Measure: CMS135

Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

Measure Versions

eMeasure Code	Measure Year	Full Version Number	Title
CMS135v12	2024	12.1.000	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS135v11	2023	11	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS135v10	2022	10.1.000	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS135v9	2021	9.2.000	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS135v8	2020	8.2.000	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) or Angiotensin Receptor-Neprilysin Inhibitor (ARNI) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS135v7	2019	7.1.000	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS135v6	2018	6.0.000	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
CMS135v5	2017	5.2.000	Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)

Description

Percentage of patients aged 18 years and older with a diagnosis of heart failure (HF) with a current or prior left ventricular ejection fraction (LVEF) ? 40% who were prescribed ACE inhibitor or ARB or ARNI therapy either within a 12-month period when seen in the outpatient setting OR at each hospital discharge.

Guidance

Patient Group Definitions

Group	Description	Instructions Links
Initial Population	All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure	Webchart Instructions
Denominator	Equals Initial Population with a current or prior LVEF <= 40%	Webchart Instructions
Denominator Exclusions	Patients with a history of heart transplant or with a Left Ventricular Assist Device (LVAD) prior to the end of the outpatient encounter with Moderate or Severe LVSD	Webchart Instructions
Numerator	Patients who were prescribed or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period	Webchart Instructions
Numerator Exclusions	Not Applicable	Webchart Instructions
Denominator Exceptions	Documentation of medical reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., pregnancy, renal failure due to ACEI, allergy, intolerance, other medical reasons). Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g., patient declined, other patient reasons).	Webchart Instructions

Details

Full eMeasure Code	eMeasure Identifier	Measure Year	Version	NQF #	GUID
CMS135v11	135	2023	11	0081	430ffc53-4122-4421-88cc-2edd8117bb3c

Steward	Developer	Endorsed By
American Heart Association	American Medical Association (AMA)	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

Clinical Recommendation Statement

Definition

Transmission Format

Applicable Value Sets

Category	Value Set	OID
Allergy/Intolerance	ACE Inhibitor or ARB Ingredient	2.16.840.1.113883.3.526.3.1489
Diagnosis	Allergy to ACE Inhibitor or ARB	2.16.840.1.113883.3.526.3.1211
Diagnosis	Heart Failure	2.16.840.1.113883.3.526.3.376
Diagnosis	Heart Transplant Related Diagnoses	2.16.840.1.113762.1.4.1178.56
Diagnosis	Intolerance to ACE Inhibitor or ARB	2.16.840.1.113883.3.526.3.1212
Diagnosis	Left Ventricular Assist Device Related Diagnoses	2.16.840.1.113762.1.4.1178.58
Diagnosis	Moderate or Severe LVSD	2.16.840.1.113883.3.526.3.1090
Diagnosis	Pregnancy	2.16.840.1.113883.3.526.3.378
Diagnostic Study, Performed	Ejection Fraction	2.16.840.1.113883.3.526.3.1134
Encounter, Performed	Care Services in Long-Term Residential Facility	2.16.840.1.113883.3.464.1003.101.12.1014
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
Medication, Active	ACE Inhibitor or ARB	2.16.840.1.113883.3.526.3.1139
Medication, Not Ordered	ACE Inhibitor or ARB	2.16.840.1.113883.3.526.3.1139
Medication, Order	ACE Inhibitor or ARB	2.16.840.1.113883.3.526.3.1139
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, Performed	Heart Transplant	2.16.840.1.113762.1.4.1178.33
Procedure, Performed	Left Ventricular Assist Device Placement	2.16.840.1.113762.1.4.1178.61