CMS164v7 – Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet

Patients 18 years of age and older with a visit during the measurement period who had an AMI, CABG, or PCI during the 12 months prior to the measurement year or who had a diagnosis of IVD overlapping the measurement year

– NUMERATOR

Patients who had an active medication of aspirin or another antiplatelet during the measurement year

 – DENOMINATOR EXCLUSIONS

• Patients who had documentation of use of anticoagulant medications overlapping the measurement year.
• Exclude patients whose hospice care overlaps the measurement period.

For Denominator:

Include patients aged 18 years and older at the start of the measurement period with a qualifying encounter during the measurement period.

• To record an encounter, navigate to Patient > Provider Note > eSuperbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.

In addition, patients should also satisfy one of the following conditions:

• ‘Myocardial Infarction’ diagnosis. The diagnosis’s prevalence period should start 12 months or less before start of measurement period. To document the MI 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.

• ‘Ischemic Vascular’ disease. The disease’s prevalence period should overlap the measurement period. To document the ischemic vascular 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.
• ‘Percutaneous Coronary Interventions’ or ‘Coronary Artery Bypass Graft’ procedure performed. The procedure’s relevant period should end 12 months or less before start of measurement period. To record the procedure, navigate to Patient > Provider Notes > 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’. The procedure is added to the provider note.

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. 

For Numerator:

Include patients with an active antiplatelet medication with the medication’s relevant period overlapping the measurement period. To record an active medication, use the workflow Patient > Provider Note > Medications. Click ‘Add’ and search for the medication. Enter the medication details and click ‘Save’. Then click ‘Accept’ and the medication is added to the provider note.

For Denominator Exclusions:

Exclude patients satisfying any of the following conditions:

• Patients with a record of an active anticoagulant where the anticoagulant’s relevant period overlaps the measurement period. To record an active medication, use the workflow Patient > Provider Note > Medications. Click ‘Add’ and search for the medication. Enter the medication details and click ‘Save’. Then click ‘Accept’ and the medication is added to the provider note.
• Patients who received hospice care during the measurement year. 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