Clinical Quality Measures

Note: The codes mentioned in the "How to Do This in Dentrix Enterprise" sections that follow are only a sampling of the codes that will work for these measures. To view more codes, refer to the tables in Medical codes.

68 Documentation of Current Medications in the Medical Record

Requirement: Percentage of patient visits for patients aged 18 years and older for which the eligible provider (EP) attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include all known prescriptions, over-the-counter drugs, herbal supplements/medicines, and vitamin/mineral/dietary (nutritional) supplements and must contain the medications' name, dosage, frequency, and route of administration.

Exception: Patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient's health status.

Initial Patient Population

The number of patients 18 years old or older before the start of the specified Measurement Period who have visits occurring during the 12-month reporting period.

Denominator

The number of patients in the Initial Patient Population.

Numerator

The number of patients (from the Denominator) for whom the EP attests to documenting a list of current medications for those patients.

How to Do This in Dentrix Enterprise

In Chart, post a Medical Encounter with an AMA-CPT code (for example, 99201 or 99212) attached (increases denominator by 1).

In Chart, update a patient's Medications in Medical Alerts, and then post a Medical Encounter with a SNOMED code (for example, 42819000124101) attached (increases numerator by 1).

74 Primary Caries Prevention Intervention as Offered by Primary Care Providers, Including Dentists

Requirement: Percentage of children who are less than 20 years of age and who received a fluoride treatment during the specified Measurement Period.

Initial Patient Population

The number of children who are less than 20 years old with a visit during the specified Measurement Period.

Stratum 1 - Patients 0 to 5 years old.

Stratum 2 - Patients 6 to 12 years old.

Stratum 3 - Patients 13 to 19 years old.

Denominator

The number of patients in the Initial Patient Population.

Numerator

The number of patients (from the Denominator) who receive a "Fluoride Treatment" (a procedure posted from the Chart with the appropriate CDT code).

How to Do This in Dentrix Enterprise

In Chart or Ledger, post an Examination using an ADA code from D0120 to D0180 or a Medical Encounter with an AMA-CPT code (for example, 99201 or 99212) attached (increases denominator by 1).

In Chart or Ledger, post an ADA Fluoride Treatment using a D1206 or D1208 code (increases numerator by 1).

75 Children Who Have Dental Decay or Cavities

Requirement: Percentage of children who are less than 20 years old who have tooth decay or cavities during the specified Measurement Period.

Initial Patient Population

The number of children who are less than 20 years old with a visit during the specified Measurement Period.

Denominator

The number of patients in the Initial Patient Population.

Numerator

The number of patients (from the Denominator) who have "Tooth Decay" or "Cavities" (a condition/diagnosis with the appropriate ICD-9-CM code attached).

How to Do This in Dentrix Enterprise

In Chart or Ledger, post an Examination using an ADA code from D0120 to D0180 or a Medical Encounter with an AMA-CPT code (for example, 99201 or 99212) attached (increases denominator by 1).

In Chart, chart a Caries as a Condition that is cross coded with an ICD-9 code; then, in Medical Alerts, add an ICD-9 Dental Caries code as a Problem (increases numerator by 1).

138 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Requirement: Percentage of patients aged 18 years or older who were screened for tobacco use one or more times within 24 months and who received cessation counseling intervention if identified as a tobacco user.

Exception: Documentation of medical reason(s) for not screening for tobacco use (for example, limited life expectancy or other medical reason).

Initial Patient Population

All patients aged 18 years old or older.

Denominator

The number of patients in the Initial Patient Population.

Numerator

The number of patients (from the Denominator) who have been identified as a "Tobacco User" (a patient with the appropriate SNOMED-CT code) or "Non-Tobacco User" (a patient with the appropriate SNOMED-CT code) within 24 months of a patient's health assessment or medical encounter being entered within the specified Measurement Period.

How to Do This in Dentrix Enterprise

In Chart, post a Medical Encounter with an AMA-CPT code (for example, 99406) attached (increases denominator by 1).

From Chart (in the Medical History Review dialog box or Medical Alerts window), record the Smoking Status. If the patient is a smoker, post a Medical Encounter with an AMA-CPT code (for example, 99429) attached (increases numerator by 1).

156 Use of High-risk Medications in the Elderly

Requirement: Percentage of patients 66 years of age or older who were ordered high-risk medications.

Initial Patient Population

Patients 66 years old or older who had a visit during the specified Measurement Period.

Denominator

The number of patients in the Initial Patient Population.

Numerator 1

Patients with an order for at least one "High-risk Medication" (a prescription with the appropriate RxNorm code) during the specified Measurement Period.

Numerator 2

Patients with an order for at least two different "High-risk Medications" (prescriptions with the appropriate RxNorm codes attached) during the specified Measurement Period.

How to Do This in Dentrix Enterprise

In Chart, post a Medical Encounter with an AMA-CPT code (for example, 99201 or 99212) attached (increases denominator by 1).

In Patient Prescription, prescribe a drug with an RxNorm code identified as High Risk attached (increases numerator by 1).

165 Controlling High Blood Pressure

Requirement: The percentage of patients 18-85 years of age who had a diagnosis of hypertension and whose BP was adequately controlled during the measurement year.

Initial Patient Population

The number of patients who were 18 years old or older and less than or equal to 85 years old before the beginning of the specified Measurement Period.

Denominator

The number of patients in the Initial Patient Population who were diagnosed with "Essential Hypertension" (a medical alert with the appropriate SNOMED-CT code or ICD-9-CM attached) up to 6 months after the specified Measurement Period and who have an "Encounter Outpatient" (a patient health assessment or medical encounter with the appropriate AMA-CPT code attached) with one of the selected Providers within the specified Measurement Period and who do not have one of the following:

Evidence of end stage renal disease (ESRD) (an "active" medical alert with the appropriate ICD-9-CM or SNOMED-CT code attached).

Active diagnosis of "Pregnancy" (an "active" medical alert with the appropriate ICD-9-CM or SNOMED-CT code).

Numerator

The number of patients (from the Denominator) who have had a diastolic blood pressure reading less than 90 mmHg and a systolic blood pressure reading less than 140 mmHg during the most recent patient health assessment with one of the selected Providers within the specified Measurement Period.

How to Do This in Dentrix Enterprise

Enter a problem in Medical Alerts no more than six months after the date of the specified Measurement Period (increases denominator by 1).

In Chart, post a Medical Encounter with an AMA-CPT code (for example, 99201 or 99212) attached (increases denominator by 1).

In Chart, enter a Patient Health Assessment for a patient who has a Systolic reading that is less than 140 and a Diastolic reading that is less than 90 on the same date as the Medical Encounter (increases numerator by 1).