Participation Tools: Individual Quality Measures for 2009 PQRI.
The 131 individual quality measures eligible for claims-based reporting in the 2009 PQRI program are listed below. The measures are sorted alphabetically by disease/condition. For each measure that you feel might be applicable to your practice, view any of the three PDF documents listed to the right of the measure for additional information.
An asterisk (*) indicates that a document has been revised since the initial posting. View release notes for a list of technical corrections since the initial posting.
These participation tools are intended for claims-based reporting of individual measures.
Participation Tools disclaimer
These participation tools include measures and specifications ("Participation Tools"). The American Medical Association, the Physician Consortium for Performance Improvement®, its members and other measure and specifications developers ("Measure Developers") do not warrant that the information contained in the Participation Tools is in every respect accurate and/or complete. The Measure Developers assume no responsibility for use of the information contained in the Participation Tools. The Measure Developers assume no responsibility for and expressly disclaim liability for damages of any kind arising out of the use of, reference to, or reliance on the content of the Participation Tools.
Participation tools for Measures Groups are also available: View the 2009 PQRI Measures Group Tools
Quality Measures
Documents
Acute Bronchitis
#116. Antibiotic treatment for adults with acute bronchitis - avoidance of inappropriate use
Acute Myocardial Infarction
#28. Aspirin at arrival for acute myocardial infarction (AMI)
Acute Otitis Externa (AOE)
#91. Topical therapy
#92. Pain assessment
#93. Systemic antimicrobial therapy – avoidance of inappropriate use
Asthma
#53. Pharmacologic therapy
#64. Asthma assessment
Cancer Care
#143. Pain intensity quantified
#144. Plan of care for pain
#156. Radiation dose limits to normal tissues
Breast Cancer
#71. Hormonal therapy for stage IC-III, ER/PR positive breast cancer
Chronic Lymphocytic Leukemia
#70. Baseline flow cytometry
Colon Cancer
#72. Chemotherapy for stage III colon cancer patients
Melanoma
#136. Follow-up aspects of care
#137. Continuity of care – recall system
#138. Coordination of care
Multiple Myeloma
#69. Treatment with bisphosphonates
Myelodysplastic Syndrome
#68. Documentation of iron stores in patients receiving erythropoietin therapy
Myelodysplastic Syndrome & Acute Leukemias
#67. Baseline cytogenetic testing performed on bone marrow
Prostate Cancer
#102. Avoidance of overuse of bone scan for staging low-risk prostate cancer patients
#104. Adjuvant hormonal therapy for high-risk prostate cancer patients
#105. Three-dimensional radiotherapy
Chest Pain (Non-traumatic)
#54. 12 lead electrocardiogram performed for non-traumatic chest pain
Chiropractic Care
#182. Functional outcome assessment in chiropractic care
Chronic Kidney Disease (CKD)
#121. Laboratory testing (calcium, phosphorus, intact parathyroid hormone (iPTH) and lipid profile)
#122. Blood pressure management
#123. Plan of care - elevated hemoglobin for patients receiving erythropoiesis-stimulating agents (ESA)
#135. Influenza Immunization
#153. Referral for arteriovenous (AV) fistula
Chronic Obstructive Pulmonary Disease (COPD)
#51. Spirometry evaluation
#52. Bronchodilator therapy
Chronic Wound Care
#186. Use of compression system in patients with venous ulcers
Community-Acquired Bacterial Pneumonia
#56. Vital signs
#57. Assessment of oxygen saturation
#58. Assessment of mental status
#59. Empiric antibiotic
Coronary Artery Disease
#06. Oral antiplatelet therapy prescribed for patients with coronary artery disease
#118. Angiotensin converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy for patients with coronary artery disease and diabetes and/or left ventricular systolic dysfunction (LVSD)
#152. Lipid profile in patients with coronary artery disease
Critical Care
#76. Prevention of catheter-related bloodstream infections (CRBSI) – central venous catheter insertion protocol
Depression – Major Depressive Disorder
#09. Antidepressant medication during acute phase for patients with major depressive disorder
#106. Diagnostic evaluation
#107. Suicide risk assessment
Diabetes Mellitus
#01. Hemoglobin A1c poor control in diabetes mellitus
#02. Low density lipoprotein cholesterol control in diabetes mellitus
#03. High blood pressure control in diabetes mellitus
#117. Dilated eye exam in diabetic patient
#119. Urine screening for microalbumin or medical attention for nephropathy in diabetic patients
#163. Foot exam
#126. Diabetic foot and ankle care, peripheral neuropathy: neurological evaluation
#127. Diabetic foot and ankle care, ulcer prevention: evaluation of footwear
End Stage Renal Disease (ESRD)
#79. Influenza immunization
Endoscopy and Polyp Surveillance
#185. Colonoscopy interval for patients with a history of adenomatous polyps – Avoidance of inappropriate use
Eye Care
Age-Related Macular Degeneration
#14. Dilated macular examination
#140. Counseling on antioxidant supplement
Cataracts
#139. Comprehensive preoperative assessment for cataract surgery with intraocular lens (IOL) placement
Diabetic Retinopathy
#18. Documentation of presence or absence of macular edema and level of severity of retinopathy
#19. Communication with the physician managing ongoing diabetes care
Primary Open Angle Glaucoma
#12. Optic nerve evaluation
#141. Reduction of intraocular pressure (IOP) by 15% OR documentation of a plan of care
Geriatric Care
#47. Advance care plan
#181. Elder maltreatment screen and follow-up plan
Falls
#154. Risk assessment
#155. Plan of care
Health Information Technology (Health IT)
#124. Adoption/use of electronic health records (EHR)
Heart Failure
#05. Angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy for left ventricular systolic dysfunction (LVSD)
#08. Beta-blocker therapy for left ventricular systolic dysfunction
Hepatitis C
#83. Testing for chronic hepatitis C (HCV) - conformation of hepatitis C viremia
#84. Ribonucleic acid (RNA) testing before initiating treatment
#85. HCV genotype testing prior to treatment
#86. Antiviral treatment prescribed
#87. HCV Ribonucleic acid (RNA) testing at week 12 of treatment
#89. Counseling regarding risk of alcohol consumption
#90. Counseling regarding use of contraception prior to antiviral therapy
#183. Hepatitis A vaccination in patients with HCV
#184. Hepatitis B vaccination in patients with HCV
Medication Management
#130. Documentation and verification of current medications in the medical record
Nuclear Medicine
#147. Correlation with existing imaging studies for all patients undergoing bone scintigraphy
Osteoarthritis
#109. Function and pain assessment
#142. Assessment for use of anti-inflammatory or analgesic over-the-counter (OTC) medications
Osteoporosis
#24. Communication with the physician managing ongoing care post-fracture
#39. Screening or therapy for osteoporosis for women aged 65 years and older
#40. Management following fracture
#41. Pharmacologic therapy
Otitis Media with Effusion (OME)
#94. Diagnostic evaluation – assessment of tympanic membrane mobility
#95. Hearing testing
Pathology
#99. Breast cancer resection pathology reporting: pT category (primary tumor) and pN category (regional lymph nodes) with histologic grade
#100. Colorectal cancer resection pathology reporting: pT category (primary tumor) and pN category (regional lymph nodes) with histologic grade
Pain Management
#131. Pain assessment prior to initiation of patient therapy and follow-up
Pediatric End Stage Renal Disease (ESRD)
#175. Influenza immunization
Perioperative (Surgical) Care
#20. Timing of antibiotic prophylaxis - Ordering physician
#21. Selection of prophylactic antibiotic - First OR second generation cephalosporin
#22. Discontinuation of prophylactic antibiotics (Non-cardiac procedures)
#23. Venous thromboembolism (VTE) prophylaxis (When indicated in ALL patients)
#30. Timing of prophylactic antibiotics - Administering physician
#45. Discontinuation of prophylactic antibiotics (Cardiac procedures)
#157. Recording of clinical stage for lung cancer and esophageal cancer resection
#158. Use of patch during conventional endarterectomy
# 172. Hemodialysis vascular access decision-making by surgeon to maximize placement of autogenous arterial venous (AV) fistula
Coronary Artery Bypass Graft (CABG)
#43. Use of internal mammary artery (IMA) in patients with isolated CABG surgery
#44. Preoperative beta-blocker in patients with isolated CABG surgery
Pharyngitis
#66. Appropriate testing for children with pharyngitis
Preventive Care and Screening
#110. Influenza immunization for patients ≥ 50 years old
#111. Pneumonia vaccination for patients 65 years and older
#112. Screening mammography
#113. Colorectal cancer screening
#114. Inquiry regarding tobacco use
#115. Advising smokers to quit
#128. Body mass index (BMI) screening and follow-up
#134. Screening for clinical depression and follow-up plan
#173. Unhealthy alcohol use - screening
Radiology
#10. Computed tomography (CT) or magnetic resonance imaging (MRI) reports
#11. Carotid imaging reports
#145. Exposure time reported for procedures using fluoroscopy
#146. Inappropriate use of "probably benign" assessment category in mammography screening
Rheumatoid Arthritis
#108. Disease modifying anti-rheumatic drug (DMARD) therapy
#176. Tuberculosis screening
#177. Periodic assessment of disease activity
#178. Functional status assessment
#179. Assessment and classification of disease prognosis
#180. Glucocorticoid management
Stroke and Stroke Rehabilitation
#31. Deep vein thrombosis (DVT) prophylaxis for ischemic stroke or intracranial hemorrhage
#32. Discharged on antiplatelet therapy
#34. Tissue plasminogen activator (t-PA) considered
#35. Screening for dysphagia
#36. Consideration of rehabilitation services
Syncope
#55. 12 Lead electrocardiogram performed for syncope
Upper Respiratory Infection (URI)
#65. Treatment for children with upper respiratory infection - avoidance of inappropriate use
Urinary Incontinence
#48. Assessment of presence or absence of urinary incontinence in women aged 65 years and older
#49. Characterization of urinary incontinence in women aged 65 years and older
#50. Plan of care for urinary incontinence in women aged 65 years and older
Many of the measures in the PQRI were developed by the AMA-convened Physician Consortium for Performance Improvement® (PCPI), in collaboration with the National Committee for Quality Assurance (NCQA) and/or a medical specialty society. For additional information on the PCPI including additional background information on the quality measures with both the rationale and evidence base for each measure, please visit the PCPI Web page.
Questions:
For additional information on the PQRI program, please visit the CMS Web site.
For questions or comments on the participation tools, please contact cpe@ama-assn.org
View the 2009 PQRI Measures Group Tools
