CMS127v10 – Pneumococcal Vaccination Status for Older Adults

Patients 66 years of age and older with a visit during the measurement period.

– DENOMINATOR EXCLUSION

Exclude patients whose hospice care overlaps the measurement period.

– NUMERATOR

Patients who received a pneumococcal vaccination on or after their 60th birthday and before the end of the measurement period; or ever had an adverse reaction to the vaccine before the end of the measurement period.

For Denominator:

Patient aged 66 years of age and older at the start of the measurement period, with a qualifying encounter during the measurement period is considered for the denominator of this measure. To record an encounter, navigate to Patient > Clinical > eSuperbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.

• Preventive Care Services-Initial Office Visit, 18 and Up
• Preventive Care Services – Established Office Visit, 18 and Up
• Office Visit
• Annual Wellness Visit
• Home Healthcare Services
• Nursing Facility Visit

For Numerator:

Patients fulfilling any of the following conditions are included in the numerator:

• Patients who were administered ‘Pneumococcal Polysaccharide 23 Vaccine’ before the end of the measurement period and who were 60 years or older at the time of vaccination. To document pneumococcal immunization, use the workflow Patient > Clinical > Immunization. Click ‘+ Dosage’ and select ‘Administer Vaccine’ and the pneumococcal vaccine category. In the vaccine search window, search for the pneumococcal vaccine. Complete the vaccine details and click ‘Save’.

• Patients who had ‘Pneumococcal polysaccharide vaccine, 23-valent (PPSV23)’ procedure performed before the end of the measurement period and who were 60 years or older at the time of procedure. To document pneumococcal vaccination procedure, navigate to Patient > Provider Note > Orders > Procedures. Click ‘Add’ and search for the procedure. Add the procedure details and click on ‘Save & Accept’/hover over ‘Sign & Accept’. If the user hovers over ‘Sign & Accept’, then click ‘Complete’.

Note:

Please ensure that the Procedure is present in the system. For this, navigate to Settings > Billing > Procedure. If the procedure is not added then, click on the ‘Add Procedure’ button. 

Here, enter the ‘Code’ and ‘Name’ of the Procedure. Once done, click on the ‘Save’ button. 

• Patients who had pneumococcal vaccine adverse reaction on or before end of measurement period. To document the vaccine reaction, 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.

For Denominator Exclusion:

Patients who were in hospice care during the measurement year are included in denominator exclusion. To document that patient is receiving hospice care outside of a hospital or long term care facility, navigate to Patient > Clinical > Evaluations. Use the below mentioned codes to order or perform an intervention:

• 385763009: Hospice Care (Regime/Therapy)
• 385765002: Hospice Care Management (Procedure)

• To document an encounter inpatient, navigate to Patient > Clinical > Evaluations.