*RETIRED* Clinical Quality Measures Report - Preventive Care and Screening: Risk-Stratified Cholesterol Fasting Low Density Lipoprotein (LDL- C)

***As of 2017, this Quality Measure has been retired by CMS. It is no longer able to be reported for Meaningful Use nor MIPS Quality measures. MacPractice maintains this documentation only for reference.***

Overview
Percentage of patients aged 20 through 79 years who had a fasting LDL-C test performed and whose risk-stratified fasting LDL-C is at or below the recommended LDL-C goal.

High Risk
All patients aged 20 through 79 years who had a fasting LDL-C or a calculated LDL-C test performed during the measurement period and have CHD or CHD Risk Equivalent OR 10 year Framingham risk > 20%

• Denominator 1:
  • The patient needs to be 20-79 years old
  • They need to be seen during the reporting period, indicated with the listed CPT codes in the report footer
  • They need an active CHD or CHD Risk Equivalent diagnosis, indicated with the listed ICD-9, ICD-10, or snomed codes in the report footer
  • They need one of the following, entered in as a Laboratory Order with a Received Date within the filtered date range-
    • LDL Code Laboratory Test performed during the filtered date range, indicated with the listed LNC codes in the report footer
    • Total Cholesterol, High Density Lipoprotein (HDL), and Triglycerides tests performed, indicated with the listed LNC codes in the report footer
• Numerator 1:
  • If the LDL Code LNC was used, the result needs to be < 100 mg/dL
  • If the Triglycerides LNC was used, the result needs to be < 400 mg/dL
• Exclusions:
  • Any patient who is diagnosed as pregnant, indicated with the listed ICD-9,ICD-10, or snomed codes in the report footer, is excluded from the report.

Moderate Risk All patients aged 20 through 79 years who had a fasting LDL-C or a calculated LDL-C test performed during the measurement period and have Multiple Risk Factors (2+) of the following: Cigarette Smoking, Hypertension, Low High Density Lipoprotein (HDL-C)**, Family History of Premature CHD, or Age (men >= 45; women >= 55) and 10-year Framingham risk <=20%

•  Denominator 2:
  • The patient needs to be 20-79 years old
  • They need to be seen during the reporting period, indicated with the listed CPT codes in the report footer
  • They need one of the following, entered in as a Laboratory Order with a Received Date within the filtered date range-
    • LDL Code Laboratory Test performed during the filtered date range, indicated with the listed LNC codes in the report footer
    • Total Cholesterol, High Density Lipoprotein (HDL), and Triglycerides tests performed, indicated with the listed LNC codes in the report footer
  • They need one of the following sets of data recorded-
    1. Framingham coronary heart disease 10 year risk >= 10 %, entered or imported as a Laboratory Order with a Received Date within the filtered date range
    2. A combination of three or more of the following-
       • Current Cigarette Smoker, entered in as a snomed code in the EMR or EHR form with a Start Date before or within the filtered date range
       • Family History CHD, entered in as a snomed code in the EMR or EHR form with a Start Date before or within the filtered date range
       • High Density Lipoprotein, entered or imported as an LNC code on a Laboratory Order with a Received Date during the filtered date range and a result
       • Diagnosis of Hypertension grouped, indicated with the listed ICD-9, ICD-10, or snomed codes in the report footer OR an active Anti-Hypertensive Pharmacologic Therapy medication
    3. A High Density Lipoprotein (HDL) result <60mg/dL, entered or imported as a Laboratory Order with a Received Date within the filtered date range and a combination of two of the following-
       • Current Cigarette Smoker, entered in as a snomed code in the EMR or EHR form with a Start Date before or within the filtered date range
       • Family History CHD, entered in as a snomed code in the EMR or EHR form with a Start Date before or within the filtered date range
       • High Density Lipoprotein, entered or imported as an LNC code on a Laboratory Order with a Received Date during the filtered date range and a result
       • Diagnosis of Hypertension grouped, indicated with the listed ICD-9, ICD-10, or snomed codes in the report footer OR an active Anti-Hypertensive Pharmacologic Therapy medication
    4. Being a male over 45 or a female over 55, a High Density Lipoprotein (HDL) result <60mg/dL, entered or imported as a Laboratory Order with a Received Date within the filtered date range, and one of the following-
       • Current Cigarette Smoker, entered in as a snomed code in the EMR or EHR form with a Start Date before or within the filtered date range
       • Family History CHD, entered in as a snomed code in the EMR or EHR form with a Start Date before or within the filtered date range
       • High Density Lipoprotein, entered or imported as an LNC code on a Laboratory Order with a Received Date during the filtered date range and a result
       • Diagnosis of Hypertension grouped, indicated with the listed ICD-9, ICD-10, or snomed codes in the report footer OR an active Anti-Hypertensive Pharmacologic Therapy medication
    5. Being a male over 45 or a female over 55, and one of the following-
       • Current Cigarette Smoker, entered in as a snomed code in the EMR or EHR form with a Start Date before or within the filtered date range
       • Family History CHD, entered in as a snomed code in the EMR or EHR form with a Start Date before or within the filtered date range
       • High Density Lipoprotein, entered or imported as an LNC code on a Laboratory Order with a Received Date during the filtered date range and a result
       • Diagnosis of Hypertension grouped, indicated with the listed ICD-9, ICD-10, or snomed codes in the report footer OR an active Anti-Hypertensive Pharmacologic Therapy medication
• Numerator 2:
  • If the LDL Code LNC was used, the result needs to be < 130 mg/dL
  • If the Triglycerides LNC was used, the result needs to be < 400 mg/d
• Exclusions:
  • Any patient who is diagnosed as pregnant, indicated with the listed ICD-9,ICD-10, or snomed codes in the report footer, is excluded from the report.

Low Risk
All patients aged 20 through 79 years who have had a fasting LDL-C or a calculated LDL-C test performed up to 4 years prior to the current measurement period and have 0 or 1 of the following risk factors: Cigarette Smoking, Hypertension, Low High Density Lipoprotein (HDL-C)**, Family History of Premature CHD, or Age (men >= 45; women >= 55) **HDL-C > or equal to 60 mg/dL subtracts 1 risk from the above (This is a negative risk factor)

• Denominator 3:
  • The patient needs to be 20-79 years old
  • They need to be seen during the reporting period, indicated with the listed CPT codes in the report footer
  • They need one of the following, entered in as a Laboratory Order with a Received Date within the filtered date range-
    • LDL Code Laboratory Test performed during the filtered date range, indicated with the listed LNC codes in the report footer
    • Total Cholesterol, High Density Lipoprotein (HDL), and Triglycerides tests performed, indicated with the listed LNC codes in the report footer
• Numerator 3:
  • If the LDL Code LNC was used, the result needs to be < 160 mg/dL
  • If the Triglycerides LNC was used, the result needs to be < 400 mg/d
• Exclusions:
  • Any patient who is diagnosed as pregnant, indicated with the listed ICD-9,ICD-10, or snomed codes in the report footer, is excluded from the report.