Percentage of patients 18-85 years of age who had a diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period, and whose most recent blood pressure was adequately controlled (<140/90mmHg) during the measurement period
– DENOMINATOR
Patients 18-85 years of age by the end of the measurement period who had a visit during the measurement period and diagnosis of essential hypertension starting before and continuing into, or starting during the first six months of the measurement period.
A qualifying visit in this case includes any of the following:
Office Visit
Annual Wellness Visit
Preventive Care Services Established Office Visit, 18 and Up
Preventive Care Services Initial Office Visit, 18 and Up
Home Healthcare Services
Online Assessments
Telephone Visits
– NUMERATOR
Patients whose most recent blood pressure is adequately controlled (systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg) during the measurement period.
Note: This blood pressure reading should not have been taken during an emergency department visit or an inpatient encounter.
– DENOMINATOR EXCLUSIONS
Patients with evidence of:
End stage renal disease (ESRD Diagnosis or Encounter)
Dialysis
Renal transplant/ESRD Procedure/Kidney Transplant
before or during the measurement period.
Patients with a diagnosis of pregnancy during the measurement period.
Patients who are in hospice care for any part of the measurement period.
Patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
Patients 66-80 by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
Advanced illness with two outpatient encounters during the measurement period or the year prior
OR advanced illness with one inpatient encounter during the measurement period or the year prior
OR taking dementia medications during the measurement period or the year prior
Patients 81 and older by the end of the measurement period with an indication of frailty for any part of the measurement period.
Patients receiving palliative care for any part of the measurement period.
– APPLICATION WORKFLOW
For Denominator:
To record a visit, navigate to Patient > Provider Note > Create Superbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.
eSuperbill for Encounter
For documenting the diagnosis for hypertension, use the workflow Patient > Provider Notes > Diagnoses. Click ‘Add’ and search for the relevant diagnosis. Fill out the details, and once done, click ‘Save’.
Example of Hypertension Diagnosis
For Numerator:
To record a patient’s latest blood pressure, head over to Patient > Provider Note > Vitals. Click ‘Add’ and enter the systolic and diastolic blood pressure readings in the respective fields. Once done, click ‘Accept’.
Recording Blood Pressure
For Denominator Exclusions:
To document
ESRD
Pregnancy
use the workflow Patient > Provider Note > Diagnoses.
Example of ESRD Diagnosis
An ESRD encounter can be recorded via Patient > Provider Note > Create Superbill.
eSuperbill for ESRD Encounter
Documentation of
Renal transplant/Kidney Transplant
Dialysis
can be done through Patient > Provider Note > Order > Procedures. Here, click ‘Add’ and search for the relevant procedure. Once done, click ‘Save & Accept’ or ‘Sign & Accept’.
Procedures
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 Evaluation
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 record an encounter for patients living long term in nursing homes, head over to Patient > Provider Note > Create Superbill or to Patient > Provider Note > Evaluations. Here, click ‘Add’ and search for the relevant finding.
Documentation of Patients Living Long Term in Nursing Homes
To document an outpatient encounter for advanced illness, navigate to Patient > Provider Note > Create Superbill. The outpatient encounters can include any of the following:
Outpatient
Observation
Emergency Department Visit
Nonacute Inpatient
To document an advanced illness, use the workflow: Patient > Provider Note > Diagnoses. Click ‘Add’ and search for the relevant advanced illness.
Example of Advanced Illness Diagnosis
To document an inpatient encounter for advanced illness, navigate to Patient > Provider Notes > Create Superbill or document via Patient > Provider Note > Evaluations.
Note: The advanced illness is to be diagnosed during the outpatient encounter.
To record frailty criteria, the following workflows can be used:
Frailty device ordered/ applied during the measurement period: Patient > Provider Note > Evaluations. From the ‘Status’ dropdown select ‘Ordered’ or ‘Applied’.
Frailty diagnosis during the measurement period: Patient > Provider Note > Diagnoses
Example of Frailty Diagnosis
Frailty symptoms during the measurement period: Patient > Provider Note > Diagnoses or Patient > Provider Note > Evaluations.
Example of Frailty Symptom
Frailty encounter during the measurement period: Patient > Provider Note > Create Superbill
The dementia medication can be documented using the workflow Patient > Provider Notes > Medications OR Patient > Provider Note > Prescription.
Example of Dementia Medication
To record a palliative assessment/intervention, head over to Patient > Provider Note > Evaluations.
Example of Palliative Care Assessment
To record a palliative encounter, navigate to Patient > Provider Note > Create Superbill or to Patient > Provider Note > Diagnoses. Here, a diagnosis for ‘Encounter for palliative care’.
