Smoking Cessation and Vaping Nicotine

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
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      Thank you for your inquiry about CMS138v13 (2025 performance period). This measure identifies a tobacco screening using the QDM datatype "Assessment, Performed" along with the value set "Tobacco Use Screening", and identifies a result using the QDM attribute "result". The "result" attribute must be identified as either "Tobacco Non-User" or "Tobacco User".

      The USPSTF references the US Food and Drug Administration definition of tobacco, which includes e-cigarettes, hookah pens and other electronic nicotine delivery systems. E-cigarettes and/or Vaping products usually contain nicotine, which is the addictive ingredient in tobacco. However, E-cigarettes and vaping products are not always classified as "smokeless tobacco" since substances other than tobacco can also be used in these products.

      This measure does not include use of non nicotine, non tobacco substances. Tobacco screenings must be completed within the required timeframe and documented using the appropriate codes noted above. Only screenings that clearly document a result that maps to “Tobacco User” or "Tobacco Non-User" will meet the definitions below. We are unable to provide guidance on how these events should be documented in the EHR. We recommend consulting your EHR vendor and clinical partners for documentation practices.

      Most Recent Tobacco Use Screening Indicates Tobacco Non User
        ( Last(["Assessment, Performed": "Tobacco Use Screening"] TobaccoUseScreening
            where Global."NormalizeInterval"(TobaccoUseScreening.relevantDatetime, TobaccoUseScreening.relevantPeriod) during day of "Measurement Period"
            sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
        ) ) MostRecentTobaccoUseScreening
          where MostRecentTobaccoUseScreening.result in "Tobacco Non User"

      Most Recent Tobacco Use Screening Indicates Tobacco User
        ( Last(["Assessment, Performed": "Tobacco Use Screening"] TobaccoUseScreening
            where Global."NormalizeInterval"(TobaccoUseScreening.relevantDatetime, TobaccoUseScreening.relevantPeriod) during day of "Measurement Period"
            sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)
        ) ) MostRecentTobaccoUseScreening
          where MostRecentTobaccoUseScreening.result in "Tobacco User"

      You may review the measure specification for further details about measure requirements: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS138v13.html. If you have questions about understanding measure requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. If you have questions regarding implementing the measure, you may refer to the "Implementation Checklist for eCQM Annual Update" for additional guidance. These resources can be found in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs. For further questions regarding CMS quality program reporting requirements, you may submit questions to the QPP helpdesk at QPP@cms.hhs.gov.
      Show
      Thank you for your inquiry about CMS138v13 (2025 performance period). This measure identifies a tobacco screening using the QDM datatype "Assessment, Performed" along with the value set "Tobacco Use Screening", and identifies a result using the QDM attribute "result". The "result" attribute must be identified as either "Tobacco Non-User" or "Tobacco User". The USPSTF references the US Food and Drug Administration definition of tobacco, which includes e-cigarettes, hookah pens and other electronic nicotine delivery systems. E-cigarettes and/or Vaping products usually contain nicotine, which is the addictive ingredient in tobacco. However, E-cigarettes and vaping products are not always classified as "smokeless tobacco" since substances other than tobacco can also be used in these products. This measure does not include use of non nicotine, non tobacco substances. Tobacco screenings must be completed within the required timeframe and documented using the appropriate codes noted above. Only screenings that clearly document a result that maps to “Tobacco User” or "Tobacco Non-User" will meet the definitions below. We are unable to provide guidance on how these events should be documented in the EHR. We recommend consulting your EHR vendor and clinical partners for documentation practices. Most Recent Tobacco Use Screening Indicates Tobacco Non User   ( Last(["Assessment, Performed": "Tobacco Use Screening"] TobaccoUseScreening       where Global."NormalizeInterval"(TobaccoUseScreening.relevantDatetime, TobaccoUseScreening.relevantPeriod) during day of "Measurement Period"       sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)   ) ) MostRecentTobaccoUseScreening     where MostRecentTobaccoUseScreening.result in "Tobacco Non User" Most Recent Tobacco Use Screening Indicates Tobacco User   ( Last(["Assessment, Performed": "Tobacco Use Screening"] TobaccoUseScreening       where Global."NormalizeInterval"(TobaccoUseScreening.relevantDatetime, TobaccoUseScreening.relevantPeriod) during day of "Measurement Period"       sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)   ) ) MostRecentTobaccoUseScreening     where MostRecentTobaccoUseScreening.result in "Tobacco User" You may review the measure specification for further details about measure requirements: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS138v13.html . If you have questions about understanding measure requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. If you have questions regarding implementing the measure, you may refer to the "Implementation Checklist for eCQM Annual Update" for additional guidance. These resources can be found in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs . For further questions regarding CMS quality program reporting requirements, you may submit questions to the QPP helpdesk at QPP@cms.hhs.gov .
    • CMS0138v14
    • Patients who report to be using vape products which may contain nicotine

      We are seeking clarification regarding Measure #138 – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention.

      Specifically, we would like guidance on how patients who report vaping or e-cigarette use should be handled within the measure specifications.

      If a patient reports current use of vaping products that may contain nicotine:

      1. Should these patients be considered “tobacco users” for purposes of denominator inclusion requiring cessation intervention?
      2. Does CMS interpret nicotine-containing electronic cigarettes as qualifying tobacco use under Measure 138 specifications?
      3. If documentation does not explicitly confirm nicotine content, how should these cases be treated for reporting compliance?

      We want to ensure our documentation and performance reporting align precisely with CMS technical specifications.

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Summer Hall
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              Updated:
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