PQRI - Registry Based Reporting (Self-nominating)

2010 EHR Warehouse Measure Specifications
Release Notes
July 2009
CMS is pleased to announce the release of the 2010 EHR Warehouse Measure
Specifications Release Notes. The list below details revisions made since the April
posting of the 2009 EHR Warehouse Measure Specifications.
The 2010 EHR Warehouse Measure Specifications have been updated to reflect clinical
practice guidelines and applicable health informatics that are the most current available
as of July 31, 2009. These specifications may be available for potential use in physician
quality initiatives, including but not limited to the Electronic Health Record (EHR)
submission under the 2010 Physician Quality Reporting Initiative (PQRI). A measure’s
inclusion in this document does not guarantee that measure will be used in any specific
CMS program in 2010 or any subsequent year.
In the case of measures that have been used in prior initiatives – such as the 2008 and
2009 PQRI EHR testing projects or the QIO-program's Doctor's Office QualityInformation Technology (DOQ-IT) project activities – the specifications detailed in the
2010 EHR Warehouse Measure Specifications supersede any specifications which may
have been used in those prior activities.
To determine which measures are included in any specific CMS program or
demonstration, interested parties should refer to the official documentation for that
program or demonstration. Please refer to the Medicare Physician Fee Schedule 2010
Final Rule (to be published in the Federal Register in November, 2009) to identify the
measures that will be available for data submission through EHRs under the 2010
PQRI, if an EHR-related program will exist in 2010.
Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus
•

Updated insulin and oral hypoglycemic/antihyperglycemic drug codes in the TOPIC_DRUG_CODES tab of the
2010 EHR Downloadable Resource table as denominator inclusions.

•

Deleted from the ENCOUNTER_CODE data element for denominator inclusion criteria, CPT code 99499.

Measure #2: Diabetes Mellitus: Low Density Lipoprotein (LDL-C) Control in Diabetes Mellitus
•

Updated insulin and oral hypoglycemic/antihyperglycemic drug codes in the TOPIC_DRUG_CODES tab of the
2010 EHR Downloadable Resource table as denominator inclusions.

•

Deleted from the ENCOUNTER_CODE data element for denominator inclusion criteria, CPT code 99499.

•

Added to the LDL_CODE data element for numerator inclusion, LOINC code 49132-4.

Measure #3: Diabetes Mellitus: High Blood Pressure Control in Diabetes Mellitus
•

Updated insulin and oral hypoglycemic/antihyperglycemic drug codes in the TOPIC_DRUG_CODES tab of the
2010 EHR Downloadable Resource table as denominator inclusions.

•

Deleted from the ENCOUNTER_CODE data element for denominator inclusion criteria, CPT code 99499.

•

Deleted from the DIASTOLIC_CODE data element for numerator inclusion, SNOMED code 67726005.

July 2009

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EHR Warehouse Measure Specifications
Release Notes Version 1.0

2010 EHR Warehouse Measure Specifications
Release Notes
Measure #5: Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker
(ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
•

Added to the EJEC_FRAC_CODE data element for denominator inclusion, CPT codes 93306, 93318.

•

Updated ARB drug codes in the TOPIC_DRUG_CODES tab of the 2010 EHR Downloadable Resource table as
numerator inclusions.

•

Updated ACE inhibitor drug codes in the TOPIC_DRUG_CODES tab of the 2010 EHR Downloadable Resource
table for numerator inclusion criteria.

•

Added to the PREGNANCY_CODE data element for denominator exclusion criteria, ICD-9-CM codes V23.85,
V23.86.

•

Deleted from the ACE_ALLERGY_CODE data element for denominator exclusion criteria, SNOMED code
1001288.

Measure #7: Coronary Artery Disease (CAD): Beta-blocker Therapy for CAD Patients with Prior Myocardial
Infarction (MI)
•

Updated beta-blocker drug codes in the TOPIC_DRUG_CODES tab of the 2010 EHR Downloadable Resource
table for numerator inclusion criteria.

•

Added to the EXCLUSION_CODE data element for denominator exclusion criteria, SNOMED codes 266361008,
309746001, 45007003, 195508000.

Measure #110: Preventive Care and Screening: Influenza Immunization for Patients ≥ 50 Years Old
•

Added to the INFLUENZA_CODE data element for numerator inclusion, SNOMED codes 396425006, 46233009
and CPT codes 90661, 90662, 90663.

•

Deleted from the ALLERGY_CODE data element for denominator exclusion criteria, SNOMED code
288310001.

Measure #111: Preventive Care and Screening: Pneumonia Vaccination for Patients 65 Years and Older
•

Added to the PNEUMO_CODE data element for numerator inclusion criteria, SNOMED codes 12866006,
333598008, 398730001.

•

Deleted from the ALLERGY_CODE data element for denominator exclusion criteria, SNOMED codes
288310001, 111737003.

Measure #112: Preventive Care and Screening: Screening Mammography
•

Added to the MAMMO_CODE data element for numerator inclusion criteria, SNOMED code 24623002.

Measure #113: Preventive Care and Screening: Colorectal Cancer Screening
•

No changes

Measure #124: Health Information Technology (HIT): Adoption/Use of Electronic Health Records (EHR)
•

No changes

July 2009

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EHR Warehouse Measure Specifications
Release Notes Version 1.0