CMS 90 - Functional Status Assessments for Congestive Heart Failure

Overview

CMS90v9 (2020)

CMS90v10 (2021)

CMS90v11 (2022)

Identifiers

CMS eCQM ID	NQF eCQM ID	NQF	MIPS Quality ID
CMS90v11	–	–	377

*MIE only supports data collection and reporting using eCQM specifications

Definitions

Description	Percentage of patients 18 years of age and older with heart failure who completed initial and follow-up patient-reported functional status assessments
Initial Patient Population	Patients 18 years of age and older who had two outpatient encounters during the measurement period and a diagnosis of heart failure that starts before and continues into the measurement period.
Denominator	Equals Initial Population
Denominator Exclusions	Exclude patients with severe cognitive impairment in any part of the measurement period. Exclude patients who are in hospice care for any part of the measurement period.
Numerator	Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12]; VR-36; Kansas City Cardiomyopathy Questionnaire [KCCQ]; KCCQ-12; Minnesota Living with Heart Failure Questionnaire [MLHFQ]; Measurement Information System [PROMIS]-10 Global Health, PROMIS-29) present in the two weeks before or during the initial FSA encounter and results for the follow-up FSA at least 30 days but no more than 180 days after the initial FSA
Numerator Exclusions	–
Denominator Exceptions	–

Additional Information

Measure Type	Process measure
Measure Scoring	Proportion measure
Granularity	Patient
Improvement Notation	Higher score indicates better quality
Domain	Person and Caregiver-Centered Experience and Outcomes

Clinical Instructions

Ensure all 18+ year-old patients with heart failure beginning prior to and continuing into the measurement period have a functional status assessment during the measurement period.

Workflow

Coming soon.

Evidence

Initial Patient Population

Name	Value Set
Encounter, Performed: Office Visit	2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed: Online Assessments	2.16.840.1.113883.3.464.1003.101.12.1089
Encounter, Performed: Telephone Visits	2.16.840.1.113883.3.464.1003.101.12.1080
Diagnosis: Heart Failure	2.16.840.1.113883.3.526.3.376

Denominator Exclusions

Name	Value Set
Diagnosis: Severe dementia (disorder)	SNOMEDCT Code 428351000124105
Intervention, Order: Hospice care ambulatory	2.16.840.1.113762.1.4.1108.15
Intervention, Performed: Hospice care ambulatory	2.16.840.1.113762.1.4.1108.15)

Numerator

Name	Value Set
Assessment, Performed: Emotional score [MLHFQ]	LOINC Code 85609-6
Assessment, Performed: Kansas City Cardiomyopathy Questionnaire - 12 item [KCCQ-12]	LOINC Code 86923-0
Assessment, Performed: Overall summary score [KCCQ-12]	LOINC Code 86924-8
Assessment, Performed: Overall summary score [KCCQ]	LOINC Code 71940-1
Assessment, Performed: Physical limitation score [KCCQ]	LOINC Code 72195-1
Assessment, Performed: Physical score [MLHFQ]	LOINC Code 85618-7
Assessment, Performed: PROMIS-10 Global Mental Health (GMH) score T-score	LOINC Code 71969-0
Assessment, Performed: PROMIS-10 Global Physical Health (GPH) score T-score	LOINC Code 71971-6
Assessment, Performed: PROMIS-29 Anxiety score T-score	LOINC Code 71967-4
Assessment, Performed: PROMIS-29 Depression score T-score	LOINC Code 71965-8
Assessment, Performed: PROMIS-29 Fatigue score T-score	LOINC Code 71963-3
Assessment, Performed: PROMIS-29 Pain interference score T-score	LOINC Code 71961-7
Assessment, Performed: PROMIS-29 Physical function score T-score	LOINC Code 71959-1
Assessment, Performed: PROMIS-29 Satisfaction with participation in social roles score T-score	LOINC Code 71957-5
Assessment, Performed: PROMIS-29 Sleep disturbance score T-score	LOINC Code 71955-9
Assessment, Performed: Quality of life score [KCCQ]	LOINC Code 72189-4
Assessment, Performed: Self-efficacy score [KCCQ]	LOINC Code 72190-2
Assessment, Performed: Social limitation score [KCCQ]	LOINC Code 72196-9
Assessment, Performed: Symptom stability score [KCCQ]	LOINC Code 72194-4
Assessment, Performed: Total symptom score [KCCQ]	LOINC Code 72191-0
Assessment, Performed: VR-12 Mental component summary (MCS) score - oblique method T-score	LOINC Code 72026-8
Assessment, Performed: VR-12 Mental component summary (MCS) score - orthogonal method T-score	LOINC Code 72028-4
Assessment, Performed: VR-12 Physical component summary (PCS) score - oblique method T-score	LOINC Code 72025-0
Assessment, Performed: VR-12 Physical component summary (PCS) score - orthogonal method T-score	LOINC Code 72027-6
Assessment, Performed: VR-36 Mental component summary (MCS) score - oblique method T-score	LOINC Code 71990-6
Assessment, Performed: VR-36 Mental component summary (MCS) score - orthogonal method T-score	LOINC Code 72008-6
Assessment, Performed: VR-36 Physical component summary (PCS) score - oblique method T-score	LOINC Code 71989-8
Assessment, Performed: VR-36 Physical component summary (PCS) score - orthogonal method T-score	LOINC Code 72007-8

Source(s)

eCQI CMS90