| Confirm Diagnosis of Chronic Conditions
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Instruction: Determine if the patient has documentation of at
least one of the specified chronic conditions.
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Click here for list of chronic conditions.
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None |
| [PCCONFIRMED] |
Yes (1): Select this option if
the patient has documentation of at least one of the specified chronic conditions
anywhere in the office/clinic record.
No/No reason documented (0): Select this option
if the patient has no documentation of at least one of the specified chronic conditions
anywhere in the office/clinic record.
If “No” – STOP ABSTRACTION
Medical record not found (2):
Select this option if you are unable to find the patient’s medical record.
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| Office/Clinic Visit Date |
THIS ELEMENT IS SYNCHRONIZED WITH THE OFFICE/CLINIC VISIT DATE
ELEMENT IN HF |
None |
None |
| [HFPCVISITDATE] |
Instruction: Enter the date of each visit to the office/clinic
in MM/DD/YYYY format during the measurement period.
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| [HFPCINVALID] |
Instruction: Determine if the pre–populated visit date is invalid.
Yes (1): Select this option if the pre–populated
visit date is invalid and indicate the reason why.
No (0): Select this option if the pre–populated
visit is not invalid.
NOTE: This element defaults to No. |
| Blood Pressure Measurement
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Instruction: Determine if the patient’s BP was recorded
at every office/clinic visit during the measurement period.
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None |
None |
| [PCBPMEASURE] |
Yes (1): Select this option if
the patient’s BP measurement was recorded at this office/clinic visit.
No/No reason documented (0): Select this option
if the patient’s BP measurement was not recorded at this office/clinic visit.
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| Breast Cancer Screening |
Instruction: Determine if a mammogram was performed during the
measurement period or year prior to the measurement period.
Note: The default setting for this element is
Claim Not Found.
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Breast imaging, breast x–ray, breast cancer screening, diagnostic
mammography, digital mammography, mammogram, screening mammography |
None |
| [PCMAMMOGRAM] |
Yes (1): Select this option if
a mammogram was performed during the measurement period or year prior to the measurement
period.
Note: Documentation in the medical record must include both of
the following:
- A note indicating the date the mammogram was performed
- AND
- The result of the finding
(Note: If there is evidence of two separate mastectomies, this
patient may be excluded from the measure. The bilateral mastectomy must have occurred
by the end of the measurement period.)
No/No reason documented (0): Select this option
if a mammogram was not performed during the measurement period or year prior to
the measurement period.
Not performed for medical reasons (3): Select this
option if there was any documentation the patient had a bilateral mastectomy.
Claim Not Found (2):
Select this option if you are not abstracting records for claims–based measures.
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| Colorectal Cancer Screening
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Instruction: Determine if colorectal cancer screening is current
during the measurement period.
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Colorectal cancer screening: documentation
colorectal screening is “up–to–date” or “current”
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None |
| [PCFOBTPERFORM]
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Yes (1): Select this
option if colorectal cancer screening is current.
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Note: Current colorectal cancer
screening is defined as performing any of the following:
- Fecal occult blood test (FOBT) annually
- Flexible sigmoidoscopy every five years
- Annual FOBT plus flexible sigmoidoscopy every five years
- Double–contrast barium enema every five years
- Colonoscopy every ten years
No/No reason documented (0): Select this option
if colorectal cancer screening is not current. |
FOBT: ColoCARE, Coloscreen, EZ Detect, Fecal
occult blood test, flushable reagent pads, flushable reagent stool blood test, guiac
smear test, Hemoccult, Seracult, stool occult blood test |
Not current for medical reasons (3):
Select this option if the screening is not current due to medical reasons.
Not current for patient reasons (4): Select this
option if the screening is not current due to patient reasons.
Not current for system reasons (5): Select this
option if the screening is not current due to system reasons. |
Not screened for medical reasons (3) may include: total
colectomy, terminal illness, other reason documented by practitioner for not performing
colorectal cancer screening |
| Influenza Immunization |
Instruction: Determine if the patient received an influenza immunization
from September through February of the measurement period.
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None |
| [PCFLUSHOT] |
Yes (1): Select this
option if the patient received an influenza immunization during the influenza season.
No/No reason documented (0): Select this option
if the patient did not receive an influenza immunization during the influenza season.
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Not received for medical reasons (3):
Select this option if the patient did not receive an influenza immunization for
medical reasons.
Not received for patient reasons (4): Select this
option if the patient did not receive an influenza immunization for patient reasons.
Not received for system reasons (5): Select this
option if the patient did not receive an influenza immunization for system reasons.
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Not received for medical reasons (3) may include: egg allergy,
adverse reaction to influenza vaccine, other reason documented by practitioner for
not receiving an influenza immunization |
| Pneumonia Vaccination |
Instruction: Determine if the patient has
ever received a pneumonia vaccination.
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|
None |
| [PCPNEUMOSHOT]
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Yes (1): Select this
option if the patient has ever received a pneumonia
vaccination.
No/No reason documented (0): Select this option
if the patient has never received a pneumonia vaccination.
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Not received for medical reasons (3):
Select this option if the patient has never received
a pneumonia vaccination for medical reasons.
Not received for patient reasons (4): Select this
option if the patient has never received a pneumonia
vaccination for patient reasons. |
Not received for medical reasons (3) may include: anaphylactic
reaction, other medical reason(s) documented by practitioner for not receiving pneumococcal
vaccination |
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