#276: Sleep Apnea: Assessment of Sleep Symptoms

Quality ID

276

High Priority Measure

No

Specifications

Registry

Measure Type

Process

Specialty

Otolaryngology

Measure description

Percentage of visits for patients aged 18 years and older with a diagnosis of obstructive sleep apnea that includes documentation of an assessment of sleep symptoms, including presence or absence of snoring and daytime sleepiness

 

Instructions

This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of sleep apnea seen during the performance period. This measure may be submitted by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

Measure Submission:

The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data.

 

Denominator

All patients aged 18 years and older with a diagnosis of sleep apnea

Denominator Criteria (Eligible Cases):

Patients aged ≥ 18 years on date of encounter

AND

Diagnosis for sleep apnea (ICD-10-CM): G47.30, G47.33

AND

Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350

WITHOUT

Telehealth Modifier: GQ, GT, 95, POS 02

 

Numerator

Patient visits with an assessment of sleep symptoms documented, including presence or absence of snoring and daytime sleepiness

Numerator Options:

Performance Met: Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness (G8839)

OR

Denominator Exception: Documentation of reason(s) for not documenting an assessment of sleep symptoms (e.g., patient didn’t have initial daytime sleepiness, patient visited between initial testing and initiation of therapy) (G8840)

OR

Performance Not Met: Sleep apnea symptoms not assessed, reason not given (G8841)

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