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[CQM] NQF 0075 Ischemic Vascular Disease (IVD): Complete Lipid Panel and LDL Control

Last Updated: Mar 11, 2015 06:31PM PDT

Measure Description

Note: There is no % requirement for CQMs. You must report as much as you can for CQMs.

Percentage of patients 18 years of age and older who were discharged alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active diagnosis of ischemic vascular disease (IVD) during the measurement period, and who had a complete lipid profile performed during the measurement period and whose LDL-C was adequately controlled (< 100 mg/dL).

Notes:
  • We do not expect primary care physicians to have significant numbers for this measure.  The most common scenario would be that of a diagnosis of Ischemic Vascular Disease or Acute Myocardial Infarction.
  • This measure is required to be reported upon but can have a denominator (see below for denominator definition) of 0.

Denominator: Total pool of AMI, CABG, PTCA, and IVD patients against which your measurement percentage is calculated.  There are 4 possible scenarios by which a patient can be counted in the denominator for Measure 0075.  In all cases, the patient is 18 years or older and has the doctor listed as the Primary Care Provider.

Denominator Scenario 1: Ischemic Vascular Disease (IVD)
Denominator Scenario 2: Acute Myocardial Infarction (AMI)
Denominator Scenario 3: Percutaneous Transluminal Coronary Angioplasty (PTCA)
Denominator Scenario 4: Coronary Artery Bypass Graft (CABG)

Numerator: The numerator represents the total number of AMI, CABG, PTCA, and IVD patients who have had their cholesterol and triglycerides properly monitored during the reporting period. There are 2 numerators for this measure.

Numerator 1 Patients in the denominator that have had a complete lipid panel OR have had all HDL, LDL, total cholesterol and triglycerides tests.
Numerator 2 Patients in the denominator that have an LDL < 100 m/dL.

How to Track This Measure in Elation

For the denominator to track correctly on Elation:

Denominator Scenario 1: Ischemic Vascular Disease (IVD)
Patient was seen for an acute inpatient or outpatient encounter in the last 2 years before the measurement end date AND had a diagnosis of IVD.  To be more specific, the following 2 conditions must be met:

1. A Visit Note for the patient in the last 2 years contains one of these inpatient or outpatient CPT's:
  • Inpatient: 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, 99255, 99291
  • Outpatient: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347-99350, 99384, 99385, 99386, 99387, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, 99456

2. AND the Problem List for the patient has one of the following ICD-9 diagnosis codes associated with it:
  • 411.0, 411.1, 411.81, 411.89, 413.0, 413.1, 413.9, 414.00, 414.01, 414.02, 414.03, 414.04, 414.05, 414.06, 414.07, 414.2, 414.8, 414.9, 429.2, 433.0, 433.01, 433.10, 433.11, 433.20, 433.21, 433.30, 433.31, 433.80, 433.81, 433.90, 433.91, 434.00, 434.01, 434.10, 434.11, 434.90, 434.91, 440.1, 440.20, 440.21, 440.22, 440.23, 440.24, 440.29, 440.4, 444.0, 444.1, 444.21, 444.22, 444.81, 444.89, 444.9, 445.01, 445.02, 445.8, 445.81

Denominator Scenario 2: Acute Myocardial Infarction (AMI)
Patient had an acute inpatient encounter AND had an AMI diagnosis anywhere between 14-24 months before the measurement end date.  To be more specific, the following 2 conditions must be met:

1. A Visit Note for the patient during the 14-24 months prior to the measurement end date contains one of these CPT's: 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, 99255, 99291

2. AND the Problem List for the patient has one of the following ICD-9 diagnosis codes associated with it: 410.01, 410.11, 410.21, 410.31, 410.41, 410.51, 410.61, 410.71, 410.81, 410.91

Denominator Scenario 3: Percutaneous Transluminal Coronary Angioplasty (PTCA)
Patient had a PTCA procedure anytime between 14-24 months prior to the measurement end date.

1. A Visit Note for the patient during the 14-24 months prior to the measurement end date contains one of these CPT's: 33140, 92980, 92982, 92995

2. AND the Problem List for the patient has one of the following ICD-9 diagnosis codes associated with it: 00.66, 36.06, 36.07, 36.09

Denominator Scenario 4: Coronary Artery Bypass Graft (CABG)
Patient had an acute inpatient encounter AND a CABG procedure anytime between 14-24 months prior to the measurement end date.
 
1. A Visit Note for the patient during the 14-24 months prior to the measurement end date contains one of these acute inpatient encounter CPT's: 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, 99255, 99291

2. AND a Visit Note for the patient during the 14-24 months prior to the measurement end date contains one of these CABG-related CPT's: 33510, 33511, 33512, 33513, 33514, 33516, 33517, 33518, 33519, 33521, 33522, 33523, 33533, 33534, 33535, 33536 

2. AND the Problem List for the patient has one of the following ICD-9 diagnosis codes associated with it: 36.1, 36.10, 36.11, 36.12, 36.13, 36.14, 36.15, 36.16, 36.17, 36.19, 36.2

For numerators 1 & 2 to track correctly on Elation:

Numerator 1:  Patients in the denominator that have had a complete lipid panel OR have had all HDL, LDL, total cholesterol and triglycerides tests.  

1. Complete lipid panel or HDL, LDL, total cholesterol, and triglycerides tests for patients in the denominator of this measure. If you receive electronic lab results for these patients through a lab interface setup in Elation, these lab results will be automatically tracked to count for this numerator.

2. If you receive faxed copies of lab results for this measure, you must manually enter trending lab values. In order for Manually Entered Lab Values to be counted for this measure, you must enter the LOINC codes associated with the lab test in order for the reports to read the Manually Entered Lab Values.

You can enter LOINC codes in the LOINC field when you add your own lab tests while manually entering lab values. Click here for more details on how to manually enter Lab Values.
 
The following is a list of all the LOINC codes associated with this measure. The ones that are in bold and italics are the ones that we recommend using. 

High Density Lipoprotein (HDL)  

2085-9 Cholesterol in HDL [Mass/volume] in Serum or Plasma
- 14646-4 Cholesterol in HDL [Moles/volume] in Serum or Plasma
- 18263-4 Cholesterol in HDL [Mass/volume] in Serum or Plasma ultracentrifugate


Total Cholesterol

- 2093-3 Cholesterol [Mass/volume] in Serum or Plasma 
- 14647-2 Cholesterol [Moles/volume] in Serum or Plasma


Triglycerides

2571-8 Triglyceride [Mass/volume] in Serum or Plasma 
12951-0 Triglyceride [Mass/volume] in Serum or Plasma by calculation
- 14927-8 Triglyceride [Moles/volume] in Serum or Plasma
- 47210-0 Triglyceride [Moles/volume] in Serum or Plasma --fasting
 

LDL test

13457-7 Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation
18262-6 Cholesterol in LDL [Mass/volume] in Serum or Plasma by Direct assay
2089-1 Cholesterol in LDL [Mass/volume] in Serum or Plasma (Labcorp) 
- 12773-8 Cholesterol in LDL [Units/volume] in Serum or Plasma by Electrophoresis
- 18261-8 Cholesterol in LDL [Mass/volume] in Serum or Plasma ultracentrifugate
- 22748-8 Cholesterol in LDL [Moles/volume] in Serum or Plasma
- 39469-2 Cholesterol in LDL [Moles/volume] in Serum or Plasma by calculation
- 49132-4 Cholesterol in LDL [Mass/volume] in Serum or Plasma by Electrophoresis
- 55440-2 Cholesterol inLDL (real) [Mass/volume] in Serum or Plasma by VAP

Numerator 2 Patients in the denominator that have an LDL < 100 mg/dL.

If LDL test result for a patient from Numerator 1 is less than 100 mg/dL, this patient will count in Numerator 2.

 

Frequently Asked Questions

Why isn't my patient showing up in the numerator (see below for numerator definition)?  I've received electronic lab results for my patient, entered in the ICD-9 and CPT codes, and double-checked that she is within range to count toward my measurement percentage.

Currently, Elation EMR only counts electronic lab results from lab partners we have interfaces with. If you receive non-electronic results, you will need to enter the results manually using the LOINC codes.  Click here to learn how to enter results manually.

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