SOAPware Learning CenterClinical Quality Measures User Guide (for 2011) Additional Measures (Choose 3 Additional Measures)*NQF 0004 (Additional): Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (a) Initiation, (b) Engagement

*NQF 0004 (Additional): Initiation and Engagement of Alcohol and Other Drug Dependence Treatment (a) Initiation, (b) Engagement

Measure:  NQF 0004 (Additional Measure)

Measure Title:  Initiation and Engagement of Alcohol and Other Drug Dependence Treatment: (a) Initiation, (b) Engagement

Measure Description:  The percentage of adolescent and adult patients with a new episode of alcohol and other drug (AOD) dependence who initiate treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis and who initiated treatment and who had two or more additional services with an AOD diagnosis within 30 days of the initiation visit.

*Note:

At this time, we do not suggest that SOAPware users select this particular quality measure. We are in the process of adjusting the work flow and reporting in order to be more consistent with the reporting requirements.

Quality Measure Documentation Workflow

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 18 years 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.  A diagnosis of alcohol and other drug dependence (recorded by using any of the ICD9 codes listed below) in the SOAPnote Assessment field or Summary Active Problems Field:

(291, 291.0, 291.1, 291.2, 291.3, 291.4, 291.5, 291.8, 291.81, 291.82, 291.89, 291.9, 292, 292.0, 292.1, 292.11, 292.12, 292.2, 292.8, 292.81, 292.82, 292.83, 292.84, 292.85, 292.89, 292.9, 303.00, 303.01, 303.02, 303.90, 303.91, 303.92, 304.00, 304.01, 304.02, 304.10, 304.11, 304.12, 304.20, 304.21, 304.22, 304.30, 304.31, 304.32, 304.40, 304.41, 304.42, 304.50, 304.51, 304.52, 304.60, 304.61, 304.62, 304.70, 304.71, 304.72, 304.80, 304.81, 304.82, 304.90, 304.91, 304.92, 305.00, 305.01, 305.02, 305.20, 305.21, 305.22, 305.30, 305.31, 305.32, 305.40, 305.41, 305.42, 305.50, 305.51, 305.52, 305.60, 305.61, 305.62, 305.70, 305.71, 305.72, 305.80, 305.81, 305.82, 305.90, 305.91, 305.92, 535.3, 535.30, 535.31, 571.1).

3.  The patient must have documentation that confirms chemical dependency issues, newly diagnosed and had initiation of treatment within 14 days of diagnosis and had a follow up within 30 days of initial treatment.  To document this, use the shortcut code, "PQRIche" in the encounter Plan field.  This will insert the picklist header, "Chemical dependency treatment QM", which will provide a list of criteria from which to document.  The following Custom code must be entered in the face-to-face encounter: 0004a (Patient has chemical dependency issues, newly diagnosed, and had initiation of treatment within 14 days of dx, and had F/U within 30 days of initial treatment).

Note: Custom code c0004b (Patient has chemical dependency issues, newly diagnosed, and did not have initiation treatment within 14 days of dx, or did not have F/U within 30 days of initial treatment) will not increase the numerator.

*  If the above is documented appropriately, this should increase the numerator and denominator for this measure to indicate that the patient had a new episode of alcohol and other drug dependence and initiated treatment through an inpatient AOD admission, outpatient visit, intensive outpatient encounter or partial hospitalization within 14 days of the diagnosis and who initiated treatment and had two or more additional services with an AOD diagnosis within 30 days of the initiation visit.

Measure Calculation Details

Numerator Calculation:

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

1.  The number of patients in the denominator who also have the appropriate custom code entered in the encounter Plan field: 0004a.

Note: Custom code 0004b will not increase the numerator.

Denominator Calculation:

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

1.  The number of patients 18 years of age or older with a face to face encounter during the reporting period;

2.  And have a diagnosis recorded in the encounter Assessment field or Summary Active Problems field using one of the following ICD9 codes:

291, 291.0, 291.1, 291.2, 291.3, 291.4, 291.5, 291.8, 291.81, 291.82, 291.89, 291.9, 292, 292.0, 292.1, 292.11, 292.12, 292.2, 292.8, 292.81, 292.82, 292.83, 292.84, 292.85, 292.89, 292.9, 303.00, 303.01, 303.02, 303.90, 303.91, 303.92, 304.00, 304.01, 304.02, 304.10, 304.11, 304.12, 304.20, 304.21, 304.22, 304.30, 304.31, 304.32, 304.40, 304.41, 304.42, 304.50, 304.51, 304.52, 304.60, 304.61, 304.62, 304.70, 304.71, 304.72, 304.80, 304.81, 304.82, 304.90, 304.91, 304.92, 305.00, 305.01, 305.02, 305.20, 305.21, 305.22, 305.30, 305.31, 305.32, 305.40, 305.41, 305.42, 305.50, 305.51, 305.52, 305.60, 305.61, 305.62, 305.70, 305.71, 305.72, 305.80, 305.81, 305.82, 305.90, 305.91, 305.92, 535.3, 535.30, 535.31, 571.1.

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.