CMS 138 - Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Medical Codify
CMS138v5 (2017)
CMS138v6 (2018)
CMS138v7 (2019)
Description: Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user. Three rates are reported:
- Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months
- Percentage of patients aged 18 years and older who were screened for tobacco use and identified as a tobacco user who received tobacco cessation intervention
- Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Initial Patient Population: All patients aged 18 years and older seen for at least two visits or at least one preventive visit during the measurement period.
Denominator:
Denominator 1: Equals Initial Population
Denominator 2: Equals Initial Population who were screened for tobacco use and identified as a tobacco user
Denominator 3: Equals Initial Population
Numerator:
Population 1: Patients who were screened for tobacco use at least once within 24 months
Population 2: Patients who received tobacco cessation intervention
Population 3: Patients who were screened for tobacco use at least once within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Inverse Measure: No
Clinical Instructions
Using the Social History section of the encounter, ensure smoking status is documented and additional details are noted with the respective status (i.e., current smoker, former smoker, etc.). Cessation counseling or medications should be noted, when applicable, in order to populate the numerator appropriately.
- While documenting the Visit Encounter, open the Social History section.
- Assess Smoking Status: (select one)
- Current every day smoker
- Current some day smoker
- Former smoker
- Never smoker
- Heavy tobacco smoker
- Light tobacco smoker
- Smoker, current status unknown
- Unknown if ever smoked
- Based on the selected smoking status, additional fields/choices may need addressed (e.g., Age Started, Age Quit, Cessation Counseling, etc.). Answer accordingly.
Evidence
Initial Patient Population
Name | Value Set |
Encounter, Performed: Annual Wellness Visit | 2.16.840.1.113883.3.526.3.1240 |
Encounter, Performed: Health & Behavioral Assessment - Individual | 2.16.840.1.113883.3.526.3.1020 |
Encounter, Performed: Health and Behavioral Assessment - Initial | 2.16.840.1.113883.3.526.3.1245 |
Encounter, Performed: Health and Behavioral Assessment, Reassessment | 2.16.840.1.113883.3.526.3.1529 |
Encounter, Performed: Home Healthcare Services | 2.16.840.1.113883.3.464.1003.101.12.1016 |
Encounter, Performed: Occupational Therapy Evaluation | 2.16.840.1.113883.3.526.3.1011 |
Encounter, Performed: Office Visit | 2.16.840.1.113883.3.464.1003.101.12.1001 |
Encounter, Performed: Ophthalmological Services | 2.16.840.1.113883.3.526.3.1285 |
Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up | 2.16.840.1.113883.3.464.1003.101.12.1025 |
Encounter, Performed: Preventive Care Services - Group Counseling | 2.16.840.1.113883.3.464.1003.101.12.1027 |
Encounter, Performed: Preventive Care Services - Other | 2.16.840.1.113883.3.464.1003.101.12.1030 |
Encounter, Performed: Preventive Care Services-Individual Counseling | 2.16.840.1.113883.3.464.1003.101.12.1026 |
Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up | 2.16.840.1.113883.3.464.1003.101.12.1023 |
Encounter, Performed: Psych Visit - Diagnostic Evaluation | 2.16.840.1.113883.3.526.3.1492 |
Encounter, Performed: Psych Visit - Psychotherapy | 2.16.840.1.113883.3.526.3.1496 |
Encounter, Performed: Psychoanalysis | 2.16.840.1.113883.3.526.3.1141 |
Encounter, Performed: Speech and Hearing Evaluation | 2.16.840.1.113883.3.526.3.1530 |
Denominator
Name | Value Set |
Assessment, Performed: Tobacco Use Screening |
2.16.840.1.113883.3.526.3.1278
2.16.840.1.113883.3.526.3.1170 |
Numerator
Name | Value Set |
Assessment, Performed: Tobacco Use Screening |
2.16.840.1.113883.3.526.3.1278
2.16.840.1.113883.3.526.3.1170 2.16.840.1.113883.3.526.3.1189 |
Intervention, Performed: Tobacco Use Cessation Counseling | 2.16.840.1.113883.3.526.3.509 |
Medication, Active: Tobacco Use Cessation Pharmacotherapy | 2.16.840.1.113883.3.526.3.1190 |
Medication, Order: Tobacco Use Cessation Pharmacotherapy | 2.16.840.1.113883.3.526.3.1190 |
Denominator Exception
Name | Value Set |
Assessment, Not Performed: Tobacco Use Screening |
2.16.840.1.113883.3.526.3.1278
2.16.840.1.113883.3.526.3.1007 |
Intervention, Not Performed: Tobacco Use Cessation Counseling |
2.16.840.1.113883.3.526.3.509
2.16.840.1.113883.3.526.3.1007 |
Medication, Not Ordered: Tobacco Use Cessation Pharmacotherapy |
2.16.840.1.113883.3.526.3.1190
2.16.840.1.113883.3.526.3.1007 |
Diagnosis: Limited Life Expectancy | 2.16.840.1.113883.3.526.3.1259 |