CMS Measure ID:

CMS249v1

Version:

1.4.000

NQF Number:

N/A

Measure Description:

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period.

Initial Patient Population:

Female patients ages 50 to 64 years with an encounter during the measurement period

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Exclude patients with a combination of risk factors (as determined by age) or one of the independent risk factors


Ages: 50-54 (>=4 combination risk factors) or 1 independent risk factor

Ages: 55-59 (>=3 combination risk factors) or 1 independent risk factor

Ages: 60-64 (>=2 combination risk factors) or 1 independent risk factor


COMBINATION RISK FACTORS [The following risk factors are all combination risk factors; they are grouped by when they occur in relation to the measurement period]:


The following risk factors may occur any time in the patient's history but must be active during the measurement period:

White (race)

BMI <= 20 kg/m2 (must be the first BMI of the measurement period)

Smoker (current during the measurement period)

Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))


The following risk factor may occur any time in the patient's history and must not start during the measurement period:

Osteopenia


The following risk factors may occur at any time in the patient's history or during the measurement period:

Rheumatoid arthritis

Hyperthyroidism

Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn's disease, cystic fibrosis, malabsorption

Chronic liver disease

Chronic malnutrition

Documentation of history of hip fracture in parent

Osteoporotic fracture

Glucocorticoids (>= 5 mg/per day) [cumulative medication duration >= 90 days]


INDEPENDENT RISK FACTORS (The following risk factors are all independent risk factors; they are grouped by when they occur in relation to the measurement period):


The following risk factors may occur at any time in the patient's history and must not start during the measurement period:

Osteoporosis


The following risk factors may occur at any time in the patient's history:

Gastric bypass

FRAX[R] ten-year probability of all major osteoporosis related fracture >= 9.3 percent

Aromatase inhibitors

Type I Diabetes

End stage renal disease

Osteogenesis imperfecta

Ankylosing spondylitis

Psoriatic arthritis

Ehlers-Danlos syndrome

Cushing's syndrome

Hyperparathyroidism

Marfan syndrome

Lupus

Numerator Statement:

Female patients who received an order for at least one DXA scan in the measurement period

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None