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Clinical Quality Measures Report - HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis

This article covers the Clinical Quality Measure Report "HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis". This report is used to meet Clinical Quality Measure requirements for MIPS and Medicaid reporting programs. We'll cover the structure of the report and how it works so you can meet your Clinical Quality Measure requirements.

Overview of Measure
The "HIV/AIDS: Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis" report tracks the percentage of patients aged 6 weeks and older with a diagnosis of HIV/AIDS who were prescribed Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis.

A patient will be in the first denominator when they have all of the following:

  • An age of 6 years or older (at the start of the reporting period)
  • At least two visits during your reporting period, with the second visit at least 90 days after the first 
  • An HIV diagnosis with an Onset Date matching the Procedure Date of their first visit
  • A CD4+ count < 200 per mm3 LNC code entered or imported to a Laboratory order with a Received Date within your reporting period

A patient will be in the first numerator when they have all of the following:

  • Both medications:  Leucovorin AND Dapson 100 MG / Pyrimethamine 12.5 MG Oral Tablet. (Leucovorin must be prescribed within 3 months or less of the from the date of the CD4+ Count. Dapson 100 MG / Pyrimethamine 12.5 MG Oral Tablet prescribed the same precribed date as Leucovorin.)

A patient will be in the second denominator when they have all of the following:

  • An age of 1-5 years (at the start of the measurement period)
  • At least two visits during your reporting period, with the second visit at least 90 days after the first 
  • An HIV diagnosis with an Onset Date matching the Procedure Date of their first visit
  • A CD4+ count < 500 per mm3 LNC code entered or imported to a Laboratory order with a Received Date within your reporting period

A patient will be in the second numerator when they have all of the following:

  • A Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis medication with an Ordered Date within 3 months of their CD4+ count Received Date

A patient will be in the third denominator when they have all of the following: 

  • An age of 6 weeks-12 months (at the start of the measurement period)
  • At least two visits during your reporting period, with the second visit at least 90 days after the first 
  • An HIV diagnosis with an Onset Date matching the Procedure Date of their first visit

A patient will be in the third numerator when they have all of the following- 

  • A Pneumocystis Jiroveci Pneumonia (PCP) Prophylaxis medication with an Ordered Date within 1 day of their HIV diagnosis Onset Date

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Filters

  • Filter Providers: This filter allows you to narrow the generated data to include and exclude specific providers. When checked, any selected providers will be included in the results.
  • Filter Offices: This filter allows you to narrow the generated data to include and exclude specific Office references.
  • Filter Ethnicities: This filter will allow you to narrow the generated results to specific ethnicities as designated in a patient's record under the Patients Ability > Patient Tab > Race/Ethnicity sub-tab.
  • Filter Races: This filter will allow you to narrow the generated results to specific races as designated in a patient's record under the Patients Ability > Patient Tab > Race/Ethnicity sub-tab.
  • Filter Sex: This filter will allow you to narrow the generated results to specific genders as designated by the "Sex" field in the Patients Ability > Patient Tab > Sex drop down menu.
  • Filter Insurances: This filter allows you to narrow down results to patients that have the selected insurances added in the Patients Ability > Patient Tab > Insurance Sub-Tab.
  • Filter Tax Identification Numbers: This filters narrows results based on the provider's Tax ID numbers. In this case, it will narrow down to patients with the associated providers.
  • Filter National Provider Identifiers: This filters narrows results based on the provider's National Provider Identifier (NPI). In this case, it will narrow down to patients with the associated providers.
  • Filter Provider Types: This filter will narrow results by the Provider Taxonomy codes present in References > User > Provider Tab > Provider Taxonomy. To be precise, it will narrow the results to patients associated with providers with the selected Taxonomy codes entered in the User Reference.
  • Filter Problem Lists: This filter will narrow the results down to patients who have the selected diagnosis codes entered into their Problem Lists. You can find these in the Clinical Ability under the Problem List widget.
  • Filter Practice Address: This filter will narrow results down to patients who are associated with the Office with an address that matches the selected address.
  • Start/End Date: These fields allow you to narrow the range of the generated results to the specified date range.
  • Start Age/End Age: These drop downs allow you to narrow results down to patients with ages in between the range.

Results

Unexpanded

  • Group Name: For reports with multiple numerator requirements, this identifies the numerator that is being checked for. In this report's case, there are three separate numerators.
  • Numerator: The number of patient that meet the numerator requirements described above.
  • Denominator: The number of patients that meet the denominator requirements described above.
  • Percentage: The percentage of patients meeting both the numerator and denominator requirements.

First expansion

  • Patient #: The Patient Account Number for the Patient in question.
  • Patient Name: The name of the patient in question, formatted as last name/first name.
  • In Numerator (Yes/No): This column identifies whether the patient in question meets the numerator requirements.
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