#330: Adult Kidney Disease: Catheter Use for Greater Than or Equal to 90 Days

Quality ID

330

High Priority Measure

Yes

Specifications

Registry

Measure Type

Outcome

Specialty

N/A

Measure description

Percentage of patients aged 18 years and older with a diagnosis of End Stage Renal Disease (ESRD) receiving maintenance hemodialysis for greater than or equal to 90 days whose mode of vascular access is a catheter

 

Instructions

This measure is to be submitted a minimum of once per performance period for patients with ESRD 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.

NOTE: Include only patients that have catheters at the time of initiation of hemodialysis through September 30 of the performance period. This will allow the evaluation of at least 90 days of catheter use for hemodialysis within the submission year.

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 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 ESRD receiving maintenance hemodialysis for greater than or equal to 90 days

Denominator Criteria (Eligible Cases):

Patients aged ≥ 18 years on date of encounter

AND

Diagnosis for ESRD (ICD-10-CM): N18.6, Z49.31

AND

Patient encounter during performance period (CPT): 90957, 90958, 90959, 90960, 90961, 90962, 90966, 90970

WITHOUT

Telehealth Modifier: GQ, GT, 95, POS 02

AND

All eligible instances of quality-data code G9240 (Documentation of patient with a catheter at the time maintenance hemodialysis is initiated as applied in the numerator for Measure #329 Adult Kidney Disease: Catheter Use at Initiation of Hemodialysis)

AND NOT

DENOMINATOR EXCLUSIONS:

Patient is undergoing palliative dialysis with a catheter: G9749

OR

Patient approved by a qualified transplant program and scheduled to receive a living donor kidney transplant: G9750

 

Numerator

Patients whose mode of vascular access is a catheter

Numerator Instructions: Of note, the performance tags indicating “Performance Met‟ and “Performance Not Met‟ are included to highlight what is being measured and submitted and not to encourage extended use of catheters for vascular access.

INVERSE MEASURE - A lower calculated performance rate for this measure indicates better clinical care or control. The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. Submitting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. For inverse measures, a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control.

Numerator Options:

Performance Met: Patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter as the mode of vascular access (G9265)

OR

Denominator Exception: Documentation of patient receiving maintenance hemodialysis for greater than or equal to 90 days with a catheter for documented reasons (e.g. other medical reasons, patient declined AVF/AVG, other patient reasons) (G9264)

OR

Performance Not Met: Patient receiving maintenance hemodialysis for greater than or equal to 90 days without a catheter as the mode of vascular access (G9266)

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