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Claims Data

Valid for Measure Submission

Preventive Care and Screening: Influenza Immunization

  • Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

    CBE ID
    0041

Preventive Care and Screening: Screening for Depression and Follow-Up Plan

  • Percentage of patients aged 12 years and older screened for depression on the date of the encounter or 14 days prior to the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the eligible encounter

    CBE ID
    0418

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

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

    Three rates are reported:
    a. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months
    b. Percentage of patients aged 18 years and older who were identified as a tobacco user who received tobacco cessation intervention

    CBE ID
    0028

Primary Caries Prevention Intervention as Part of Well/Ill Child Care as Offered by Primary Care Medical Providers

  • The measure will a) track the extent to which the PCMP or clinic (determined by the provider number used for billing) applies FV as part of the EPSDT examination and b) track the degree to which each billing entity’s use of the EPSDT with FV codes increases from year to year (more children varnished and more children receiving FV four times a year according to ADA recommendations for high-risk children).

    CBE ID
    1419

Primary PCI received within 90 minutes of hospital arrival

  • Percentage of acute myocardial infarction (AMI) patients with ST-segment elevation or LBBB on the ECG closest to arrival time receiving primary percutaneous coronary intervention (PCI) during the hospital stay with a time from hospital arrival to PCI of 90 minutes or less.

    CBE ID
    0163

Procedures and Tests

  • Performance Measure Name: Procedures and Tests
    Description: Patients who are transferred from an ED to another healthcare facility have communicated with the receiving facility within 60 minutes of discharge a list of tests done and results sent.

    CBE ID
    0297

Prophylactic Antibiotic Received Within One Hour Prior to Surgical Incision

  • Surgical patients with prophylactic antibiotics initiated within one hour prior to surgical incision. Patients who received vancomycin or a fluoroquinolone for prophylactic antibiotics should have the antibiotics initiated within two hours prior to surgical incision. Due to the longer infusion time required for vancomycin or a fluoroquinolone, it is acceptable to start these antibiotics within two hours prior to incision time.

    CBE ID
    0527