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Measure: CMS147

Preventive Care and Screening: Influenza Immunization

Measure Versions

eMeasure Code Measure Year Full Version Number Title
CMS147v11 2022 11.0.000 Preventive Care and Screening: Influenza Immunization
CMS147v10 2021 10.2.000 Preventive Care and Screening: Influenza Immunization
CMS147v9 2020 9.1.000 Preventive Care and Screening: Influenza Immunization
CMS147v8 2019 8.1.000 Preventive Care and Screening: Influenza Immunization
CMS147v7 2018 7.2.000 Preventive Care and Screening: Influenza Immunization
CMS147v6 2017 6.1.000 Preventive Care and Screening: Influenza Immunization

Description

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

Guidance

The timeframe for the visit during the "Encounter, Performed: Encounter-Influenza" or "Procedure, Performed: Peritoneal Dialysis" or "Procedure, Performed: Hemodialysis" in the Population Criteria-Denominator, refers to the influenza season defined by the measure: October through March (October 1 for the year prior to the start of the reporting period through March 31 during the reporting period). The "Encounter-Influenza" Grouping OID detailed in the data criteria section below is comprised of several individual OIDs of different encounter types. The individual OIDs are included in the value set and should be reviewed to determine that an applicable visit occurred during the timeframe for "Encounter, Performed: Encounter-Influenza" as specified in the denominator. To enable reporting of this measure at the close of the reporting period, this measure will only assess the influenza season that ends in March of the reporting period. The subsequent influenza season (ending March of the following year) will be measured and reported in the following year. To account for the majority of reporting years' appropriate flu season duration, the measure logic will look at the first 89 days of the measurement period for the appropriate criteria and actions to be present/performed (January 1 through March 31). The measure developer believes it is best to keep the logic as static as possible from one reporting year to the next. Therefore, during leap years, only encounters that occur through March 30 will be counted in the denominator.

Patient Group Definitions

Group Description Instructions Links
Initial PopulationAll patients aged 6 months and older seen for at least two visits or at least one preventive visit during the measurement periodWebchart Instructions
DenominatorEquals Initial Population and seen for a visit between October 1 and March 31Webchart Instructions
Denominator ExclusionsNone
NumeratorPatients who received an influenza immunization OR who reported previous receipt of an influenza immunizationWebchart Instructions
Numerator ExclusionsNot ApplicableWebchart Instructions
Denominator ExceptionsDocumentation of medical reason(s) for not receiving influenza immunization (eg, patient allergy, other medical reasons) Documentation of patient reason(s) for not receiving influenza immunization (eg, patient declined, other patient reasons) Documentation of system reason(s) for not receiving influenza immunization (eg, vaccine not available, other system reasons)Webchart Instructions

Details

Full eMeasure Code eMeasure Identifier Measure Year Version NQF # GUID
CMS147v6 147 2017 6.1.000 0041 a244aa29-7d11-4616-888a-86e376bfcc6f
Steward Developer Endorsed By
American Medical Association (AMA) PCPI(R) Foundation (PCPI[R]) National Quality Forum
Scoring Method Measure Type Stratification Risk Adjustment
Proportion PROCESS None None

Rate Aggregation

None

Improvement Notation

Higher score indicates better quality

Rationale

Annual influenza vaccination is the most effective method for preventing influenza virus infection and its complications. Influenza vaccine is recommended for all persons aged >=6 months who do not have contraindications to vaccination.

Clinical Recommendation Statement

Routine annual influenza vaccination is recommended for all persons aged >= 6 months who do not have contraindications. Optimally, vaccination should occur before onset of influenza activity in the community. Health care providers should offer vaccination by October, if possible. Vaccination should continue to be offered as long as influenza viruses are circulating. (CDC/ACIP, 2015)

Definition

Previous Receipt - receipt of the current season's influenza immunization from another provider OR from same provider prior to the visit to which the measure is applied (typically, prior vaccination would include influenza vaccine given since August 1st)

Transmission Format

TBD

Applicable Value Sets

Category Value Set OID
Communication: From Patient to Provider Influenza Vaccination Declined 2.16.840.1.113883.3.526.3.1255
Communication: From Patient to Provider Previous Receipt of Influenza Vaccine 2.16.840.1.113883.3.526.3.1185
Diagnosis Allergy to Eggs 2.16.840.1.113883.3.526.3.1253
Diagnosis Allergy to Influenza Vaccine 2.16.840.1.113883.3.526.3.1256
Diagnosis Intolerance to Influenza Vaccine 2.16.840.1.113883.3.526.3.1257
Encounter, Performed Annual Wellness Visit 2.16.840.1.113883.3.526.3.1240
Encounter, Performed Care Services in Long-Term Residential Facility 2.16.840.1.113883.3.464.1003.101.12.1014
Encounter, Performed Discharge Services - Nursing Facility 2.16.840.1.113883.3.464.1003.101.12.1013
Encounter, Performed Encounter-Influenza 2.16.840.1.113883.3.526.3.1252
Encounter, Performed Face-to-Face Interaction 2.16.840.1.113883.3.464.1003.101.12.1048
Encounter, Performed Home Healthcare Services 2.16.840.1.113883.3.464.1003.101.12.1016
Encounter, Performed Nursing Facility Visit 2.16.840.1.113883.3.464.1003.101.12.1012
Encounter, Performed Office Visit 2.16.840.1.113883.3.464.1003.101.12.1001
Encounter, Performed Outpatient Consultation 2.16.840.1.113883.3.464.1003.101.12.1008
Encounter, Performed Patient Provider Interaction 2.16.840.1.113883.3.526.3.1012
Encounter, Performed Preventive Care - Established Office Visit, 0 to 17 2.16.840.1.113883.3.464.1003.101.12.1024
Encounter, Performed Preventive Care Services - Established Office Visit, 18 and Up 2.16.840.1.113883.3.464.1003.101.12.1025
Encounter, Performed Preventive Care Services - Group Counseling 2.16.840.1.113883.3.464.1003.101.12.1027
Encounter, Performed Preventive Care Services - Other 2.16.840.1.113883.3.464.1003.101.12.1030
Encounter, Performed Preventive Care Services-Individual Counseling 2.16.840.1.113883.3.464.1003.101.12.1026
Encounter, Performed Preventive Care Services-Initial Office Visit, 18 and Up 2.16.840.1.113883.3.464.1003.101.12.1023
Encounter, Performed Preventive Care- Initial Office Visit, 0 to 17 2.16.840.1.113883.3.464.1003.101.12.1022
Immunization, Administered Medical Reason 2.16.840.1.113883.3.526.3.1007
Immunization, Administered Patient Reason 2.16.840.1.113883.3.526.3.1008
Immunization, Administered System Reason 2.16.840.1.113883.3.526.3.1009
Immunization, Allergy Influenza Vaccine 2.16.840.1.113883.3.526.3.1254
Immunization, Intolerance Influenza Vaccine 2.16.840.1.113883.3.526.3.1254
Patient Characteristic Ethnicity Ethnicity 2.16.840.1.114222.4.11.837
Patient Characteristic Payer Payer 2.16.840.1.114222.4.11.3591
Patient Characteristic Race Race 2.16.840.1.114222.4.11.836
Patient Characteristic Sex ONC Administrative Sex 2.16.840.1.113762.1.4.1
Procedure, Intolerance Influenza Vaccination 2.16.840.1.113883.3.526.3.402
Procedure, Performed Hemodialysis 2.16.840.1.113883.3.526.3.1083
Procedure, Performed Influenza Vaccination 2.16.840.1.113883.3.526.3.402
Procedure, Performed Medical Reason 2.16.840.1.113883.3.526.3.1007
Procedure, Performed Patient Reason 2.16.840.1.113883.3.526.3.1008
Procedure, Performed Peritoneal Dialysis 2.16.840.1.113883.3.526.3.1084
Procedure, Performed System Reason 2.16.840.1.113883.3.526.3.1009

References

Grohskopf LA, Sokolow LZ, Olsen SJ, et al. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015-16 Influenza Season. MMWR Morb Mortal Wkly Rep 2015; 64:818. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm. Accessed November 9, 2015.

Disclaimer

The Measures are not clinical guidelines, do not establish a standard of medical care, and have not been tested for all potential applications. The Measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, eg, use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the Measures require a license agreement between the user and the PCPI(R) Foundation (PCPI[R]) or the American Medical Association (AMA). Neither the American Medical Association (AMA), nor the AMA-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI), now known as the PCPI, nor their members shall be responsible for any use of the Measures. AMA and PCPI encourage use of the Measures by other health care professionals, where appropriate. THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Limited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The AMA, the PCPI and its members and former members of the AMA-PCPI disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT[R]) or other coding contained in the specifications. CPT(R) contained in the Measure specifications is copyright 2004-2015 American Medical Association. LOINC(R) is copyright 2004-2015 Regenstrief Institute, Inc. This material contains SNOMED CLINICAL TERMS (SNOMED CT[R]) copyright 2004-2015 International Health Terminology Standards Development Organisation (IHTSDO). ICD-10 is copyright 2015 World Health Organization. All Rights Reserved. Due to technical limitations, registered trademarks are indicated by (R) or [R].

Copyright

Copyright 2015 PCPI(R) Foundation and American Medical Association.  All Rights Reserved.

Source: https://ecqi.healthit.gov/ecqm/measures/cms147v6