Measure: Percentage of the following patients – all considered at high risk of cardiovascular events – who were prescribed or were on statin therapy during the measurement period:
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| Measure Type | High Priority Measure | Scoring |
| Process | No | A higher percentage indicates better quality |
| Denominator | Denominator 1: All patients who have an active diagnosis of clinical ASCVD or ever had an ASCVD procedure Denominator 2: Patients aged ≥ 20 years at the beginning of the measurement period who have ever had a laboratory result of LDL-C ≥ 190 mg/dL or were previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia Denominator 3: Patients aged 40-75 years at the beginning of the measurement period with Type 1 or Type 2 diabetes |
| Numerator | Patients who are actively using or who receive an order (prescription) for statin therapy at any time during the measurement period |
| Denominator Exceptions |
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| Denominator Exclusions |
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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
Denominator 1
Patients who meet the following criteria will be included in the denominator:
Have an active diagnosis of clinical ASCVD during the Measurement Period or who have ever had an ASCVD procedure
AND
- Have at least one eligible encounter during the Measurement Period finalized by the EC
Encounter Codes Eligible for Denominator 1
CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99395, 99396, 99397, 99429, 99401, 99402, 99403, 99404, 99385, 99386, 99387
HCPCS: G0438, G0439
Diagnosis
The patient must have an active diagnosis of clinical ASCVD during Measurement Period. Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for clinical ASCVD can be located here.
ASCVD Procedure
To document an ASCVD procedure as an order, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
CPT: 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536, 92920, 92924, 92928, 92933, 92937, 92941, 92943
HCPCS: S2205, S2206, S2207, S2208, S2209
Order Status must be marked as Complete.
To document an ASCVD procedure from the patient history, Go to Encounter > Past History > Structured > Surgical History and select the hardcoded Coronary artery bypass graft node
Denominator 2
Patients who meet the following criteria will be included in the denominator:
Age is ≥ 20 years at the beginning of the Measurement Period
AND
Had an LDL cholesterol (LDL-C) lab result ≥ 190 mg/dL or was previously diagnosed with or currently have an active diagnosis of familial hypercholesterolemia
AND
Do not have an active diagnosis of ASCVD or any prior ASCVD procedure
AND
- Have at least one eligible encounter during the Measurement Period finalized by the EC
Encounter Codes Eligible for Denominator 2
CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99395, 99396, 99397, 99429, 99401, 99402, 99403, 99404, 99385, 99386, 99387
HCPCS: G0438, G0439
LDL-C Result
To document the LDL-C lab result, it must be stored as an e-Lab in the patient chart.
- From the Clinic Inbox, select the lab result to be stored and click View
- If the lab result is systematically matched to a patient, the Patient section will be populated in the lab result display
- If the lab result is not matched or the matched patient needs to be changed, the user will need to search for the patient
- Optional: click Select to search for and select a patient
- Select the I have verified the following lab results belong to the above patient checkbox
- Click Sign/Route
- 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.
Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis code for familial hypercholesterolemia is:
ICD-10: E78.01
ASCVD Diagnosis and Procedure
See Denominator 1 for eligible codes.
Denominator 3
Patients who meet the following criteria will be included in the denominator:
Age ≥ 40 years and ≤ 75 years at the beginning of the Measurement Period
Have a diagnosis of diabetes during the Measurement Period
Do not have an active diagnosis of ASCVD or any prior ASCVD procedure or an LDL-C lab result ≥ 190 mg/dL or a previous or current diagnosis of familial hypercholesterolemia
Have at least one eligible encounter during the Measurement Period finalized by the EC
AND
AND
AND
Encounter Codes Eligible for Denominator 3
CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99395, 99396, 99397, 99429, 99401, 99402, 99403, 99404, 99385, 99386, 99387
HCPCS: G0438, G0439
Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for diabetes can be located here.
ASCVD Diagnosis and Procedure
See Denominator 1 for eligible codes.
LDL-C Result and Familial Hypercholesterolemia Diagnosis
See Denominator 2 for eligible criteria.
Denominator Exceptions
A patient will be counted as an exception for this measure if they meet any of the following conditions:
Is in hospice care for any part of the Measurement Period
Is receiving palliative care for any part of the Measurement Period
Has a diagnosis of hepatitis, liver disease, statin associated muscle symptoms, or ESRD
Has an allergy to statin medication
Has a medical reason for not being prescribed statin therapy
Hospice Care Services
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.
Palliative Care
Palliative care services can be documented using the FACIT-Pal Questionnaire flowsheet, as an order, or as a diagnosis.
FACIT-Pal Questionnaire Flowsheet
Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
Click Add New Flowsheet
Select the FACIT-Pal Questionnaire flowsheet and click Add
Click Add Column
Populate the patient’s responses to the questions as appropriate
Click OK to save
Palliative Care Services Order
Go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
HCPCS: G9054
Order Status must be marked as Complete.
Palliative Care Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis code for palliative care is:
ICD-10: Z51.5
Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis codes for these exceptions are:
Hepatitis A
ICD-10: B15.0, B15.9
Hepatitis B
ICD-10: B16.0, B16.1, B16.2, B16.9, B18.0, B18.1, B19.10, B19.11
Liver Disease
ICD-10: B17.0, B17.10, B17.11, B17.2, B17.8, B17.9, B18.2, B18.8, B18.9, B19.0, B19.20, B19.21, B19.9, K70.0, K70.10, K70.11, K70.2, K70.30, K70.31, K70.40, K70.41, K70.9, K71.0, K71.10, K71.11, K71.2, K71.3, K71.4, K71.50, K71.51, K71.6, K71.7, K71.8, K71.9, K72.00, K72.01, K72.10, K72.11, K72.90, K72.91, K73.0, K73.1, K73.2, K73.8, K73.9, K74.00, K74.01, K74.02, K74.1, K74.2, K74.3, K74.4, K74.5, K74.60, K74.69, K75.4, O98.411, O98.412, O98.413, O98.419B17.0, B17.10, B17.11, B17.2, B17.8, B17.9, B18.2, B18.8, B18.9, B19.0, B19.20, B19.21, B19.9, K70.0, K70.10, K70.11, K70.2, K70.30, K70.31, K70.40, K70.41, K70.9, K71.0, K71.10, K71.11, K71.2, K71.3, K71.4, K71.50, K71.51, K71.6, K71.7, K71.8, K71.9, K72.00, K72.01, K72.10, K72.11, K72.90, K72.91, K73.0, K73.1, K73.2, K73.8, K73.9, K74.00, K74.01, K74.02, K74.1, K74.2, K74.3, K74.4, K74.5, K74.60, K74.69, K75.4, O98.411, O98.412, O98.413, O98.419
Statin Associated Muscle Symptoms
ICD-9: 359.9, 729.1
ICD-10: G72.0, G72.9, M60.9, M79.10
End Stage Renal Disease
ICD-10: N18.6
Allergy to Statin Medication
To document a patient allergy to statin medication:
Go to Encounter > Allergies/Meds Hx
Click Manage Allergies/Med Hx
From the Allergies section, click the Add Allergen icon (
)From the Allergen field, search for and add one of the following items :
rosuvastatin
simvastatin
fluvastatin
pravastatin
lovastatin
atorvastatin
pitavastatin
Statins-Hmg-Coa Reductase Inhibitors
Optional: populate additional information about the allergy
Click Save
Medical Reason
To document a medical reason the patient was not prescribed statin therapy:
Go to Encounter > Orders/Procedure > Orders/Referrals
Click Add to add one of the following eligible codes:
Order Status must be Not Performed
Not Performed Reason must be Procedure contraindication
Click Add to save
HCPCS: G8815, G8817
Denominator Exclusions
A patient will be excluded from this measure if they meet any of the following conditions:
- Are breastfeeding at any time during the Measurement Period
- Have a diagnosis of rhabdomyolysis at any time during the Measurement Period
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis codes for these exclusions are:
Breastfeeding
ICD-10: O91.03, O91.13, O91.23, O92.03, O92.13, O92.5, O92.70, O92.79, Z39.1
Rhabdomyolysis
ICD-10: M62.82, T79.6XXA, T79.6XXD, T79.6XXS
Numerator
A patient will be counted in the numerator if they are actively using or receive a prescription for statin therapy at any time during the Measurement Period.
Medication
To prescribe a medication for statin therapy, go to Encounter > Medications > Manage/Prescribe Meds > New Prescription. A comprehensive list of eligible medications can be located here.
eCQI Reference
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