226. Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Percentage of patients aged 12 years and older who were screened for tobacco use one or more times within the measurement period AND who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period if identified as a tobacco user.

This measure is to be submitted a minimum of once per performance period for patients seen during the performance period. This measure is intended to reflect the quality of services provided for preventive screening for tobacco use. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who provided the measure-specific denominator coding.

There are three performance criteria for this measure:

  • Criterion 1. Percentage of patients aged 12 years and older who were screened for tobacco use one or more times within the measurement period
  • Criterion 2. Percentage of patients aged 12 years and older who were identified as a tobacco user during the measurement period who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period
  • Criterion 3. Percentage of patients aged 12 years and older who were screened for tobacco use one or more times within the measurement period AND who received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period

The denominator of submission criterion 2 is a subset of the resulting numerator for submission criterion 1, as submission criterion 2 is limited to assessing if patients identified as tobacco users received an appropriate tobacco cessation intervention. For all patients, submission criteria 1 and 3 are applicable, but submission criterion 2 will only be applicable for those patients who are identified as tobacco users. Therefore, data for every patient that meets the age and encounter requirements will only be submitted for submission criteria 1 and 3, whereas data submitted for submission criterion 2 will be for a subset of patients who meet the age and encounter requirements, as the denominator has been further limited to those who were identified as tobacco users.

Screen the patient for tobacco use:

  1. Open the Clipboard.
    1. Open the Patient Chart.
    2. Tap the More action bar icon and select Clipboard.
  2. Tap Edit.
  3. Tap Social History.
  4. Select a Smoking Status.

    If the status is former smoker or nonsmoker, the measure is met; otherwise, compete the following steps.

  5. Tap Mark Reviewed.
  6. Open the Ocular Exam.
  7. Select a tobacco use disorder Diagnosis.
  8. Select a counseling Plan.
  9. Select the Smoking Cessation Counseling section check box.

  10. Tap Done.
  11. Document the rest of the exam and Finalize.

Alternatively, code quality with a special plan:

  1. Open the Ocular Exam.
  2. Select a Diagnosis and Plan.
  3. Tap Special Plans and select MIPS.
  4. From Popular Plans, select MIPS Quality.
  5. Tap the More tab.
  6. Select TOB.
  7. Select the appropriate procedure from the Quality 226 drop-down.
  8. Tap Done.
  9. Document the rest of the exam and Finalize.
  • Claims
  • Registry
  • AAO IRIS

This topic describes how points are calculated for this measure. To learn more about scoring, go to Scoring.

Benchmarks are displayed here as both a chart and a table. The chart gives you a visual representation and helps you quickly compare benchmarks across different reporting methods. The table lists the specific benchmark criteria for each available reporting method.

 

Submission Method 3rd Decile 4th Decile 5th Decile 6th Decile 7th Decile 8th Decile 9th Decile 10th Decile
Claims 95.94– 99.99 — — — — — — 100
Registry 39.13– 61.53 61.54– 78.59 78.60– 89.28 89.29– 97.09 97.10– 99.99 — — 100
AAO IRIS 39.13– 61.53 61.54– 78.59 78.60– 89.28 89.29– 97.09 97.10– 99.99 — — 100

Patients aged 12 years or older;

AND

Who had at least two visits during the measurement period:

90791, 90792, 90832, 90834, 90837, 90845, 92002, 92004, 92012, 92014, 92521, 92522, 92523, 92524, 92540, 92557, 92622, 92625, 96156, 96158, 97161, 97162, 97163, 97165, 97166, 97167, 97168, 97802, 97803, 97804, 98980, 99024, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99421, 99422, 99423, 99457, G0270, G0271, G2250, G2251, G2252

OR who had at least one preventive visits during the measurement period:

99384*, 99385*, 99386*, 99387*, 99394*, 99395*, 99396*, 99397*, 99401*, 99402*, 99403*, 99404*, 99411*, 99412*, 99429*, G0438, G0439

The claims-based reporting method requires only one visit during the measurement period.

CPT codes listed with an asterisk (*) are noncovered services under the Physician Fee Schedule and will not be counted toward the denominator in claims-based reporting.

Denominator Exclusions

Hospice services provided to patient any time during the measurement period

M1159

Patients who were screened for tobacco use at least once within 24 months;

AND who received tobacco cessation intervention if identified as a tobacco user.

Performance Met

Patient screened for tobacco use AND identified as a tobacco user:

G9902

OR

Patient screened for tobacco use AND identified as a tobacco nonuser:

G9903

Performance Not Met

Patient not screened for tobacco use, reason not given:

G9905

To satisfy the intent of this measure, a patient must have at least one tobacco use screening during the measurement period. If a patient has multiple tobacco use screenings during the measurement period, only the most recent screening, which has a documented status of tobacco user or tobacco nonuser, will be used to satisfy the measure requirements.

In the event that a patient is screened for tobacco use and tobacco status is unknown, submit G9905.

Patients aged 12 years or older;

AND identified as a tobacco User in Numerator 1:

G9902

AND

Who had at least two visits during the measurement period:

90791, 90792, 90832, 90834, 90837, 90845, 92002, 92004, 92012, 92014, 92521, 92522, 92523, 92524, 92540, 92557, 92622, 92625, 96156, 96158, 97161, 97162, 97163, 97165, 97166, 97167, 97168, 97802, 97803, 97804, 98980, 99024, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99421, 99422, 99423, 99457, G0270, G0271, G2250, G2251, G2252

OR who had at least one preventive visits during the measurement period:

99384*, 99385*, 99386*, 99387*, 99394*, 99395*, 99396*, 99397*, 99401*, 99402*, 99403*, 99404*, 99411*, 99412*, 99429*, G0438, G0439

The claims-based reporting method requires only one visit.

CPT codes listed with an asterisk (*) are noncovered services under the Physician Fee Schedule and will not be counted toward the denominator in claims-based reporting.

Denominator Exclusions

Hospice services provided to patient any time during the measurement period

M1159

Patients identified as a tobacco users who received tobacco cessation intervention.

Performance Met

Patient identified as a tobacco user received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period(counseling and/or pharmacotherapy)

G9906

Performance Not Met

Patient identified as tobacco user did not receive tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling and/or pharmacotherapy)

G9908

Patients aged 12 years or older;

AND

Who had at least two visits during the measurement period:

90791, 90792, 90832, 90834, 90837, 90845, 92002, 92004, 92012, 92014, 92521, 92522, 92523, 92524, 92540, 92557, 92622, 92625, 96156, 96158, 97161, 97162, 97163, 97165, 97166, 97167, 97168, 97802, 97803, 97804, 98980, 99024, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99344, 99345, 99347, 99348, 99349, 99350, 99421, 99422, 99423, 99457, G0270, G0271, G2250, G2251, G2252

OR who had at least one preventive visits during the measurement period:

99384*, 99385*, 99386*, 99387*, 99394*, 99395*, 99396*, 99397*, 99401*, 99402*, 99403*, 99404*, 99411*, 99412*, 99429*, G0438, G0439

The claims-based reporting method requires only one visit.

CPT codes listed with an asterisk (*) are noncovered services under the Physician Fee Schedule and will not be counted toward the denominator in claims-based reporting.

Denominator Exclusions

Hospice services provided to patient any time during the measurement period

M1159

Patients who were screened for tobacco use at least once within 12 months;

AND who received tobacco cessation intervention if identified as a tobacco user.

Performance Met

Patient screened for tobacco use AND received tobacco cessation intervention during the measurement period or in the six months prior to the measurement period (counseling, pharmacotherapy, or both), if identified as a tobacco user:

G0030

OR

Current tobacco nonuser:

1036F

Performance Not Met

Tobacco screening not performed OR tobacco cessation intervention not provided during the measurement period or in the six months prior to the measurement period

G0029