Percentage of patients with sepsis due to MSSA bacteremia who received beta-lactam antibiotic (e.g. Nafcillin, Oxacillin or Cefazolin) as definitive therapy
This measure is to be submitted each episode a patient is hospitalized with sepsis due to MSSA bacteremia during the performance period. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.
Measure Submission Type:
Measure data may be submitted by individual MIPS eligible clinicians, groups, or third party intermediaries. 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 as allowed by the measure. The quality-data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.
All hospitalized patients with sepsis due to MSSA bacteremia
DENOMINATOR NOTE: A patient 18 years or older who has an initial inpatient encounter with symptoms of bacteremia that is documented of being methicillin-susceptible staphylococcus aureus.
Denominator Criteria (Eligible Cases):
All patients 18 years or older
Diagnosis for Sepsis due to MSSA (ICD-10-CM): A41.01
Patient encounter during performance period (CPT): 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99232, 99233, 99234, 99235, 99236, 99291
Number of denominator eligible patients treated with a beta-lactam antibiotic (e.g. Nafcillin, Oxacillin or Cefazolin) as definitive therapy
Beta-Lactam – For the purposes of this measure, a beta-lactam antibiotic is defined as Nafcillin, Oxacillin or Cefazolin.
Performance Met: Patient treated with a beta-lactam antibiotic as definitive therapy (G9558)
Denominator Exception: Documentation of medical reason(s) for not prescribing a beta-lactam antibiotic (e.g., allergy, intolerance to beta-lactam antibiotics) (G9559)
Performance Not Met: Patient not treated with a beta-lactam antibiotic as definitive therapy, reason not given (G9560)