NQF 0027 (Additional): Smoking and Tobacco Use Cessation, Medical Assistance (2012)

Measure: NQF 0027 (Additional Measure)

Measure Title: Smoking and Tobacco Use Cessation, Medical assistance: a. Advising Smokers and Tobacco Users to Quit, b. Discussing Smoking and Tobacco Use Cessation Medications, c. Discussing Smoking and Tobacco Use Cessation Strategies

Measure Description: The percentage of patients 18 years of age and older who were current smokers or tobacco users, who were seen by a practitioner during the measurement year and who received advice to quit smoking or tobacco use or whose practitioner recommended or discussed smoking or tobacco use cessation medications, methods or strategies.

Quality Measure Documentation Workflow

In order for the Clinical Quality Measure report to generate, the following must be documented in the relevant patient's chart:

1. The patient must be age 18 years old or older at the start of the reporting period and have at least one face to face encounter with the provider during the reporting period.

2. Patient must have documentation that they are a current smoker or tobacco user . This can be documented one of two ways:

(a) Using the shortcut code "TobQM". This will insert the pick list header "Tobacco Use QM", which will provide a list of criteria from which to document. The CPT code 1034F or 1035F must display in the encounter Plan field or Summary Interventions field in order to document that the patient is a tobacco user.

OR

(b) Patient must have one of the following diagnosis items entered in the Summary Active Problems or encounter Assessment field: 305.1 or 305.10.

3. In addition, the patient must have documentation that they received advice to quit smoking or tobacco use or recommended or discussed smoking or tobacco use cessation medications, methods or strategies. To document this, use the shortcut code "TobQM" and select one of the following codes to display in the encounter Plan field or Summary Interventions field: 99406, 99407, G0375, G0376, G8402, G9016, S4995, S9075, S9453.

Measure Calculation Details

Eligible Providers will be required to report two population criteria (two numerators and two denominators) for this Clinical Quality Measure.

Population Criteria #1: Current Smokers or Tobacco Users

Numerator Calculation #1:

The numerator for this measure is calculated based on the following:

1. The number of patients in the denominator that also have one of the following codes recorded in the encounter Plan field or Summary Interventions field using "TobQM":

  • 1034F: Tobacco - current smoker
  • 1035F: Tobacco - Smokeless tobacco user

OR

2. One of the following ICD9 Codes in the Active Problems or encounter Assessment field:

  • 305.1
  • 305.10: Nicotine Dependence

The following codes will not increase the numerator:

  • G8403: Tobacco (smoker) use and no cessation intervention, counseling
  • 1036F: Tobacco non-use
  • 1000F: Tobacco use assessed
  • 1000F-8P: Tobacco use not assessed - reason not specified
  • G8094: COPD pt with no smoking cessation intervention

Denominator Calculation #1:

The denominator for this measure is calculated based on the following:

1. The number of patients that are age 18 years old or older at the start of the reporting period and have at least one face to face encounter with the provider during the reporting period.

Population Criteria #2: Current Smokers or Tobacco Users who have received Tobacco Use Cessation Counseling

Numerator Calculation #2:

The numerator for this measure is calculated based on the following:

1. The number of patients in the denominator that also have one of the following CPT code recorded in the encounter Plan field or Summary Interventions field using "TobQM":

  • 99406: Behav Chng Smoking 3-10 min.
  • 99407: Behav Chang Smoking <10 min.
  • G0375: Tobacco (smoke) use cessation intervention, counseling
  • G0376: Tobacco/Smoking cessation counseling > 10 min.
  • G8402: Tobacco (smoke) use cessation intervention, counseling
  • G9016: Tobacco/Smoking cessation counseling
  • S4995: Tobacco/Smoking cessation gum therapy advised
  • S9075: Tobacco/Smoking cessation treatment (with medication)
  • S9453: Tobacco/Smoking cessation class

The following codes will not increase the numerator:

  • G8403: Tobacco (smoker) use and no cessation intervention, counseling
  • 1036F: Tobacco non-use
  • 1000F: Tobacco use assessed
  • 1000F-8P: Tobacco use not assessed - reason not specified
  • G8094: COPD pt with no smoking cessation intervention

Denominator Calculation #2:

The denominator for this measure is calculated based on the following:

1. The number of patients that are age 18 years old or older at the start of the reporting period and have at least one face to face encounter with the provider during the reporting period.

Report Clinical Quality Measures to CMS/States

All of the items listed in the above steps need to be documented as structured data (as detailed above) in order to allow the user to capture the numerator, denominator and percentage for this quality measure.

For information on how to export the numerator, denominator and percentage for each Clinical Quality Measure, click here.

For more information on reporting clinical quality measures, click here.