Quality ID #47 (NQF 0326): Advance Care Plan

DESCRIPTION

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan. This measure is to be submitted a minimum of once per performance period for patients seen during the performance period.

DENOMINATOR CRITERIA: All of the following

1.      Patients aged 65 years and older and with anyone below codes:

90791, 90832, 90834, 90837, 90845, 90846, 90847, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99218, 99219, 99220, 99221, 99222, 99223, 99231, 99232, 99233, 99234, 99235, 99236, 99291, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0402, G0438, G0439

2.      WITHOUT Place of Service (POS): 23.

3.     Telehealth encounters with modifiers are eligible

GQ, GT, 95, or POS 02

DENOMINATOR EXCLUSION:

G9692 – Hospice services received by patient any time during the measurement period.

NUMERATOR CRITERIA: Any one of the following

  • 1123F – Advance Care Planning discussed and documented; advance care plan or surrogate decision maker documented in the medical record
  • 1124F – Advance Care Planning discussed and documented in the medical record; patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan