CMS147v13 – Preventive Care and Screening: Influenza Immunization

Pneumococcal Vaccination Status for Older Adults CMS147v13 Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization.
– INITIAL POPULATION

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
  • Patients who ever had an anaphylaxis due to the influenza vaccine on or before June 30 of the measurement period
– APPLICATION WORKFLOW

For Denominator:

  • To record the encounter, navigate to Patient > Provider Note > Create Superbill. Under the ‘Procedure-CPTs’ heading, enter the relevant encounter code.
eSuperbill for Encounter
  • 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’.
Example of Hemodialysis Procedure

For Numerator:

  • Documentation of the influenza immunization can be done via Patient > Provider Note > 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’.
Example of Influenza Vaccination
  • 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’.
Example of Influenza Vaccine Administration Procedure

For Denominator Exclusions:

  • To document that a patient is receiving hospice care outside of a hospital or long-term care facility, navigate to Patient > Provider Note > Evaluations. Use the below mentioned codes to order or perform an intervention:
    • 385763009: Hospice Care (Regime/Therapy)
    • 385765002: Hospice Care Management (Procedure)
Hospice Care Intervention
  • To document an inpatient encounter, navigate to Patient > Provider Note > Evaluations.
Example of Inpatient Encounter
  • To document a hospice care assessment, follow the workflow Patient > Provider Note > Evaluations. Click ‘Add’ and search for ‘Hospice Care [Minimum Data Set]’. Then select ‘Performed’ from the ‘Status’ dropdown and ‘Yes’ from the ‘Result’ field.
Hospice Care Assessment
  • A hospice encounter can be documented through Patient > Provider Note > Evaluations or Patient > Provider Note > Create Superbill.
  • To document Influenza Vaccine Anaphylaxis care, navigate to Patient > Provider Notes > Evaluations and search for relevant diagnosis.