Measure: CMS147
Preventive Care and Screening: Influenza Immunization
Measure Versions
eMeasure Code |
Measure Year |
Full Version Number |
Title |
CMS147v12 |
2023 |
12 |
Preventive Care and Screening: Influenza Immunization |
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.
As a result of updated CDC/ACIP guidelines which include the interim recommendation that live attenuated influenza vaccine (LAIV) should not be used due to low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013-14 and 2015-16 seasons, the measure specifications have been updated and no longer include LAIV or intranasal flu vaccine as an option for numerator eligibility.
Patient Group Definitions
Group |
Description |
Instructions Links |
Initial Population | All patients aged 6 months and older seen for a visit during the measurement period | Webchart Instructions |
Denominator | Equals Initial Population and seen for a visit between October 1 and March 31 | Webchart Instructions |
Denominator Exclusions | None | |
Numerator | Patients who received an influenza immunization OR who reported previous receipt of an influenza immunization | Webchart Instructions |
Numerator Exclusions | Not Applicable | Webchart Instructions |
Denominator Exceptions | Documentation 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 |
CMS147v7 |
147 |
2018 |
7.2.000 |
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
Influenza vaccination is the most effective protection against influenza virus infection (CDC, 2016). Influenza may lead to serious complications including hospitalization or death (CDC, 2016). Influenza vaccine is recommended for all persons aged >=6 months who do not have contraindications to vaccination. However, data indicate that less than half of all eligible individuals receive an influenza vaccination (CDC, 2015). This measure promotes annual influenza vaccination for all persons aged >= 6 months.
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/Advisory Committee on Immunization Practices (ACIP), 2016)
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 |
Substance, Allergy |
Egg Substance |
2.16.840.1.113883.3.526.3.1537 |
References
Seasonal Influenza: Flu Basics. Centers for Disease Control and Prevention Web site.
http://www.cdc.gov/flu/about/disease/index.htm. Updated May 4, 2016. Accessed June 23, 2016.
Flu vaccination coverage: United States, 2014-15 Influenza Season. Centers for Disease Control and Prevention Web site.
http://www.cdc.gov/flu/fluvaxview/coverage-1415estimates.htm. Updated September 17, 2015. Accessed June 23, 2016.
Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and Control of Seasonal Influenza with Vaccines. MMWR Recomm Rep 2016;65(No. RR-5):1-54. DOI: http://dx.doi.org/10.15585/mmwr.rr6505a
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), nor 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 2004-2016 American Medical Association. LOINC(R) is copyright 2004-2016 Regenstrief Institute, Inc. This material contains SNOMED CLINICAL TERMS (SNOMED CT[R]) copyright 2004-2016 International Health Terminology Standards Development Organisation (IHTSDO). ICD-10 is copyright 2016 World Health Organization. All Rights Reserved.
Due to technical limitations, registered trademarks are indicated by (R) or [R].
Copyright
Copyright 2017 PCPI(R) Foundation and American Medical Association. All Rights Reserved.
Source:
https://ecqi.healthit.gov/ecqm/measures/cms147v7