High Priority MeasureYes
Percentage of calendar months within a 12-month period during which patients aged 17 years and younger with a diagnosis of End Stage Renal Disease (ESRD) undergoing maintenance hemodialysis in an outpatient dialysis facility have an assessment of the adequacy of volume management from a nephrologist
This measure is to be submitted each calendar month patients are seen with a diagnosis of ESRD (who are undergoing maintenance hemodialysis in an outpatient dialysis facility) during the performance period. The most recent quality code submitted will be used for performance calculation. It is anticipated that eligible clinicians providing care for patients with ESRD will submit this measure.
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 submissions; however, these codes may be submitted for those registries that utilize claims data.
All calendar months during which patients aged 17 years and younger with a diagnosis of ESRD are undergoing maintenance hemodialysis in an outpatient dialysis facility
Denominator Criteria (Eligible Cases):
Patients aged ≤ 17 years on date of encounter
Diagnosis for ESRD (ICD-10-CM): N18.6
Patient encounter during the performance period (CPT): 90951, 90952, 90953, 90954, 90955, 90956, 90957, 90958, 90959, 90963, 90964, 90965, 90967, 90968, 90969
Telehealth Modifier: GQ, GT, 95, POS 02
Patient receiving maintenance hemodialysis in an outpatient dialysis facility: G8956
Calendar months during which patients have an assessment of the adequacy of volume management from a nephrologist
Adequacy of Volume Management – Adequacy of volume management for a patient on dialysis is determined by assessing whether or not the patient achieved a target end dialysis weight after receiving dialysis, by a comparison of the patient-specific target end dialysis weight and the actual post dialysis weight
Performance Met: Most recent assessment of adequacy of volume management documented (G8955)
Performance Not Met: Assessment of adequacy of volume management not documented, Reason not given (G8958)