2016 PQRS Measure #431: Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

DESCRIPTION

Percentage of patients aged 18 years and older who were screened at least once within the last 24 months for unhealthy alcohol use using a systematic screening method AND who received brief counseling if identified as an unhealthy alcohol user

INSTRUCTIONS

This measure is to be reported once per reporting period for patients seen during the reporting period. This measure is intended to reflect the quality of services provided for preventive screening for unhealthy alcohol use. There is no diagnosis associated with this measure. This measure may be reported by clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

Measure Reporting via Registry:
CPT or HCPCS codes and patient demographics are used to identify patients who are included in the measure’s denominator. The listed numerator options are used to report the numerator of the measure.

The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data.

DENOMINATOR

All patients aged 18 years and older who were seen twice for any visits or who had at least one preventive care visit during the 12 month measurement period

Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years
AND
Patient encounter during the performance period (CPT or HCPCS): 90791, 90792, 90832, 90834, 90837, 90845, 96150, 96151, 96152, 97003, 97004, 97802, 97803, 97804, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, G0270, G0271, G0438, G0439
AND
Two Denominator Eligible Visits
OR
At Least One Preventive Care Visit

NUMERATOR

Patients who were screened at least once within the last 24 months for unhealthy alcohol use using a systematic screening method AND who received brief counseling if identified as an unhealthy alcohol user

Definitions:
Systematic screening method - For purposes of this measure, one of the following systematic methods to assess unhealthy alcohol use must be utilized. Systematic screening methods and thresholds for defining unhealthy alcohol use include:
 AUDIT Screening Instrument (score ≥ 8)
 AUDIT-C Screening Instrument (score ≥ 4 for men; score ≥ 3 for women)
 Single Question Screening - How many times in the past year have you had 5 (for men) or 4 (for women and all adults older than 65 years) or more drinks in a day? (response ≥2)

Brief counseling - Brief counseling for unhealthy alcohol use refers to one or more counseling sessions, a minimum of 5-15 minutes, which may include: feedback on alcohol use and harms; identification of high risk situations for drinking and coping strategies; increased motivation and the development of a personal plan to reduce drinking.

NUMERATOR NOTE: In the event that a patient is screened for unhealthy alcohol use and identified as a user but did not receive alcohol cessation counseling report G9624.

Numerator Options:
Performance Met: Patient identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method and received brief counseling (G9621)
OR
Performance Met: Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method (G9622)
OR
Medical Performance Exclusion: Documentation of medical reason(s) for not screening for unhealthy alcohol use (e.g., limited life expectancy, other medical reasons) (G9623)
OR
Performance Not Met: Patient not screened for unhealthy alcohol screening using a systematic screening method OR patient did not receive brief counseling, reason not given (G9624)
I want to compliment you and your colleagues for fine work.

Practice Administrator, Internal Medicine, Saint Augustine, FL

I've looked at all of them now and I'm convinced that yours is the best registry. So professional, so simple to use and backed by knowledgeable, personal support. I'm confident that I'll get PQRS reporting right!

Private Group Practice, Colorado

This is an intuitive interface that gathers just the info you need and nothing more. Whoever put it together had a good understanding of the info needed and how to set it up logically.

Physician, General Practice Network, Greensboro, NC

I recommended this solution to my colleagues and they're signing up too!

Physician Assistant, Family Care Group Practices, Chicago, IL

FYI, we did get a nice check from CMS (over $20,000!) so it is well worthwhile.

University of Pennsylvania

"I didn't know that I could have it any better. Somebody needs to let others know about all of the benefits of PQRSPRO!"

RN/Coder, Private Cardiology Practice

About 80% of our patient populate are Medicare, so CMS PQRS program incentives have been very lucrative for us.

RN/Coder, Private Cardiology Practice

We used a popular, more expensive PQRS Registry last year and had issues with the website but could not get anyone on the phone and had to leave voicemail and follow-up with an email.  For the money that we paid, they should have better customer service. PQRSPRO customer service is a Rolls Royce compared to the Volkswagen I experienced last year. When I called, I spoke to someone right away!

RN/Coder, Private Cardiology Practice

The PQRSPRO Registry system was easier to use than the other one.  Chart abstraction was simple and easy to understand and all measure questions were asked at once.  The other system made me wait for a prompt to move on once I answered one question – a much slower process.

RN/Coder, Private Cardiology Practice

The cost of PQRSPRO is much more reasonable than any other!

RN/Coder, Private Cardiology Practice

The final measure report was great and will also be useful for submitting to our malpractice insurance carrier to qualify for a discounted premium rate.

RN/Coder, Private Cardiology Practice

Users reported receiving up to $70,000 from participation in 2010 via our system.

President, Healthmonix

We are very happy with you and your company. Thank you for all of you efforts.

After trying for a couple years to receive the bonus, we finally received it this year using your system.

Your support has been awesome!

I wish we would've known about you three years ago! This was a breeze!

Group Cardiology Practice, Illinois

We are very satisfied with your process and service and confident that our practice will benefit from the incentive and avoid the penalties.

Intern, Ophthalmology Practice

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

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.