CMS771v3 – Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic Hyperplasia

Male patients with an initial diagnosis of benign prostatic hyperplasia 6 months prior to, or during the measurement period, and a urinary symptom score assessment within 1 month of initial diagnosis and a follow-up urinary symptom score assessment within 6-12 months, who had a qualifying visit during the measurement period.

– DENOMINATOR EXCLUSIONS

• Patients with urinary retention that starts within 1 year of initial BPH diagnosis.
• Patients with an initial BPH diagnosis that starts during, or within 30 days of hospitalization.
• Patients with a diagnosis of morbid obesity, or with a BMI Exam > 40 before the follow up urinary symptom score.

– NUMERATOR

Patients with a documented improvement of at least 3 points in their urinary symptom score during the measurement period.

For Denominator:

Patients fulfilling the following criteria are included in the denominator of this measure:

• Male patients with a qualifying encounter during the measurement period. To record a qualifying encounter, navigate to Patient > Provider Note > eSuperbill. Under the ‘Procedure – CPTs’ heading, enter the encounter code.

• Patients with BPH (benign prostatic hyperplasia) diagnosis within 6 months before or after the start of the measurement period. To document the diagnosis, use the workflow Patient > Provider Note > Diagnoses, and click ‘Add’. Search for the diagnosis, add the diagnosis details and click ‘Save’. Then click ‘Accept’ and the diagnosis is added to the provider note.

• Patients with urinary symptom score within 1 month after the BPH diagnosis.
• Patients with urinary symptom score 6 to 12 months after the BPH diagnosis.

For the urinary symptom score, one of the following conditions must be satisfied:

• ‘AUA Symptom Index and ‘Quality of Life’ assessments results recorded on the same day: To record the ‘AUASI’ and ‘Quality of Life’ assessments navigate to Patient > Clinical > Evaluations. Click ‘+ Add’ and search for an assessment. Select ‘Performed’ from the ‘Status’ dropdown and enter the result in the ‘Result’ field. Then click ‘Sign’ or ‘Save’.

• Documented IPSS Assessment Result: To record the assessment navigate to Patient > Clinical > Evaluations.

For Numerator:

Patients with urinary symptom score improvement greater than or equal to 3 are included in the numerator. Urinary symptom score should be recorded within 1 month after the BPH diagnosis and then 6 to 12 months after the BPH diagnosis.

To document the BPH diagnosis, use the workflow Patient > Provider Note > Diagnoses.

For the urinary symptom score, one of the following conditions must be satisfied:

• ‘AUA Symptom Index’ and ‘Quality of Life’ assessments results recorded on the same day: To record the ‘AUASI’ and ‘Quality of Life’ assessments navigate to Patient > Clinical > Evaluations. Click ‘+ Add’ and search for an assessment. Select ‘Performed’ from the ‘Status’ dropdown and enter the result in the ‘Result’ field. Then click ‘Sign’ or ‘Save’.
• Documented IPSS Assessment Result: To record the assessment navigate to Patient > Clinical > Evaluations.

For Denominator Exclusions:

Patients satisfying one of the following conditions are excluded from the denominator:

• Patients with urinary retention diagnosis starting within 1 year after the BPH diagnosis. To document the urinary retention diagnosis, use the workflow Patient > Provider Note > Diagnoses.
• Patients with BPH diagnosis starting during or within 30 days after the end of hospitalization. To record the ‘Hospital Services for urology care’ encounter, use the workflow Patient > Provider Note > eSuperbill.
• Patients with morbid obesity diagnosis and urinary symptom score 6 to 12 months after the BPH diagnosis.
  • To document the BPH and morbid obesity diagnoses, use the workflow Patient > Provider Note > Diagnoses.
  • To record the urinary symptom score assessments, navigate to Patient > Clinical > Evaluations.
• Patients with BMI exam result greater than 40 and urinary symptom score 6 to 12 months after the BPH diagnosis.
  • To document the BPH diagnosis, use the workflow Patient > Provider Note > Diagnoses.
  • To record the urinary symptom score assessments, navigate to Patient > Clinical > Evaluations.
  • To record the BMI, use the workflow Patient > Provider Note > Vitals. Click ‘Add’ and enter the ‘Weight and ‘Height’ readings. The BMI is automatically calculated.