#340: HIV Medical Visit Frequency

Quality ID

340

NQF

2079

High Priority Measure

Yes

Specifications

Registry

Measure Type

Process

Specialty

Allergy/Immunology Infectious Disease

Measure description

Percentage of patients, regardless of age with a diagnosis of HIV who had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits

 

Instructions

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. 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 submissions; however, these codes may be submitted for those registries that utilize claims data.

 

Denominator

Patients, regardless of age, with a diagnosis of HIV with at least one medical visit in the performance period

DENOMINATOR NOTE: In order to determine denominator eligibility, patients should be diagnosed with HIV during the first 3 months of the 24-month measurement period or have a diagnosis prior to the performance period. Performance of the measure is met when there is at least one medical visit in each 6 month interval with 60 days between denominator eligible encounters for patients with HIV within the 24- month measurement.

Denominator Criteria (Eligible Cases):

Patients, regardless of age

AND

Diagnosis of HIV/AIDS (ICD-10-CM): B20, Z21

AND

Patient encounter during the performance period (CPT or HCPCS): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, G0402

AND NOT

DENOMINATOR EXCLUSION:

Patient died at any time during the 24‐month measurement period: G9751

 

Numerator

Number of patients who had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits

Numerator Options:

Performance Met: Patient had at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits (G9247)

OR

Performance Not Met: Patient did not have at least one medical visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between medical visits (G9246)

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