Clinical Quality Measure
CMS136v3 (NQF 0108) - Pediatric Recommended Core Measure

ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication

Percentage of children 6-12 years of age and newly dispensed a medication for attention-deficit/hyperactivity disorder (ADHD) who had appropriate follow-up care. Two rates are reported. (a) Percentage of children who had one follow-up visit with a practitioner with prescribing authority during the 30-Day Initiation Phase. (b) Percentage of children who remained on ADHD medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two additional follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.

NQS DOMAIN:   Clinical Process/Effectiveness




Description and Implementation within the EMR software

There are 2 denominators each having 1 numerator in this measure and this translates to 2 sets in total.

Denominator 1: All patients 6-12 years of age with at least 1 encounter within the reporting period who were dispensed an ADHD medication.

Numerator 1: Patients in the above mentioned list who had at least one face-to-face visit with a provider within 30 days after the IPSD. UniCharts looks for the custom code QM108A: [Quality Measure] ADHD medication prescribed, follow-up visit has been scheduled for within next 30 days or QM108B: [Quality Measure] ADHD medication prescribed, follow-up visit has NOT been scheduled for within next 30 days within the PROCEDURES/SERVICES section on the ENCOUNTER form as the required documentation.

Denominator 2: All patients 6-12 years of age with at least 1 encounter within the reporting period who were dispensed an ADHD medication and remained on the medication for at least 210 days out of the 300 days following the IPSD.

Numerator 1: Patients in the above mentioned list who had one face-to-face visit with a provider within 30 days after the IPSD and at least two follow-up visits with a provider during the Continuation and Maintenance Phase. UniCharts looks for the custom code QM108C: [Quality Measure] ADHD medication completed its 210 days and 2 or more follow-up visits were made after IPSD or QM108D: [Quality Measure] ADHD medication completed its 210 days but less than 2 follow-up visits were made after IPSD or QM108E: [Quality Measure] ADHD medication was discontinued before the completion of 210 days within the PROCEDURES/SERVICES section on the ENCOUNTER form as the required documentation.

Note that the system will automatically look for diagnosis of Narcolepsy in eligible patients and include those instances in denominator exclusions if found. Just make sure that one of the Narcolepsy ICD codes G47.411, G47.419, G47.421 or G47.429 is selected in ASSESSMENT/DIAGNOSIS section if the patient has this disease.

Exceptions: None

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