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Preventive Care & Screening: Tobacco Use: Screening and Cessation Intervention

Updated: 08/19/2020
Views: 1814

Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 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 24 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 24 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 is 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 is entered when you created the patient’s account.
  • 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 is 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 24 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 24 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.
  • Smoking Status is entered in Social History.
  • 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 the 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:
  • Complete the note and make sure to include an E/M Codes or CPT/HCPCS Codes on the Superbill.
    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.
  • Sign the note.

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

Guidance: If a patient has multiple tobacco use screenings during the 24-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.   
Quality ID: 226
CMS Measure ID: CMS138
Measure type: Process
High Priority Measure: No