CMS147v12 – Preventive Care and Screening: Influenza Immunization

All patients aged 6 months and older seen for a visit during the measurement period.

A qualifying visit in this case can include any of the following:

• Office Visit
• Outpatient Consultation
• Care Services in Long Term Residential Facility
• Home Healthcare Services
• Patient Provider Interaction
• Preventive Care Services, Initial Office Visit, 0 to 17
• Preventive Care Services Initial Office Visit, 18 and Up
• Preventive Care Services Individual Counseling
• Preventive Care Services Group Counseling
• Unlisted preventive medicine service
• Discharge Services Nursing Facility
• Nursing Facility Visit
• Annual Wellness Visit
• Preventive Care, Established Office Visit, 0 to 17
• Preventive Care Services Established Office Visit, 18 and Up
• Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal.
• Online Assessments
• Telephone Visits

– DENOMINATOR 

All patients aged 6 months and older seen for a visit between October 1 of the year prior to the measurement period and March 31 of the measurement period (also known as the influenza season).

Qualifying visits during influenza season can include any of the following:

• Annual Wellness Visit
• Office Visit
• Outpatient Consultation
• Care Services in Long Term Residential Facility
• Home Healthcare Services
• Preventive Care Services, Initial Office Visit, 0 to 17
• Preventive Care Services, Initial Office Visit, 18 and Up
• Unlisted Preventive Medicine Service
• Preventive Care Services Group Counseling
• Preventive Care Services Individual Counselling
• Discharge Services Nursing Facility
• Nursing Facility Visit
• Preventive Care, Established Office Visit, 0 to 17
• Preventive Care Services Established Office Visit, 18 and Up

Note: Patients receiving Hemodialysis or Peritoneal Dialysis are more prone to influenza, and thus are strongly recommended to get an annual influenza immunization.

– NUMERATOR

Patients who received an influenza immunization OR who reported previous receipt of an influenza immunization between July 1 of the year prior to the measurement period to June 30 of the measurement period.

– DENOMINATOR EXCLUSIONS

Patients who are in hospice care for any part of the measurement period.

For Denominator:

• To record the encounter, navigate to Patient > Provider Notes > Create Superbill. Under the ‘Procedure-CPTs’ heading, enter the relevant encounter code.

• To document Hemodialysis or Peritoneal Dialysis, use the workflow Patient > Provider Notes > Orders > Procedures. Click ‘Add’ and search for the relevant procedure. Once all details are added, click on ‘Save & Accept’ or ‘Sign & Accept’.

For Numerator:

• Documentation of the influenza immunization can be done via Patient > Provider Notes > Immunizations. Here, click ‘Add’ and then click ‘+Dosage’. From the drop-down, hover over ‘Administer Vaccine’ and select Influenza. On the pop-up window that is displayed, search for the relevant influenza vaccination, fill out the required information and click ‘Save’.

• The administration of influenza vaccination can also be documented as a procedure. To do so, navigate to Patient > Provider Notes > Orders > Procedures. Click ‘Add’ and search for the relevant procedure. Fill out the details as needed and once done, click ‘Save’.

For Denominator Exclusions:

To document a patient receiving hospice care, navigate to Patient > Provider Notes > Evaluations. Hospice Care can also be recorded by the workflow Patient > Provider Notes > Create eSuperbill. Under the ‘Procedure-CPTs’ heading, add the relevant hospice care code.