High Priority MeasureYes
SpecialtyAllergy/Immunology Family Medicine Infectious Disease Internal Medicine
The percentage of patients, regardless of age, with a diagnosis of HIV with a HIV viral load less than 200 copies/mL at last HIV viral load test during the measurement year
This measure is to be submitted a minimum of once per performance period for patients with HIV seen during the performance period. This measure is intended to reflect the quality of services provided for the primary management of patients with HIV.
The listed denominator criteria are 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.
Patients, regardless of age, with a diagnosis of HIV who had at least one medical visit during the performance period
Denominator Criteria (Eligible Cases):
Patients, regardless of age
Diagnosis of HIV/AIDS (ICD-10-CM): B20, Z21
Patient encounter during the performance period (CPT or HCPCS): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, G0402
Number of patients with a HIV viral load less than 200 copies/mL at last viral load test
Performance Met: Documentation of viral load less than 200 copies/mL (G9243)
Performance Not Met: Documentation of viral load equal to or greater than 200 copies/mL or viral load not performed (G9242)