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HIV/AIDS: Pneumocystis jiroveci pneumonia (PCP) Prophylaxis

CBE ID
0405
Endorsed
Endorsement Status
E&M Committee Rationale/Justification

Steward no longer seeking to maintain endorsement

1.1 New or Maintenance
Is Under Review
No
Next Planned Maintenance Review
Fall 2023
1.3 Measure Description

Percentage of patients aged 6 weeks or older with a diagnosis of HIV/AIDS, who were prescribed Pneumocystis jiroveci pneumonia (PCP) prophylaxis

        • 1.14 Numerator

          Numerator 1: Patients who were prescribed Pneumocystis jiroveci pneumonia (PCP) prophylaxis within 3 months of CD4 count below 200 cells/mm3

          Numerator 2: Patients who were prescribed Pneumocystis jiroveci pneumonia (PCP) prophylaxis within 3 months of CD4 count below 500 cells/mm3 or a CD4 percentage below 15%

          Numerator 3: Patients who were prescribed Pneumocystis jiroveci pneumonia (PCP) prophylaxis at the time of HIV diagnosis

          Report a rate for each numerator (e.g., Numerator 1/Denominator 1, etc.) and a total rate (Total Numerator/Total Denominator)

        • 1.15 Denominator

          Denominator 1. All patients aged 6 years and older with a diagnosis of HIV/AIDS and a CD4 count below 200 cells/mm3, who had at least two visits during the measurement year, with at least 90 days in between each visit; and, 

          Denominator 2. All patients aged 1 through 5 years of age with a diagnosis of HIV/AIDS and a CD4 count below 500 cells/mm3 or a CD4 percentage below 15%, who had at least two visits during the measurement year, with at least 90 days in between each visit; and, 

          Denominator 3. All patients aged 6 weeks through 12 months with a diagnosis of HIV, who had at least two visits during the measurement year, with at least 90 days in between each visit

          Total denominator: The sum of the three denominators

        • Exclusions

          Denominator 1 Exclusion: Patient did not receive PCP prophylaxis because there was a CD4 count above 200 cells/mm3 during the three months after a CD4 count below 200 cells/mm3

          Denominator 2 Exclusion: Patient did not receive PCP prophylaxis because there was a CD4 count above 500 cells/mm3 or CD4 percentage above 15% during the three months after a CD4 count below 500 cells/mm3 or CD4 percentage below 15%

        • 1.13a Data dictionary not attached
          No
          OLD 1.12 MAT output not attached
          Attached
        • Most Recent Endorsement Activity
          Endorsed Infectious Disease Endorsement Maintenance Project
          Initial Endorsement
          Last Updated
          Removal Date
        • Steward Organization Email
          Steward Organization Copyright

          This Measure, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposed, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the Measures require a license agreement between the user and American Medical Association, (on behalf of the Consortium) or NCQA. Neither the AMA, NCQA, Consortium nor its members shall be responsible for any use of the Measure.

          © 2012 American Medical Association and National Committee for Quality Assurance. All Rights Reserved

          Limited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The AMA, the Consortium and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications.

              • Risk adjustment approach
                Off
                Risk adjustment approach
                Off
                Conceptual model for risk adjustment
                Off
                Conceptual model for risk adjustment
                Off