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Claims Data

Valid for Measure Submission

New Rheumatoid Arthritis Baseline ESR or CRP within Three Months

  • This measure identifies adult patients newly diagnosed with rheumatoid arthritis during the first 8 months of the measurement year who received erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) lab tests either 4 months (3 months + 1-month grace period) before or after the initial diagnosis.

    CBE ID
    0601

Non-Emergent Coronary Artery Bypass Graft (CABG) Measure

  • The Non-Emergent CABG episode-based cost measure evaluates a clinician’s risk-adjusted cost to Medicare for patients who undergo a CABG procedure during the performance period. The measure score is the clinician’s risk-adjusted cost for the episode group averaged across all episodes attributed to the clinician. This procedural measure includes costs of services that are clinically related to the attributed clinician’s role in managing care during each episode from 30 days prior to the clinical event that opens, or “triggers,” the episode through 90 days after the trigger.

    CBE ID
    3625

Nursing Information

  • Percentage of patients transferred to another HEALTHCARE FACILITY whose medical record documentation indicated that nursing information was communicated to the receiving FACILITY within 60 minutes of departure

    CBE ID
    0296

Oncology: Radiation Dose Limits to Normal Tissues

  • Percentage of patients, regardless of age, with a diagnosis of breast, rectal, pancreatic or lung cancer receiving 3D conformal radiation therapy who had documentation in medical record that radiation dose limits to normal tissues were established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissues

    CBE ID
    0382

Oncology: Treatment Summary Communication – Radiation Oncology

  • Percentage of patients, regardless of age, with a diagnosis of cancer who have undergone brachytherapy or external beam radiation therapy who have a treatment summary report in the chart that was communicated to the physician(s) providing continuing care and to the patient within one month of completing treatment

    CBE ID
    0381

Optimal End Stage Renal Disease (ESRD) Starts

  • Information From 2015 Submission

    Optimal End Stage Renal Disease (ESRD) Starts is the percentage of new adult ESRD patients during the measurement period who experience a planned start of renal replacement therapy by receiving a preemptive kidney transplant, by initiating home dialysis (peritoneal dialysis or home hemodialysis), or by initiating outpatient in-center hemodialysis via arteriovenous fistula or arteriovenous graft.

    CBE ID
    2594

Oral Evaluation, Dental Services

  • Percentage of enrolled children under age 21 years who received a comprehensive or periodic oral evaluation within the reporting year.

    CBE ID
    2517

Osteoarthritis: Function and Pain Assessment

  • Type of score: Proportion
    Percentage of patient visits for patients aged 21 years and older with a diagnosis of osteoarthritis with assessment for function and pain

    CBE ID
    0050