2016 PQRS Measure #110: Preventive Care and Screening: Influenza Immunization

DESCRIPTION

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

INSTRUCTIONS

This measure is to be reported a minimum of once for visits for patients seen between January and March for the 2014-2016 influenza season AND a minimum of once for visits for patients seen between October and December for the 2016-2017 influenza season. This measure is intended to determine whether or not all patients aged 6 months and older received (either from the reporting physician or from an alternate care provider) the influenza immunization during the flu season. 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.

 If reporting this measure between January 1, 2016 and March 31, 2016, quality-data code G8482 should be reported when the influenza immunization is administered to the patient during the months of August, September, October, November, and December of 2014 or January, February, and March of 2016 for the flu season ending March 31, 2016.
 If reporting this measure between October 1, 2016 and December 31, 2016, quality-data code G8482 should be reported when the influenza immunization is administered to the patient during the months of August, September, October, November, and December of 2016 for the flu season ending March 31, 2017.
 Influenza immunizations administered during the month of August or September of a given flu season (either 2014-2016 flu season OR 2016-2017 flu season) can be reported when a visit occurs during the flu season (October 1 - March 31). In these cases, G8482 should be reported.

DENOMINATOR

All patients aged 6 months and older seen for a visit between October 1 and March 31

AND

Patient encounter during the reporting period (CPT or HCPCS): 90945, 90947, 90951, 90952, 90953, 90954, 90955, 90956, 90957, 90958, 90959, 90960, 90961, 90962, 90963, 90964, 90965, 90966, 90967, 90968, 90969, 90970, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0438, G0439

NUMERATOR

Patients who received an influenza immunization OR who reported previous receipt of an influenza immunization 

Numerator Instructions:
The numerator for this measure can be met by reporting either administration of an influenza vaccination or that the patient reported previous receipt of the current season’s influenza immunization. If the performance of the numerator is not met, a clinician can report a valid performance exclusion for having not administered an influenza vaccination. For clinicians reporting a performance exclusion for this measure, there should be a clear rationale and documented reason for not administering an influenza immunization if the patient did not indicate previous receipt, which could include a medical reason (e.g., patient allergy), patient reason (e.g., patient declined), or system reason (e.g., vaccination not available). The system reason should be indicated only for cases of disruption or shortage of influenza vaccination supply.

Definition:
Previous Receipt – Receipt of the current season’s influenza immunization from another provider OR from same provider prior to the visit to which the measure is applied (typically, prior vaccination would include influenza vaccine given since August 1st).
Numerator Quality-Data Coding Options for Reporting Satisfactorily:
Influenza Immunization Administered
Performance Met: G8482: Influenza immunization administered or previously received


OR


Influenza Immunization not Administered for Documented Reasons
Other Performance Exclusion: G8483: Influenza immunization was not administered for reasons documented by clinician (eg, patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)


OR


Influenza Immunization not Administered, Reason not Given
Performance Not Met: G8484: Influenza immunization was not administered, reason not given

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Preventive Care and Screening: Influenza Immunization

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