Skip to main content

Heart Failure (HF) : Warfarin Therapy Patients with Atrial Fibrillation

CBE ID
0084
1.4 Project
Cardiovascular
Endorsement Status
Endorsement Removed
1.1 New or Maintenance
Maintenance
Previous Endorsement Cycle
Full Year 2010
Is Under Review
No
1.3 Measure Description

Percentage of patients with HF who also have paroxysmal or chronic atrial fibrillation who were prescribed warfarin therapy.

    • 1.14 Numerator

      Patients who were prescribed warfarin therapy
      (drug list available at www.ama-assn.org/ama/pub/category/4837.html) Or
      CPT-II code: 4012F Warfarin therapy prescribed.

    • 1.15 Denominator

      All HF patients > 18 years of age with paroxysmal or chronic atrial fibrillation
      Patient Selection:
      ICD-9-CM codes for HF: 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 428.0, 428.1, 428.20-428.23, 428.30-428.33, 428.40-428.43, 428.9
      And
      ICD-9-CM code for Atrial Fibrillation: 427.31
      And
      Patient’s age is > 18 years of age

    • Exclusions

      Documentation of medical reason(s) for not prescribing warfarin therapy:
      •Allergy/intolerance
      995.0 and E934.2, 995.1 and E934.2, 995.2 and E934.2; Or
      •Risk of bleeding or bleeding disorder
      ICD-9-CM exclusion codes: 203.00-208.91, 280.0, 280.9, 285.1, 286.0-286.7, 286.9, 287.30, 287.31, 287.32, 287.33, 287.39, 287.4, 287.5, 430, 431, 432.0, 432.1, 432.9, 437.3, 459.0, 530.7, 531.00-531.01, 531.20-531.21, 531.40-531.41, 531.60-531.61, 532.00-532.01, 532.20-532.21, 532.40-532.41, 532.60-532.61, 533.00-533.01, 533.20-533.21, 533.40-533.41, 533.60-533.61, 534.00- 534.01, 534.20-534.21, 534.40-534.41, 534.60-534.61, 569.3, 570, 571.2, 571.5, 578.0, 578.1, 578.9, 599.7, 786.3;
      Or
      •Other medical reason(s) documented by the practitioner for not prescribing warfarin therapy;
      Or
      •CPT-II code w/modifier: 4012F 1P
      Documentation of patient reason(s) (e.g., economic, social, religious)
      Or
      CPT-II code w/modifier: 4012F 2P
      Documentation of system reason(s) for not prescribing warfaring therapy
      OR
      CPT II code 4012F 3P

    • Most Recent Endorsement Activity
      Measure Retired and Endorsement Removed Cardiovascular Project 2010-2013
      Initial Endorsement
      Last Updated
      Removal Date
    • Steward
      Physician Consortium for Performance Improvement
      Steward Organization POC Email
      [email protected]