CMS145v13: Coronary Artery Disease (CAD): Beta-Blocker Therapy-Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <= 40%)

Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease seen within a 12 month period who also have a prior MI or a current or prior LVEF <= 40% who were prescribed beta-blocker therapy. There are two performance rates and clinicians can choose to report on one or the other.

  1. Percentage of patients with a diagnosis of CAD or history of cardiac surgery who have a current or prior LVEF <= 40% who were prescribed beta-blocker therapy
  2. Percentage of patients with a diagnosis of CAD or history of cardiac surgery who have a prior (within the past 3 years) myocardial infarction who were prescribed beta-blocker therapy

Numerator #1 & #2

Patients who were prescribed beta-blocker therapy. This can be completed in two ways:

  • Script Writer: Provider prescribes beta-blocker therapy through the Amazing Charts Script Writer
  • Current Medications: The patient has a beta-blocker therapy medication listed in their current meds list.
    • Note: The provider does not have to be the prescribing provider to get credit. 

Denominator #1

Patients ages 18 and up will be added to the denominator if they meet all the following criteria:

  • Two encounters during the measurement period (One of these encounters will be used to evaluate the numerator.)
  • Has Left Ventricular Ejection Fraction (LVEF) equal to or under 40%, recorded in the Review of Systems, Physical Exam, or Assessment. Any of the following phrases will qualify
    • 'LVEF = 40' or 'LVEF 40' (or any other number between 0 and 40)
    • 'EF = 40' or 'EF 40' (or any other number between 0 and 40)
    • 'Ejection Fraction = 40' or 'Ejection Fraction 40' (or any other number between 0 and 40)
    • 'Left Ventricular Ejection Fraction = 40' or 'Left Ventricular Ejection Fraction 40' (or any other number between 0 and 40)
    • 'Left Ventricular Ejection Fraction <= 40' or 'LVEF <= 40' or 'EF <= 40' or 'Ejection Fraction <= 40'
  • Diagnosis or Surgery: The patient must meet one of the criteria below (diagnosis or procedure) for this criteria to be counted: 
    • Coronary Artery Disease recorded during one of the encounters used to qualify for the denominator (which will be the same encounter used to calculate the numerator): using an appropriate diagnosis code.
    • History of Cardiac Surgery identified with an appropriate CPT assigned to the encounter.
    • History of Cardiac Surgery identified by text in the Past Medical History field of a patient encounter. The text can contain any of the following phrases:
      • Coronary artery bypass graft
      • CABG
      • PTCA
    • History of Cardiac Surgery identified by an appropriate diagnosis assigned to the patients problem list

Denominator #2

Patients ages 18 and up will be added to the denominator if they meet all the criteria: #1, #2 and one of the items from #3

  1. Two encounters during the measurement period identified by an appropriate CPT codes: .(One of these encounters will be used to evaluate the numerator.)
  2. Diagnosis of myocardial infarction (within the last 3 years) using an appropriate diagnosis code
  3. Diagnosis or Surgery: The patient meets at least one of the criteria below:
    • Coronary Artery Disease recorded during one of the encounters used to qualify for the denominator (which will be the same encounter used to calculate the numerator), using an appropriate ICD-10 code
    • History of Cardiac Surgery identified with an appropriate CPT in a superbill
    • History of Cardiac Surgery identified by text in the Past Medical History field of a patient encounter. The text can contain any of the following phrases:
      • Coronary artery bypass graft
      • CABG
      • PTCA
    • History of Cardiac Surgery identified by an appropriate diagnosis assigned to the patients problem list

Denominator Exceptions

Documentation of medical reason(s) for not prescribing beta-blocker therapy (e.g., arrhythmia, asthma, bradycardia, hypotension, patients with atrioventricular block without cardiac pacer, observation of consecutive heart rates < 50, allergy, intolerance, other medical reasons):

  • DX of Arrhythmia, Hypotension, Asthma, or Bradycardia in patient's problem list
  • allergy to beta blockers listed in the allergy section of the chart.
  • Free Text in the Plan or Assessment either:
    • "Patient not prescribed beta blocker"
    • "intolerance to beta blocker"
  • Documentation of patient reason(s) for not prescribing beta-blocker therapy: Free Text "Patient Declines Beta Blocker" in Assessment or Plan