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Measure: CMS75

Children Who Have Dental Decay or Cavities

Measure Versions

eMeasure Code Measure Year Full Version Number Title
CMS75v12 2024 12.0.000 Children Who Have Dental Decay or Cavities
CMS75v11 2023 11 Children Who Have Dental Decay or Cavities
CMS75v10 2022 10.0.000 Children Who Have Dental Decay or Cavities
CMS75v9 2021 9.2.000 Children Who Have Dental Decay or Cavities
CMS75v8 2020 8.1.000 Children Who Have Dental Decay or Cavities
CMS75v7 2019 7.2.000 Children Who Have Dental Decay or Cavities
CMS75v6 2018 6.1.000 Children Who Have Dental Decay or Cavities
CMS75v5 2017 5.1.000 Children Who Have Dental Decay or Cavities

Description

Percentage of children, age 0-20 years, who have had tooth decay or cavities during the measurement period

Guidance

None

Patient Group Definitions

Group Description Instructions Links
Initial PopulationChildren, age 0-20 years, with a visit during the measurement periodWebchart Instructions
DenominatorEquals Initial PopulationWebchart Instructions
Denominator ExclusionsNone
NumeratorChildren who had cavities or decayed teethWebchart Instructions
Numerator ExclusionsNot applicableWebchart Instructions
Denominator ExceptionsNone

Details

Full eMeasure Code eMeasure Identifier Measure Year Version NQF # GUID
CMS75v5 75 2017 5.1.000 Not Applicable 61947125-4376-4a7b-ab7a-ac2be9bd9138
Steward Developer Endorsed By
National Committee for Quality Assurance Centers for Medicare & Medicaid Services (CMS)
Scoring Method Measure Type Stratification Risk Adjustment
Proportion OUTCOME None None

Rate Aggregation

None

Improvement Notation

A lower score indicates better quality

Rationale

Dental cavities have been identified as the most common chronic disease for children. Nationally, 19.4% of children have dental decay or cavities.

Clinical Recommendation Statement

Children who have dental decay or cavities are less likely to be in very good or excellent overall health than children without decay or cavities. Children with decay are also more likely to have other oral health problems such as toothaches, broken teeth, and bleeding gums.

Definition

None

Transmission Format

TBD

Applicable Value Sets

Category Value Set OID
Diagnosis Dental Caries 2.16.840.1.113883.3.464.1003.125.12.1004
Encounter, Performed Clinical Oral Evaluation 2.16.840.1.113883.3.464.1003.125.12.1003
Encounter, Performed Face-to-Face Interaction 2.16.840.1.113883.3.464.1003.101.12.1048
Encounter, Performed Office Visit 2.16.840.1.113883.3.464.1003.101.12.1001
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-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
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

References

Child and Adolescent Health Measurement Initiative. 2007 National Survey of Children's Health, Data Resource Center for Child Adolescent Health website. www.nschdata.org
Edelstein BL, Chinn CH. Update on disparities in oral health and access to dental care for America's children. Acad Pediatr.2009;9(6):415-419.
Milgrom P, Zero DT, Tanzer JM. An examination of the advances in science and technology of prevention of tooth decay in young children since the Surgeon General's Report on Oral Health. Acad Pediatr. 2009;9(6):404-409.

Disclaimer

These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

Copyright

Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications. 

CPT(R) contained in the Measure specifications is copyright 2004-2015 American Medical Association. LOINC(R) copyright 2004-2015 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2015 International Health Terminology Standards Development Organisation. ICD-10 copyright 2015 World Health Organization. All Rights Reserved.

Source: https://ecqi.healthit.gov/ecqm/measures/cms75v5