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  2. CQM-6433

Issue with smoking cessation quality measure

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    • Resolution: Answered
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    • Danielle Gainor
    • 517-332-0100
    • MidMichigan ENT
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      Thank you for your feedback. The following response was provided with the assumption that this feedback was directed towards CMS138v12 (Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention) and not CMS122v12 (Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)). The measure Numerator 2 and Numerator 3 require tobacco cessation intervention if the patient is screened for tobacco use and identified as a tobacco user. The measure includes tobacco use cessation counseling codes that may include referral to tobacco cessation-related services or providers, education about the benefits of stopping tobacco use, education about the negative side effects of using tobacco, and monitoring for tobacco cessation; as long as any of these interventions were provided/documented using any codes from the value set "Tobacco Use Cessation Counseling" (2.16.840.1.113883.3.526.3.509), the measure requirements can be met. The current measure does not include patient reasons for not completing the tobacco screening or interventions as they do not meet the clinical intent of the measure, but we will consider this feedback for a future version of the measure.
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      Thank you for your feedback. The following response was provided with the assumption that this feedback was directed towards CMS138v12 (Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention) and not CMS122v12 (Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%)). The measure Numerator 2 and Numerator 3 require tobacco cessation intervention if the patient is screened for tobacco use and identified as a tobacco user. The measure includes tobacco use cessation counseling codes that may include referral to tobacco cessation-related services or providers, education about the benefits of stopping tobacco use, education about the negative side effects of using tobacco, and monitoring for tobacco cessation; as long as any of these interventions were provided/documented using any codes from the value set "Tobacco Use Cessation Counseling" (2.16.840.1.113883.3.526.3.509), the measure requirements can be met. The current measure does not include patient reasons for not completing the tobacco screening or interventions as they do not meet the clinical intent of the measure, but we will consider this feedback for a future version of the measure.
    • CMS0122v12, CMS0138v12
    • CMS0122v11
    • Many patients are refusing counseling, causing impacts on measure performance.

      We are having many patients getting frustrated with smoking cessation counseling. They are receiving this from providers at multiple primary and specialty offices repeatedly and are downright refusing the counseling. It is not improving quality of care and it is leading to delays in patient intake when our staff is getting berated by patients for offering counseling or bringing up the question of counseling. We document in the note when patients are refusing the smoking cessation counseling but we are being told that this alone is not adequate and we will get dinged as though this patient was not screened and counseled. What do you propose is a fair way to resolve this issue without penalizing practices for trying to complete the measure for which patients are refusing (and any measure for that matter)?

            edave Mathematica EC eCQM Team
            Gainor848 Danielle Gainor (Inactive)
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