CMS 156 - Use of High-Risk Medications in the Elderly
Medical Codify
CMS156v5 (2017)
CMS156v6 (2018)
CMS156v7 (2019)
Description: Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are reported.
- Percentage of patients who were ordered at least one high-risk medication.
- Percentage of patients who were ordered at least two of the same high-risk medications.
Initial Patient Population: Patients 65 years and older who had a visit during the measurement period.
Denominator: Equals Initial Population
Numerator:
Numerator 1: Patients with an order for at least one high-risk medication during the measurement period
Numerator 2: Patients with at least two orders for the same high-risk medication during the measurement period
Inverse Measure: Yes
Clinical Instructions
Track all patients that are 65+ and prescribed high-risk medications. Two rates are reported, so be aware that patients with at least one high-risk medication, as well as patients with at least two orders for the same high-risk medication, will be reported for the measurement period.
- While documenting the encounter, use the Presenting Medications section and Medication Orders section to prescribe and reconcile medications, as usual.
- Prescribe medications, as needed.
- Continue documenting the encounter, as appropriate.
- When complete, Close and Archive the encounter.
Evidence
Initial Patient Population
Name | Value Set |
Encounter, Performed: Annual Wellness Visit | 2.16.840.1.113883.3.526.3.1240 |
Encounter, Performed: Home Healthcare Services | 2.16.840.1.113883.3.464.1003.101.12.1016 |
Encounter, Performed: Office Visit | 2.16.840.1.113883.3.464.1003.101.12.1001 |
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-Initial Office Visit, 18 and Up | 2.16.840.1.113883.3.464.1003.101.12.1023 |
Encounter, Performed: Care Services in Long-Term Residential Facility | 2.16.840.1.113883.3.464.1003.101.12.1014 |
Encounter, Performed: Discharge Services - Nursing Facility | 2.16.840.1.113883.3.464.1003.101.12.1013 |
Encounter, Performed: Encounter Inpatient | 2.16.840.1.113883.3.666.5.307 |
Encounter, Performed: Nursing Facility Visit | 2.16.840.1.113883.3.464.1003.101.12.1012 |
Encounter, Performed: Ophthalmologic Outpatient Visit | 2.16.840.1.113883.3.464.1003.101.11.1206 |
Denominator
Equals Initial Population
Numerator
Name | Value Set |
Acetaminophen / Butalbital / Caffeine / Codeine | 2.16.840.1.113883.3.464.1003.196.12.1326 |
Acetaminophen / Butalbital / Caffeine | 2.16.840.1.113883.3.464.1003.196.12.1363 |
Acetaminophen / Butalbital | 2.16.840.1.113883.3.464.1003.196.12.1317 |
Acetaminophen / Chlorpheniramine / Dextromethorphan / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1310 |
Acetaminophen / Chlorpheniramine / Dextromethorphan / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1321 |
Acetaminophen / Chlorpheniramine / Dextromethorphan | 2.16.840.1.113883.3.464.1003.196.12.1421 |
Acetaminophen / Chlorpheniramine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1328 |
Acetaminophen / Chlorpheniramine / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1316 |
Acetaminophen / Dexbrompheniramine | 2.16.840.1.113883.3.464.1003.196.12.1405 |
Acetaminophen / Dextromethorphan / Diphenhydramine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1399 |
Acetaminophen / Dextromethorphan / Doxylamine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1287 |
Acetaminophen / Dextromethorphan / Doxylamine | 2.16.840.1.113883.3.464.1003.196.12.1338 |
Acetaminophen / Diphenhydramine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1318 |
Acetaminophen / Diphenhydramine | 2.16.840.1.113883.3.464.1003.196.12.1350 |
Amitriptyline / Chlordiazepoxide | 2.16.840.1.113883.3.464.1003.196.12.1286 |
Amitriptyline / Perphenazine | 2.16.840.1.113883.3.464.1003.196.12.1428 |
Amitriptyline Hydrochloride | 2.16.840.1.113883.3.464.1003.196.12.1373 |
Amoxapine | 2.16.840.1.113883.3.464.1003.196.12.1273 |
Anti Infectives, other | 2.16.840.1.113883.3.464.1003.196.12.1481 |
Aspirin / Butalbital / Caffeine | 2.16.840.1.113883.3.464.1003.196.12.1347 |
Aspirin / Caffeine / Orphenadrine | 2.16.840.1.113883.3.464.1003.196.12.1302 |
Atropine / Diphenoxylate | 2.16.840.1.113883.3.464.1003.196.12.1274 |
Atropine / Hyoscyamine / Phenobarbital / Scopolamine | 2.16.840.1.113883.3.464.1003.196.12.1355 |
Benztropine | 2.16.840.1.113883.3.464.1003.196.12.1361 |
Brompheniramine / Codeine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1409 |
Brompheniramine / Codeine / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1450 |
Brompheniramine / Dextromethorphan / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1325 |
Brompheniramine / Dextromethorphan / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1339 |
Brompheniramine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1327 |
Brompheniramine / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1332 |
Brompheniramine | 2.16.840.1.113883.3.464.1003.196.12.1427 |
Butabarbital | 2.16.840.1.113883.3.464.1003.196.12.1402 |
Carbinoxamine | 2.16.840.1.113883.3.464.1003.196.12.1306 |
Carisoprodol | 2.16.840.1.113883.3.464.1003.196.12.1369 |
Chlophedianol / Chlorpheniramine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1412 |
Chlophedianol / Dexchlorpheniramine / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1447 |
Chlorpheniramine / Codeine | 2.16.840.1.113883.3.464.1003.196.12.1301 |
Chlorpheniramine / Dextromethorphan / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1312 |
Chlorpheniramine / Dextromethorphan / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1337 |
Chlorpheniramine / Hydrocodone / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1299 |
Chlorpheniramine / Hydrocodone | 2.16.840.1.113883.3.464.1003.196.12.1330 |
Chlorpheniramine / Phenylephrine / Phenyltoloxamine | 2.16.840.1.113883.3.464.1003.196.12.1453 |
Chlorpheniramine / Phenylephrine / Pyrilamine | 2.16.840.1.113883.3.464.1003.196.12.1309 |
Chlorpheniramine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1343 |
Chlorpheniramine / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1315 |
Chlorpheniramine | 2.16.840.1.113883.3.464.1003.196.12.1352 |
Chlorpropamide | 2.16.840.1.113883.3.464.1003.196.12.1303 |
Chlorzoxazone | 2.16.840.1.113883.3.464.1003.196.12.1362 |
Clemastine | 2.16.840.1.113883.3.464.1003.196.12.1308 |
Clomipramine | 2.16.840.1.113883.3.464.1003.196.12.1336 |
Conjugated Estrogens / Medroxyprogesterone | 2.16.840.1.113883.3.464.1003.196.12.1324 |
Conjugated Estrogens | 2.16.840.1.113883.3.464.1003.196.12.1357 |
Cyclobenzaprine Hydrochloride | 2.16.840.1.113883.3.464.1003.196.12.1372 |
Cyproheptadine | 2.16.840.1.113883.3.464.1003.196.12.1277 |
Desiccated Thyroid | 2.16.840.1.113883.3.464.1003.196.12.1354 |
Desipramine | 2.16.840.1.113883.3.464.1003.196.12.1278 |
Dexbrompheniramine / Dextromethorphan / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1426 |
Dexbrompheniramine / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1430 |
Dexbrompheniramine Maleate / Pseudoephedrine Hydrochloride | 2.16.840.1.113883.3.464.1003.196.12.1429 |
Dexbrompheniramine | 2.16.840.1.113883.3.464.1003.196.12.1375 |
Dexchlorpheniramine / Dextromethorphan / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1300 |
Dexchlorpheniramine / Pseudoephedrine | 2.16.840.1.113883.3.464.1003.196.12.1425 |
Dextromethorphan / Diphenhydramine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1397 |
Dextromethorphan / Doxylamine | 2.16.840.1.113883.3.464.1003.196.12.1452 |
Dicyclomine | 2.16.840.1.113883.3.464.1003.196.12.1279 |
Dienogest / Estradiol Multiphasic | 2.16.840.1.113883.3.464.1003.196.12.1398 |
Dimenhydrinate | 2.16.840.1.113883.3.464.1003.196.12.1500 |
Diphenhydramine / Ibuprofen | 2.16.840.1.113883.3.464.1003.196.12.1293 |
Diphenhydramine / Phenylephrine | 2.16.840.1.113883.3.464.1003.196.12.1307 |
Diphenhydramine Hydrochloride | 2.16.840.1.113883.3.464.1003.196.12.1371 |
Dipyridamole | 2.16.840.1.113883.3.464.1003.196.12.1349 |
Disopyramide | 2.16.840.1.113883.3.464.1003.196.12.1311 |
Drospirenone / Estradiol | 2.16.840.1.113883.3.464.1003.196.12.1410 |
Esterified Estrogens / Methyltestosterone | 2.16.840.1.113883.3.464.1003.196.12.1320 |
Esterified Estrogens | 2.16.840.1.113883.3.464.1003.196.12.1419 |
Estradiol / Norethindrone | 2.16.840.1.113883.3.464.1003.196.12.1323 |
Estradiol | 2.16.840.1.113883.3.464.1003.196.12.1365 |
Estropipate | 2.16.840.1.113883.3.464.1003.196.12.1319 |
Glyburide / Metformin | 2.16.840.1.113883.3.464.1003.196.12.1360 |
Glyburide | 2.16.840.1.113883.3.464.1003.196.12.1368 |
Guanfacine | 2.16.840.1.113883.3.464.1003.196.12.1341 |
High Risk Medications for the Elderly | 2.16.840.1.113883.3.464.1003.196.12.1253 |
High-Risk Medications With Days Supply Criteria | 2.16.840.1.113883.3.464.1003.196.12.1254 |
Hydrochlorothiazide / Methyldopa | 2.16.840.1.113883.3.464.1003.196.12.1414 |
Hydroxyzine | 2.16.840.1.113883.3.464.1003.196.12.1374 |
Hyoscyamine / Methenamine / Mblue / Phenyl Salicyl / Sodium Biphosphate | 2.16.840.1.113883.3.464.1003.196.12.1504 |
Hyoscyamine / Methenamine / Mblue / Phenyl Salicyl | 2.16.840.1.113883.3.464.1003.196.12.1503 |
Hyoscyamine / Methenamine / Mblue / Sodium Biphosphate | 2.16.840.1.113883.3.464.1003.196.12.1505 |
Hyoscyamine | 2.16.840.1.113883.3.464.1003.196.12.1501 |
Imipramine | 2.16.840.1.113883.3.464.1003.196.12.1359 |
Indomethacin | 2.16.840.1.113883.3.464.1003.196.12.1366 |
Isoxsuprine | 2.16.840.1.113883.3.464.1003.196.12.1422 |
Ketorolac Tromethamine | 2.16.840.1.113883.3.464.1003.196.12.1364 |
List of Single RxNorm Code Concepts for High Risk Drugs for the Elderly | 2.16.840.1.113883.3.464.1003.196.12.1272 |
Meclizine | 2.16.840.1.113883.3.464.1003.196.12.1506 |
Megestrol | 2.16.840.1.113883.3.464.1003.196.12.1342 |
Meperidine | 2.16.840.1.113883.3.464.1003.196.12.1351 |
Meprobamate | 2.16.840.1.113883.3.464.1003.196.12.1284 |
Metaxalone | 2.16.840.1.113883.3.464.1003.196.12.1358 |
Methocarbamol | 2.16.840.1.113883.3.464.1003.196.12.1370 |
Methyldopa | 2.16.840.1.113883.3.464.1003.196.12.1331 |
Nifedipine | 2.16.840.1.113883.3.464.1003.196.12.1353 |
Nonbenzodiazepine hypnotics | 2.16.840.1.113883.3.464.1003.196.12.1480 |
Nortriptyline | 2.16.840.1.113883.3.464.1003.196.12.1507 |
Paroxetine | 2.16.840.1.113883.3.464.1003.196.12.1508 |
Phenobarbital | 2.16.840.1.113883.3.464.1003.196.12.1348 |
Promethazine Hydrochloride | 2.16.840.1.113883.3.464.1003.196.12.1367 |
Protriptyline | 2.16.840.1.113883.3.464.1003.196.12.1509 |
Pseudoephedrine / Triprolidine | 2.16.840.1.113883.3.464.1003.196.12.1345 |
Trihexyphenidyl | 2.16.840.1.113883.3.464.1003.196.12.1334 |
Trimipramine | 2.16.840.1.113883.3.464.1003.196.12.1285 |
Triprolidine | 2.16.840.1.113883.3.464.1003.196.12.1408 |
Denominator Exclusion
Name | Value Set |
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 |