Quick Reference Guides
Breast Cancer Screening
Adult primary care measure for women 40 to 69 years of age who had one or more mammograms
during the current calendar year or the year prior to the current calendar year.
Cervical
Cancer Screening
Adult primary care measure for women 21 to 64 years of age who received one or more
Pap tests during the current calendar year or the two years prior to the current
calendar year.
Colorectal
Cancer Screening
Adult primary care measure for patients 50 to 75 years of age who had appropriate
screening for colorectal cancer through one of these standards of care: fecal occult
blood test (FOBT) during the current calendar year, flexible sigmoidoscopy during
the calendar year or the four years prior to the current calendar year, or colonoscopy
during the current calendar year or the nine years prior to the current calendar
year.
Chlamydia
Screening
Adult primary care measure for women 16 to 24 years of age who were identified as
sexually active and who had at least one test for chlamydia during the current calendar
year.
Cholesterol
Management Screening
Adult primary care measure for patients 18 to 75 years of age who were discharged
alive for acute myocardial infarction (AMI), coronary artery bypass graft (CABG),
or percutaneous coronary interventions (PCI) from Jan. 1 – Nov. 1 of the year prior
to the calendar year, or had a diagnosis of ischemic vascular disease (IVD) during
the current calendar year and the year prior to the current calendar year, and who
also had an LDL-C screening during the calendar year.
Comprehensive
Diabetes Standards of Care
Adult primary care measures for patients with diabetes 18 to 75 years of age who:
- Receive a retinal or dilated eye exam by an eye care professional (optometrist or
ophthalmologist) in the current calendar year, or a negative retinal exam (no evidence
of retinopathy) by an eye care professional in the year prior to the current calendar
year.
- Receive at least one lipid profile (or all component tests) during the current calendar
year.
- Receive one or more HbA1c tests per year.
- Receive at least one test for microalbumin during the current calendar year or who
had evidence of medical attention for existing nephropathy.
Type 2 Diabetes Eye Exams
Adult primary care measures for patients with diabetes 18 to 75 years of age who
receive a retinal or dilated eye exam by an eye care professional (optometrist or
ophthalmologist) in the current calendar year, or a negative retinal exam (no evidence
of retinopathy) by an eye care professional in the year prior to the current calendar
year.
Rheumatoid Arthritis
Clinical care measure for patients 18 years of age and older who were diagnosed
with rheumatoid arthritis and received at least one ambulatory prescription for
a disease-modifying anti-rheumatic drug (DMARD).
Asthma Appropriate
Medications (5 to 50 Years)
Adult and pediatric primary care measures for patients identified as having persistent
asthma during the measurement year and the year prior who were dispensed appropriate
medication.
Access to
Care: Well-Child Visits (0 to 6 Years)
Pediatric primary care measure for children who had age-appropriate well-child visits.
Immunizations:
Childhood Immunizations (0 to 2 Years)
Pediatric primary care measure for children having the recommended number and type
of immunizations on or before their second birthday.
Immunizations:
Adolescent Immunizations
Clinical measures for immunization of children and teenagers ages 7 to 18 years.
Includes recommended immunizations, vaccine and administrative CPT codes, and descriptions.
Appropriate
Respiratory Care: Children with Pharyngitis
Pediatric primary care measure for children 2 to 18 years of age who were diagnosed
with pharyngitis, prescribed an antibiotic, and received a group A streptococcus
(strep) test for the episode.
Appropriate
Respiratory Care: Children with Upper Respiratory Infections
Pediatric primary care measure for children 3 months to 18 years of age who were
diagnosed with upper respiratory infections.
