NQF 0028: Preventive Care and Screening Measure Pair: a. Tobacco Use Assessment, b. Tobacco Cessation Intervention

Transcription

1 NQF 0028: Preventive Care and Screening Measure Pair: a. Tbacc Use Assessment, b. Tbacc Cessatin Interventin Descriptin: Cre: Alt Cre: Specialty: Frequency: Every 2 years a. Percentage f patients aged 18 years and lder wh have been seen fr at least 2 ffice visits wh were queried abut tbacc use ne r mre times within 24 mnths b. Percentage f patients aged 18 years and lder identified as tbacc users within the past 24 mnths and have been seen fr at least 2 ffice visits, wh received cessatin interventin. Reprting Numeratr A Tbacc Use Dcumented/Assessed within 2 years Assess ne f the fllwing Active Prblems: Never a smker (ICD-9: Nne) Frmer smker (ICD-9: V15.82) Smker, current status unknwn (ICD-9: Nne) Current sme day smker (ICD-9: 305.1) Current every day smker (ICD-9: 305.1) Unknwn if ever smked (ICD-9: Nne) Tbacc Use (ICD-9: 305.1) Denminatr A Patients >= 18 years ld Tw Outpatient Encunters r 1 Preventive Medicine Encunter with EP within measurement perid CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99411, 99412, 99420, 99429, 99385, 99386, 99387, 99395, 99396, 99397, 99401, 99402, 99403, Numeratr B Dcument ne f the fllwing Smking Cessatin Interventin w/in 2 years Any f fllwing medicatin prescribed within 2 years f the measurement perid 12 HR Budeprin 150 MG Extended Release Tablet 12 HR Wellbutrin 150 MG Extended Release Tablet 12 HR Zyban 150 MG Extended Release Tablet Budeprin 150 MG Extended Release Tablet Buprban 150 MG 12 HR Extended Release Tablet Buprban 150 MG Extended Release Tablet Cmmit Lzenge 2 r 4MG Lzenge Habitrl 7, 14 r 21 MG/Day 24 HR Transdermal Patch Nicderm C-Q 7, 14 r 21MG/Day 24 HR Transdermal Patch Nicrelief 2 r 4 MG Chewing Gum Nicrelief 2 r 4 MG Lzenge Nicrette 2 MG Chewing Gum Nicrette 2 r 4 MG Lzenge Nicrette Plus 4 MG Chewing Gum Nictine 1 MG Lzenge

2 Nictine 2 MG Sublingual Tablet Nictrl 15 MG per 16 HR Transdermal Patch Nictrl 15 MG per 24 HR Transdermal Patch Nictrl 4 MG/ACTUAT Inhalant Slutin Nictrl 5 MG per 16 HR Transdermal Patch Thrive 2 r 4MG Chewing Gum Wellbutrin 150 MG Extended Release Tablet Zyban 150 MG Extended Release Tablet Patient Instructins: Stp, Smking SNOMED: Patient Instructins: Smking and tbacc-use cessatin cunseling visit; intermediate, 3-10min CPT: Patient Instructins: Smking and tbacc-use cessatin cunseling visit; >10min CPT: Medcin Terms dcumented via Flwsheets r v10 M-templates r v11 Nte Assessment Frms Anticipatry Guidance: Tbacc Use Anticipatry Guidance: Smking and Drug Use Assessment & Interventin Use f nnsmking tbacc Assessment & Interventin Use f smking tbacc Assessment & Interventin Use f tbacc CNS stimulants nictine Placrilex (Nicrette Gum) CNS stimulants nictine Transdermal patch Health Seminar n Smking Cessatin Interventin and cunseling n cessatin f tbacc use Interventin & Cunseling cessatin f tbacc use 3-10 min. Interventin & Cunseling cessatin f tbacc use > 10 min. Patient Gals - Cut Smking T X Packs Per Day Pharmaclgic therapy fr cessatin f tbacc use Self-help grup Smking Cessatin Denminatr B Patients >= 18 years ld Tw Outpatient Encunters r 1 Preventive Medicine Encunter with EP within reprting perid CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99411, 99412, 99420, 99429, 99385, 99386, 99387, 99395, 99396, 99397, 99401, 99402, 99403, Patients dcumented as Tbacc prir t end f reprting perid Smker, current status unknwn (ICD-9: Nne) Current sme day smker (ICD-9: 305.1) Current every day smker (ICD-9: 305.1) Tbacc Use (ICD-9: 305.1) Exclusins Nne

3 Overview and Setup Related Preferences: TWAdmin Alerts Smking Status nt Dcumented Pertains t Cre Objective Measure fr Dcument Smking Status Reslved (aka alert ges away) when the patient has ne f the fllwing CDC Smking Status Active Prblems r Scial Histry (see list in Additinal Inf) TWAdmin General Encunter Summary Review Befre Save Setting it fr Only when my alerts exist will nly shw yu the Encunter Summary when yu click cmmit if there is a My Alert Related Setup: Patient Instructins: The fllwing Patient Instructins are delivered with Orderable Item Dictinary (OID). If yu want t use any f these instructins in the ACI r in the CareGuide t meet Numeratr B: Smking Cessatin then update the OID with the fllwing SNOMED r CPT Cdes. Cnsider adding these instructins t yur Specialty r Favrites List Stp, Smking: Assign SNOMED Smking and tbacc-use cessatin cunseling visit; intermediate, 3-10min Assign CPT: Smking and tbacc-use cessatin cunseling visit; >10min Assign CPT: Fr Smking Cessatin Agents, ensure that yu are dcumenting all OTC Nictine patches Cnsider adding keywrds t easily find yur frequently prescribed medicatins Cnsider adding the Smking Status Terms t yur Specialty Quicklist fr Active Prblems. NOTE: Sme prblems d nt have an ICD-9 cde. In rder t retrieve these cdes Return ICD-9 Only filter must be turned ff. Never a smker Frmer smker Smker, current status unknwn Current sme day smker Current every day smker Unknwn if ever smked Additinal Infrmatin Fr the Active Prblems, if there is nt an assessment date, then the reprt will use the nset date, then if there is nt an nset date, then the reprt will use the encunter date when the prblem was created. Cnsider using Ppulatin Health Queries t add reminders fr the patient s withut a Smking Status Active Prblem r Scial Histry. The fllwing are CDC s NHIS standard recdes fr smking status ( Never a smker Frmer smker Smker, current status unknwn Current sme day smker Current every day smker Unknwn if ever smked Fr any histrical items entered using ther tbacc r smking related Active Prblems r Scial Histry the reprts will lk at the fllwing mappings t determine if the term means Tbacc r Nn Tbacc

4 Tbacc Use Terms Reprt Mapping Active Prblem r Scial Histry Status=Active Status=Denied Abstinence frm Smking Tbacc Nn- Tbacc Chewing nictine-cntaining substances Tbacc Chewing nictine-cntaining substances gum Chewing nictine-cntaining substances tbacc Cigars ( A Day) Tbacc Current Every Day Smker Tbacc Current Smker Tbacc Tbacc Nn- Current Sme Day Smker Tbacc Frmer Smker Tbacc Nn- Leaving a Scial r Wrk Setting fr a Cigarette Tbacc Maternal Tbacc Use "x" Tbacc Never a Smker Tbacc Nn- Nictine Dependence Nictine Dependence Cntinuus Nictine Dependence episdic Nictine Dependence in remissin Nictine-related disrders Patient Gals - Cut Smking T X Packs Per Day Tbacc Previus Histry f smking Recent Increase in Cigarettes Per Day Tbacc Recently Stpping Smking Tbacc Nn- Tbacc Smker, Current Status Unknwn Tbacc

5 Smking Tbacc Tbacc Nn- Smking a Pipe Tbacc Tbacc Nn- Smking Cigarettes Tbacc Tbacc Nn- Smking Cigarettes fr Pack-Years Tbacc Smking Cigarettes Starting Only After First Meal f Day Smking Cigarettes Starting Only in Afternn/Evening Tbacc Tbacc Smking Cigarettes Starting Upn Awakening Tbacc Smking Cigarettes Starting with a Greater than 50 Pack-years Histry Smking Cigarettes Starting with First Beverage/Fd f Day Tbacc Tbacc Smking during pregnancy Tbacc Smking While Wearing Nictine Patch Tbacc Tbacc Use Tbacc Tbacc Nn- Unknwn if ever smked Unsuccessful Attempt(s) t Stp Smking Tbacc Using nasal snuff Tbacc Use Wishing t Stp Smking Tbacc Wishing t Stp Smking due t family pressure Tbacc Wishing t Stp Smking due t scial pressure Tbacc Wishing t Stp Smking due t urging at wrk Tbacc Wishing t Stp Smking fr health reasns Tbacc

6 References Certified Wrkflws Chart Review Basic (F1) and Detail (F2) Intake Prcess: Detailed (E2) Applicatin Design and Behavir Resurce (ADBR) fr Allscripts Enterprise EHR v11. Step by Step Prtcl: Recrd Smking Status ( Key Wrds and Favrites Setup Ppulatin Health Mgmt 11.2 Steps n hw t Update CPT Cdes Steps n Snmed