PERSISTENCE OF BETA BLOCKER TREATMENT AFTER A HEART ATTACK
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1 PERSISTENCE OF BETA BLOCKER TREATMENT AFTER A HEART ATTACK APPLICATIONS OBJECTIVE Purpose of Measure: ELIGIBLE POPULATION Which members are included? HEDIS (Administrative) NCQA Accreditation (Medicare only) NCQA Rating (Medicare only) To identify members who were hospitalized and discharged from July 1st of the year prior to the measurement year to June 30th of the measurement year with a diagnosis of AMI and who received persistent beta-blocker treatment for six (6) months after discharge. Members 18 years and older as of December 31 of the measurement year. STANDARD OF CARE Beta-blockers should be prescribed for at least six (6) months following acute myocardial infarction. NCQA ACCEPTED Please see code table. CODES: DOCUMENTATION REQUIREMENTS What documentation should be submitted? REFERENCES Table PBH-B: Beta-Blocker Medications* Description Prescription Noncardioselective beta-blockers Cardioselective beta-blockers Antihypertensive combinations Carvedilol Labetalol Nadolol Penbutolol Pindolol Betaxolol Bisoprolol Acebutolol Atenolol Atenolol-chlorthalidone Bendroflumethiazidenadolol Bisoprololhydrochlorothiazide Propranolol Timolol Sotalol Metoprolol Nebivolol Hydrochlorothiazidemetoprolol Hydrochlorothiazidepropranolol Documentation should include date of service, date of diagnosis of AMI, and clear evidence that Betablocker was prescribed (medication list containing beta-blocker and the date it was prescribed, note indicating the name of the beta-blocker and the date it was prescribed, or a copy of the prescription that was given to the member). For more information, please refer to Passport Health
2 Plan s Cardiovascular Clinical Practice Guideline. The criteria above are based on standards established under NCQA s HEDIS 2017 Technical Specifications. HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). If you have questions about medications or our formulary, please visit our website or contact: o Paula Straub, Outreach Pharmacist Consultant (contracted) pstraub@phdelivery.com or phone , covers regions 3, 5, and 6 o Cheryl Stevens, Outreach Pharmacist Consultant Covers region 1, 2, 4, 7, & 8. cstevens@phdelivery.com or phone *If you have any questions about the Healthy Heart Program, please contact a Care Advisor at , press 0, then press TTY users may call
3 PERSISTENCE OF BETA-BLOCKER TREATMENT AFTER A HEART ATTACK Meet Screening Criteria AMI ICD10CM I21.01 [I21.01] ST elevation (STEMI) myocardial infarction involving left main coronary artery ICD10CM I21.02 [I21.02] ST elevation (STEMI) myocardial infarction involving left anterior descending coronary artery ICD10CM I21.09 [I21.09] ST elevation (STEMI) myocardial infarction involving other coronary artery of anterior wall ICD10CM I21.11 [I21.11] ST elevation (STEMI) myocardial infarction involving right coronary artery ICD10CM I21.19 [I21.19] ST elevation (STEMI) myocardial infarction involving other coronary artery of inferior wall ICD10CM I21.21 [I21.21] ST elevation (STEMI) myocardial infarction involving left circumflex coronary artery ICD10CM I21.29 [I21.29] ST elevation (STEMI) myocardial infarction involving other sites ICD10CM I21.3 [I21.3] ST elevation (STEMI) myocardial infarction of unspecified site ICD10CM I21.4 [I21.4] Non-ST elevation (NSTEMI) myocardial infarction ICD9CM AMI anterolateral, init ICD9CM AMI anterior wall, init ICD9CM AMI inferolateral, init ICD9CM AMI inferopost, initial ICD9CM AMI inferior wall, init ICD9CM AMI lateral NEC, initial ICD9CM True post infarct, init ICD9CM Subendo infarct, initial ICD9CM AMI NEC, initial ICD9CM AMI NOS, initial Exclusions Asthma ICD10CM J45.20 [J45.20] Mild intermittent asthma, uncomplicated ICD10CM J45.21 [J45.21] Mild intermittent asthma with (acute) exacerbation ICD10CM J45.22 [J45.22] Mild intermittent asthma with status asthmaticus ICD10CM J45.30 [J45.30] Mild persistent asthma, uncomplicated ICD10CM J45.31 [J45.31] Mild persistent asthma with (acute) exacerbation ICD10CM J45.32 [J45.32] Mild persistent asthma with status asthmaticus ICD10CM J45.40 [J45.40] Moderate persistent asthma, uncomplicated
4 ICD10CM J45.41 [J45.41] Moderate persistent asthma with (acute) exacerbation ICD10CM J45.42 [J45.42] Moderate persistent asthma with status asthmaticus ICD10CM J45.50 [J45.50] Severe persistent asthma, uncomplicated ICD10CM J45.51 [J45.51] Severe persistent asthma with (acute) exacerbation ICD10CM J45.52 [J45.52] Severe persistent asthma with status asthmaticus ICD10CM J [J45.901] Unspecified asthma with (acute) exacerbation ICD10CM J [J45.902] Unspecified asthma with status asthmaticus ICD10CM J [J45.909] Unspecified asthma, uncomplicated ICD10CM J [J45.990] Exercise induced bronchospasm ICD10CM J [J45.991] Cough variant asthma ICD10CM J [J45.998] Other asthma ICD9CM Extrinsic asthma NOS ICD9CM Ext asthma w status asth ICD9CM Ext asthma w(acute) exac ICD9CM Intrinsic asthma NOS ICD9CM Int asthma w status asth ICD9CM Int asthma w (ac) exac ICD9CM Exercse ind bronchospasm ICD9CM Cough variant asthma ICD9CM Asthma NOS ICD9CM Asthma w status asthmat ICD9CM Asthma NOS w (ac) exac COPD ICD10CM J44.0 [J44.0] Chronic obstructive pulmonary disease with acute lower respiratory infection ICD10CM J44.1 [J44.1] Chronic obstructive pulmonary disease with (acute) exacerbation ICD10CM J44.9 [J44.9] Chronic obstructive pulmonary disease, unspecified ICD9CM Chronic obst asthma NOS ICD9CM Ch ob asthma w stat asth ICD9CM Ch obst asth w (ac) exac ICD9CM 496 Chr airway obstruct NEC Obstructive Chronic Bronchitis ICD9CM Obst chr bronc w/o exac ICD9CM Obs chr bronc w(ac) exac ICD9CM Obs chr bronc w ac bronc Chronic Respiratory Conditions Due to Fumes/Vapors ICD10CM J68.4 [J68.4] Chronic respiratory conditions due to chemicals, gases, fumes and vapors
5 ICD9CM Fum/vapor chr resp cond Beta-Blocker Contraindications ICD10CM I44.1 [I44.1] Atrioventricular block, second degree ICD10CM I44.2 [I44.2] Atrioventricular block, complete ICD10CM I44.4 [I44.4] Left anterior fascicular block ICD10CM I44.5 [I44.5] Left posterior fascicular block ICD10CM I44.60 [I44.60] Unspecified fascicular block ICD10CM I44.69 [I44.69] Other fascicular block ICD10CM I44.7 [I44.7] Left bundle-branch block, unspecified ICD10CM I45.0 [I45.0] Right fascicular block ICD10CM I45.10 [I45.10] Unspecified right bundle-branch block ICD10CM I45.19 [I45.19] Other right bundle-branch block ICD10CM I45.2 [I45.2] Bifascicular block ICD10CM I45.3 [I45.3] Trifascicular block ICD10CM I45.6 [I45.6] Pre-excitation syndrome ICD10CM I49.5 [I49.5] Sick sinus syndrome ICD10CM I95.0 [I95.0] Idiopathic hypotension ICD10CM I95.1 [I95.1] Orthostatic hypotension ICD10CM I95.2 [I95.2] Hypotension due to drugs ICD10CM I95.3 [I95.3] Hypotension of hemodialysis ICD10CM I95.81 [I95.81] Postprocedural hypotension ICD10CM I95.89 [I95.89] Other hypotension ICD10CM I95.9 [I95.9] Hypotension, unspecified ICD10CM R00.1 [R00.1] Bradycardia, unspecified ICD9CM Atriovent block complete ICD9CM Atrioven block-mobitz ii ICD9CM Av block-2nd degree NEC ICD9CM Left bb hemiblock ICD9CM Left bb block NEC ICD9CM Rt bundle branch block ICD9CM Rt bbb/lft post fasc blk ICD9CM Rt bbb/lft ant fasc blk ICD9CM Bilat bb block NEC ICD9CM Trifascicular block ICD9CM Anomalous av excitation ICD9CM Sinoatrial node dysfunct ICD9CM Cardiac dysrhythmias NEC ICD9CM Orthostatic hypotension ICD9CM Chronic hypotension
6 ICD9CM Hemododialysis hypotensn ICD9CM Iatrogenc hypotnsion NEC ICD9CM Hypotension NEC ICD9CM Hypotension NOS
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