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CMS 138 - Preventive Care & Screening: Tobacco Use: Screening and Cessation Intervention

Updated: 08/23/2021
Views: 2109

CMS 138 / Quality ID #226

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 12 months AND who received cessation counseling intervention if identified as a tobacco user.

Three rates are reported:

  1. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 12 months.
  2. Percentage of patients aged 18 years and older who were screened for tobacco use and identified as a tobacco user who received tobacco cessation intervention.
  3. Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 12 months AND who received tobacco cessation intervention if identified as a tobacco user.
Initial Population: All patients aged 18 years and older seen for at least two visits or at least one preventive visit during the measurement period.
Denominator:  Denominator 1:  Initial population.
  • Patient’s age is calculated based on the patient’s Date of Birth, which was entered when you created the patient’s account.
  • Create a note detailing the patient’s office visit.
Denominator 2: Initial population who were screened for tobacco use and identified as a tobacco user.
  • Patient’s age is calculated based on the patient’s Date of Birth, which was entered when you created the patient’s account.
  • Create a note detailing the patient’s office visit.
  • Smoking Status is entered in Social History.
  • On the date of service, click on Care Checklist from within the note.
  • Select "Completed" for Tobacco Use Screening (Age 12+): Tobacco Use Screening Completed on the date that it was discussed with the patient which should be the date of the note.

Denominator 3:  Initial population.

  • Patient’s age is calculated based on the patient’s Date of Birth, which was entered when you created the patient’s account.
  • Create a note detailing the patient’s office visit.
Numerator: Numerator 1: Patients who were screened for tobacco use at least once within 12 months.
  • On the date of service, click on Care Checklist from within the note.
  • Select "Completed" for Tobacco Use Screening (Age 12+): Tobacco Use Screening Completed on the date that it was discussed with the patient which should be the date of the note.
Numerator 2: Patients who received a tobacco cessation intervention.
  • On the date of service, click on Care Checklist from within the note.
  • Select "Completed" for Tobacco Use Screening (Age 12+): Tobacco Use Screening Completed on the date that it was discussed with the patient which should be the date of the note.
Numerator 3: Patients who were screened for tobacco use at least once within 12 months AND who received tobacco cessation intervention if identified as a tobacco user.
  • On the date of service, click on Care Checklist from within the note.
  • Select "Completed" for Tobacco Use Screening (Age 12+): Tobacco Use Screening Completed on the date that it was discussed with the patient which should be the date of the note.
  • Then, select "Completed" for Tobacco Cessation Counseling (Age 12+): Cessation counseling provided on the date that it was discussed with the patient which should be the date of the note.
Denominator Exceptions: Exception 1: If there was a medical reason(s) for not screening the patient for tobacco use:
  • On the date of service, click on Care Checklist from within the note.
  • Select "Excepted" for Tobacco Use Screening (Age 12+): Tobacco Use Screening Completed on the date that it was discussed with the patient which should be the date of the note.
  • Select Medical Contraindication from the drop-down.
Exception 2: If there is a medical reason(s) for not providing tobacco cessation intervention (e.g., limited life expectancy, other medical reason).
  • On the date of service, click on Care Checklist from within the note.
  • Select "Excepted" for Tobacco Use Screening (Age 12+): Tobacco Use Screening Completed on the date that it was discussed with the patient which should be the date of the note.
  • Select the appropriate medical reason from the drop-down.
Exception 3: If there is a medical reason(s) for not screening the patient for tobacco use OR for not providing tobacco cessation intervention for patients identified as tobacco users (e.g., limited life expectancy, other medical reason).
  • On the date of service, click on Care Checklist from within the note.
  • Select "Excepted" for Tobacco Use Screening (Age 12+): Tobacco Use Screening Completed on the date that it was discussed with the patient which should be the date of the note.
  • Select the appropriate medical reason from the drop-down.
  • Select "Excepted" for Tobacco Cessation Counseling (Age 12+): Cessation counseling provided on the date that it was discussed with the patient which should be the date of the note.
  • Select the appropriate medical reason from the drop-down.
Office Visit Documentation:
  • Enter Procedure Codes including E/M Codes or HCPCS Codes on the Superbill.
  • Complete and sign the note.
    Note: Select "Not Completed" for Tobacco Use Screening (Age 12+): Tobacco Use Screening Completed and /or Tobacco Cessation Counseling (Age 12+): Cessation counseling provided in the Care Checklist when the tobacco use screening and /or the cessation counseling was not completed by the provider.

Once all steps have been completed, the measure will be added to the Quality Measures Report.

Guidance: If a patient has multiple tobacco use screenings during the 12-month period, only the most recent screening, which has a documented status of tobacco user or tobacco non-user, will be used to satisfy the measure requirements.   
Measure type: Process
High Priority Measure: No
Telehealth Eligible: Yes