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CMS 135 - Heart Failure: Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic

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Updated: 05/20/2024 | Views: 1114

CMS 135 / Quality ID# 005

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 or already taking ACE inhibitor or ARB or ARNI therapy during the measurement period.

Denominator:  All patients aged 18 years and older with two qualifying encounters during the measurement period with a diagnosis of heart failure and a LVEF <= 40%.
  • Patient’s age is calculated based on the patient’s Date of Birth, which is entered when you created the patient’s account.
  • Create a note detailing the patient’s office visit.
  • The diagnosis of "Heart Failure" is entered in the patient’s Problems with a Start Date.
  • LVEF results are manually entered in Labs/Studies.
Denominator Exclusion: 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.
  • "History of Heart Transplant" is documented under Problems.
  • "Left Ventricular Assist Device (LVAD)" is documented under Problems.
  • "Moderate or Severe LVSD" is documented under Problems.
Numerator: Patients who were prescribed or already taking ACE inhibitor or ARB therapy during the measurement period.
  • Angiotensin Converting Enzyme (ACE) inhibitor or Angiotensin Receptor Blocker (ARB) therapy are either prescribed at the time of the visit in Medications.
Denominator Exceptions:
  1.  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)
  2. Documentation of patient reason(s) for not prescribing ACE inhibitor or ARB or ARNI therapy (e.g. patient declined, other patient reason)
  • If "Pregnancy", "Renal Failure", "Allergy to ACE Inhibitor", and/or "Allergy to ARB ingredients" are documented in Problems, each with a Start Date. These patients will be excluded from the numerator.
  • If "Allergy to ACE Inhibitor" and/or "Allergy to ARB ingredients" are documented in Allergies, each with a Start Date. These patients will be excluded from the numerator.
  • If there was a Medical or Patient reason for not prescribing ACE inhibitor or ARB therapy, add the medication as Not Administered and select a reason (Medical Contraindication or Refusal of Treatment by Patient) for non administration.
Office Visit Documentation:
Measure type: Process
High Priority Measure: No
Telehealth Eligible: Yes