, 59614, 59618, 59620, 59622, 59812, 59820, 59821, 59830, 59840, 59841, 59850, 59851, 59852, 59855, 59856, 59857, 59866, 59870, 59871, 59897, 59898, 59899

HCPCS: S0199, S4981, S8055

Affirmative Response to Sexual Activity – Vaginal Sex
  1. Go to Encounter > Past History > Structured > Social History
  2. Select the hardcoded Sexual Activity node
  3. Select Type of sexual activity and Vaginal
Denominator Exclusions

A patient will be excluded from the measure if:

  • The only characteristic of sexual activity that qualifies them for the denominator is a pregnancy test

    AND

  • They received a prescription for isotretinoin on the date of the pregnancy test or the six days after the pregnancy test or they received an x-ray study on the date of the pregnancy test or the six days after the pregnancy test

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

Medication

To prescribe a medication, go to Encounter > Medications > Manage/Prescribe Meds > New Prescription or Chart > Medications/Assessments > Modify. A comprehensive list of eligible isotretinoin medications can be located here.

Procedure Codes Eligible for Denominator Exclusion

To document the order of an x-ray study, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add the one of the eligible codes listed below:

CPT: 70010, 70030, 70134, 70140, 70150, 70170, 70190, 70240, 70332, 70360, 70370, 70380, 70390, 70450, 70460, 70470, 70480, 70481, 70490, 70491, 70492, 70496, 70540, 70542, 70543, 70545, 70551, 70552, 70553, 71046, 71047, 71048, 71111, 71260, 71270, 71550, 71551, 71552, 72010, 72084, 72125, 72126, 72129, 72133, 72141, 72142, 72146, 72147, 72148, 72149, 72156, 72157, 72158, 72175, 72196, 72197, 72220, 72270, 73000, 73090, 73206, 73218, 73219, 73706, 74174, 74175, 74177, 74183, 74190, 74248, 74355, 74363, 74440, 74485, 74710, 74713, 75572, 75736, 76310, 76380, 77046, 77047, 77307, 77308, 78300, 72192, 72193, 72194, 73600, 73610, 77012, 70544, 71250, 71555, 74170, 71110, 71100, 70210, 70220, 72127, 72126, 72128, 72130, 71130, 70330, 72110, 72131, 72132, 70100, 70110, 70120, 70130, 70160, 70200, 70250, 70260, 70300, 70310, 70320, 70328, 70336, 70482, 70486, 70487, 70488, 70546, 70547, 70548, 70549, 71045, 71101, 71120, 72020, 72040, 72050, 72052, 72070, 72072, 72074, 72080, 72081, 72082, 72083, 72100, 72114, 72120, 73010, 73020, 73030, 73040, 73050, 73060, 73070, 73080, 73085, 73130, 73140, 73200, 73201, 73202, 73220, 73221, 73222, 73223, 73225, 73725, 73501, 73502, 73503, 73521, 73522, 73523, 73551, 73552, 73560, 73562, 73564, 73565, 73580, 73615, 73620, 73630, 73650, 73660, 73700, 73701, 73702, 73718, 73719, 73720, 73721, 73722, 73723, 73725, 74018, 74019, 74021, 74150, 74160, 74176, 74178, 74181, 74182, 74185, 74230, 74252, 74263, 74328, 74329, 74330, 74360, 74430, 74712, 74740, 74742, 74755, 75557, 75559, 75561, 75563, 75573, 75705, 77078, 73590, 73592, 74210, 74220, 74221, 74240, 74246, 74250, 74251, 74261, 74262, 74270, 74280,, 74400, 74420, 74425, 75571, 75574, 72170, 72190, 74181, 74022, 74290, 77073, 70557, 70558, 70559, 73115, 73092, 74290, 27369, 72195, 73000, 77022, 73090, 73525, 76000, 72198, 77014 ,77075, 76390, 72159, 27096, 72200 ,77003, 75565, 77084, 75989, 74022, 77054, 77077, 49440, 77076, 77048, 73110, 74340, 72159, 77013, 70555, 77021, 77072, 77011, 75989

Order Status must be marked as Pending or Complete.

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

A patient will be counted in the numerator if they received at least one chlamydia screening during the Measurement Period. To document that a chlamydia screening was performed, an e-Lab result for the test must be stored to the patient chart.

Store e-Lab Result
  1. From the Clinic Inbox, select the lab result to be stored and click View
    1. If the lab result is systematically matched to a patient, the Patient section will be populated in the lab result display
    2. If the lab result is not matched or the matched patient needs to be changed, the user will need to search for the patient
  2. Optional: click Select to search for and select a patient
  3. Select the I have verified the following lab results belong to the above patient checkbox
  4. Click Sign/Route
  5. Select the Sign checkbox and click OK

Stored e-Lab results can be viewed in the Flowsheets/Labs > Scanned/E-Labs tab of the patient chart.

eCQI Reference

https://ecqi.healthit.gov/ecqm/ec/2024/cms0153v12

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