2016 PQRS Dementia Measures Group

What are the Data Collection Requirements?

If you would like to report on this measures group, you will need to:

  1. Understand the measures that are included and verify that these are relevant to your practice.

    What Measures Do I Need to Report?
    To successfully report on this measures group, you will need to satisfy the measures listed below. Click on the measure title for more information.
    • PQRS Measure # 47
      Care Plan
      Percentage of patients, regardless of age, with a diagnosis of dementia whose severity of dementia was classified as mild, moderate or severe at least once within a 12 month period
    • PQRS Measure # 280
      Dementia: Staging of Dementia
      Percentage of patients, regardless of age, with a diagnosis of dementia whose severity of dementia was classified as mild, moderate or severe at least once within a 12 month period
    • PQRS Measure # 281
      Dementia: Cognitive Assessment
      Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12 month period
    • PQRS Measure # 282
      Dementia: Functional Status Assessment
      Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of functional status is performed and the results reviewed at least once within a 12 month period
    • PQRS Measure # 283
      Dementia: Neuropsychiatric Symptom Assessment
      Percentage of patients, regardless of age, with a diagnosis of dementia and for whom an assessment of neuropsychiatric symptoms is performed and results reviewed at least once in a 12 month period
    • PQRS Measure # 284
      Dementia: Management of Neuropsychiatric Symptoms
      Percentage of patients, regardless of age, with a diagnosis of dementia who have one or more neuropsychiatric symptoms who received or were recommended to receive an intervention for neuropsychiatric symptoms within a 12 month period
    • PQRS Measure # 285
      Dementia: Screening for Depressive Symptoms
      Percentage of patients, regardless of age, with a diagnosis of dementia who were screened for depressive symptoms within a 12 month period
    • PQRS Measure # 286
      Dementia: Counseling Regarding Safety Concerns
      Percentage of patients, regardless of age, with a diagnosis of dementia or their caregiver(s) who were counseled or referred for counseling regarding safety concerns within a 12 month period
    • PQRS Measure # 287
      Dementia: Counseling Regarding Risks of Driving
      Percentage of patients, regardless of age, with a diagnosis of dementia or their caregiver(s) who were counseled regarding the risks of driving and the alternatives to driving at least once within a 12 month period
    • PQRS Measure # 288
      Dementia: Caregiver Education and Support
      Percentage of patients, regardless of age, with a diagnosis of dementia whose caregiver(s) were provided with education on dementia disease management and health behavior changes AND referred to additional resources for support within a 12 month period
  2. To meet the reporting requirement, enter data from 20 unique patient visits, a majority of which (at least 11) must be Medicare Part B Fee-For-Service (FFS) patients.
  3. Select unique patient visits that have a diagnosis related to the measure. For Medicare patients, this means a valid diagnosis code billed to Medicare in 2015 (January 1 - December 31, 2015) accompanied by a valid patient encounter code. Below is the list of valid diagnosis and patient encounter codes.

    What diagnosis codes are valid?

    ICD-9-CM [for use 1/1/2015 – 9/30/2015]: 094.1, 290.0, 290.10, 290.11, 290.12, 290.13, 290.20, 290.21, 290.3, 290.40, 290.41, 290.42, 290.43, 290.8, 290.9, 294.10, 294.11, 294.20, 294.21, 294.8, 331.0, 331.11, 331.19, 331.82
    ICD-10-CM [for use 10/1/2015 – 12/31/2015]: A52.17, F01.50, F01.51, F02.80, F02.81, F03.90, F03.91, F05, F06.8, G30.0, G30.1, G30.8, G30.9, G31.01, G31.09, G31.83

    What patient encounter codes are valid?

    90791, 90792, 90832, 90834, 90837, 96116, 96118, 96119, 96120, 96150, 96151, 96152, 96154, 97003, 97004, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
  4. To report satisfactorily the Dementia Measures Group it requires all applicable measures for each patient within the eligible professional’s patient sample to be reported a minimum of once during the reporting period.

ALERT: Measure #47 need only be reported on patients 65 years and older.

Measures groups containing a measure with a 0% performance rate will not be counted as satisfactorily reporting the measures group. The recommended clinical quality action must be performed on at least one patient for each measure within the measures group reported by the eligible professional. Performance exclusion quality-data codes are not counted in the performance denominator. If the eligible professional submits all performance exclusion quality-data codes, the performance rate would be 0/0 and would be considered satisfactorily reporting. If a measure within a measures group is not applicable to a patient, the patient would not be counted in the performance denominator for that measure (e.g., Preventive Care Measures Group - Measure #39: Screening or Therapy for Osteoporosis for Women would not be applicable to male patients according to the patient sample criteria). If the measure is not applicable for all patients within the sample, the performance rate would be 0/0 and would be considered satisfactorily reporting.

Measures groups cannot be altered to include or omit specific individual measures. Measures group reporting requires data entry for only 20 unique 2015 patient visits, a majority of which (at least 11) need to be Medicare FFS patients. All applicable measures within the group must be reported at least once for each patient within the sample population seen by the eligible professional during the reporting period (January 1 through December 31, 2015) for each of the 20 unique patient visits of which a majority are Medicare Part B FFS patients.

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Dementia Measures Group

 

Measures Include

Measure # 280
Dementia: Staging of Dementia

Measure # 281
Dementia: Cognitive Assessment

Measure # 282
Dementia: Functional Status Assessment

Measure # 283
Dementia: Neuropsychiatric Symptom Assessment

Measure # 284
Dementia: Management of Neuropsychiatric Symptoms

Measure # 285
Dementia: Screening for Depressive Symptoms
Measure # 286
Dementia: Counseling Regarding Safety Concerns

Measure # 287
Dementia: Counseling Regarding Risks of Driving

Measure # 288
Dementia: Caregiver Education and Support

CMS Disclaimer

If reporting for Physician Quality Reporting System (PQRS) through another Centers for Medicare and Medicaid Services’ (CMS) program (such as the Medicare Shared Savings Program, Comprehensive Primary Care Initiative, Pioneer Accountable Care Organizations), please check the program’s requirements for information on how to report quality data to earn a PQRS incentive and/or avoid the PQRS payment adjustment.

Please note, although CMS has attempted to align or adopt similar reporting requirements across programs, eligible professionals (EPs) should look to the respective quality program to ensure they satisfy the PQRS, Electronic Health Record (EHR) Incentive Program, Value-based Payment Modifier (VM), etc. requirements of each of these programs.

You should not select that you participate in the Medicare PQRS-EHR Incentive Pilot when you attest to this question on the CMS website. The Healthmonix Registry is NOT a qualified submission vendor for clinical quality measures for purposes of meaningful use.