CMS 145 - Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%)

Overview

CMS145v8 (2020)
CMS145v9 (2021)
CMS145v10 (2022)

Identifiers

CMS eCQM IDNQF eCQM IDNQFMIPS Quality ID
CMS145v100070e0070007
*MIE only supports data collection and reporting using eCQM specifications

Definitions

DescriptionPercentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period who also have a prior MI or a current or prior LVEF < 40% who were prescribed beta-blocker therapy
Initial Patient PopulationAll patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12-month period
DenominatorEquals Initial Population who also have prior (within the past 3 years) MI or a current or prior LVEF <40%
Denominator Exclusions
NumeratorPatients who were prescribed beta-blocker therapy
Numerator Exclusions
Denominator Exceptions
  • Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., allergy, intolerance, other medical reasons).

  • Documentation of patient reason(s) for not prescribing beta-blocker therapy (e.g., patient declined, other patient reasons).

  • Documentation of system reason(s) for not prescribing beta-blocker therapy (e.g., other reasons attributable to the health care system).

Additional Information

Measure TypeProcess measure
Measure ScoringProportion measure
Rate AggregationPopulation 1: Patients with left ventricular systolic dysfunction (LVEF <40%) Population 2: Patients with a prior (within the past 3 years) myocardial infarction

Performance Rate = (Numerator 1 + Numerator 2)/ [(Denominator 1 - Denominator Exceptions 1) + (Denominator 2 - Denominator Exceptions 2)]

GranularityPatient
Improvement NotationHigher score indicates better quality
DomainEffective Clinical Care

Clinical Instructions

New UI Visit Encounter (valid RC202109+)

Original Visit Encounter

Track all patients aged 18+ prescribed beta-blocker therapy within a 12-month period of the diagnosis of coronary artery disease with prior myocardial infarction (MI) or a current or prior LVEF < 40%.

  1. Ensure patient has one of the following diagnoses:
    1. Moderate left ventricular systolic dysfunction (disorder) - SNOMED 981000124106
    2. Severe left ventricular systolic dysfunction (disorder) - SNOMED 991000124109
  2. Numerator will be populated with patients prescribed a beta-blocker therapy within the measure period.

Evidence

Initial Patient Population

NameValue Set
Diagnosis: Coronary Artery Disease No MI2.16.840.1.113883.3.526.3.369
Encounter, Performed: Care Services in Long-Term Residential Facility2.16.840.1.113883.3.464.1003.101.12.1014
Encounter, Performed: Home Healthcare Services2.16.840.1.113883.3.464.1003.101.12.1016
Encounter, Performed: Nursing Facility Visit2.16.840.1.113883.3.464.1003.101.12.1012
Encounter, Performed: Office Visit2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed: Outpatient Consultation2.16.840.1.113883.3.464.1003.101.12.1008
Encounter, Performed: Patient Provider Interaction2.16.840.1.113883.3.526.3.1012

Denominator

NameValue Set
Diagnosis: Left ventricular systolic dysfunction (disorder)SNOMEDCT Code 134401001
Diagnosis: Moderate or Severe LVSD2.16.840.1.113883.3.526.3.1090
Diagnosis: Myocardial Infarction2.16.840.1.113883.3.526.3.403
Diagnostic Study, Performed: Ejection Fraction2.16.840.1.113883.3.526.3.1134

Numerator

NameValue Set
Medication, Active: Beta Blocker Therapy2.16.840.1.113883.3.526.3.1174
Medication, Active: Beta Blocker Therapy for LVSD2.16.840.1.113883.3.526.3.1184

Denominator Exceptions

NameValue Set
Allergy/Intolerance: Beta Blocker Therapy Ingredient2.16.840.1.113883.3.526.3.1493
Allergy/Intolerance: Substance with beta adrenergic receptor antagonist mechanism of action (substance)SNOMEDCT Code 373254001
Device, Applied: Cardiac Pacer2.16.840.1.113883.3.526.3.1193
Diagnosis: Allergy to Beta Blocker Therapy2.16.840.1.113883.3.526.3.1177
Diagnosis: Arrhythmia2.16.840.1.113883.3.526.3.366
Diagnosis: Asthma2.16.840.1.113883.3.526.3.362
Diagnosis: Atrioventricular Block2.16.840.1.113883.3.526.3.367
Diagnosis: Bradycardia2.16.840.1.113883.3.526.3.412
Diagnosis: Cardiac Pacer in Situ2.16.840.1.113883.3.526.3.368
Diagnosis: Hypotension2.16.840.1.113883.3.526.3.370
Diagnosis: Intolerance to Beta Blocker Therapy2.16.840.1.113883.3.526.3.1178
Physical Exam, Performed: Heart Rate2.16.840.1.113883.3.526.3.1176
Procedure, Performed: Cardiac Surgery2.16.840.1.113883.3.526.3.371

Source(s)

eCQI CMS145


WebChart Documentation

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