Download Initial Patient Population/Denominator

NQF-0036 Asthma
Initial Patient
Population: Patients 5-64 years of age with persistent asthma and a visit during the measurement period
Patients who were dispensed at least one prescription for a preferred therapy during the
measurement period
Numerator:
Exclusions: Not Applicable
Equals Initial Patient Population
Exceptions: None Exclusions: Patients with emphysema, COPD, cystic fibrosis or acute
Denominator:
respiratory failure during or prior to the measurement period
Initial Patient Population/Denominator To be considered a part of the denominator, the patient must be great than or equal to 5 years old and less than 64 years old. The patient must also have one of the following three diagnoses recorded before or during the measurement period, and the diagnosis must still be active at the start of the measurement period.  severe persistent asthma
 mild persistent asthma
 moderate persistent asthma
In addition to the diagnoses above, the patient must have an encounter with a superbill that includes one of the
following CPT codes, or they must have a problem added to their problem list that indicates a face-to-face
interaction:
CPT codes added to the superbill:
1. Office Visit: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
2. Established Office Visit 0 to 17: 99391, 99392, 99393, 99394
3. Established Office Visit, 18 and up: 99395, 99396, 99397
4. Preventative Care Services-Initial Office Visit, 18 and up: 99385, 99386, 99387
5. Preventative Care Services-Initial Office Visit, 0 to 17: 99381, 99382, 99383, 99384
6. Home Healthcare Services: 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
Problem added to the Problem list indicating a Face to Face Interaction
1. Subsequent hospital visit by physician
2. Subsequent nursing facility visit
3. Encounter for check-up
4. Visit out of hours
5. Weekend visit
6. Nursing evaluation of patient and report
7. History and physical examination with evaluation and management of nursing facility patient
8. Patient-initiated encounter
9. Provider-initiated encounter
10. Patient encounter procedure
11. Follow-up encounter
12. Urgent follow-up
13. Home visit
14. Emergency department patient visit
15. Follow-up inpatient consultation visit
16. Initial evaluation and management of healthy individual
Denominator Exclusions Patients in the denominator will be excluded from the denominator if they have a diagnosis indicating acute
respiratory failure, COPD, Cystic Fibrosis or Emphysema, which started before or during the measurement period
and was still active at the beginning of the measurement period. The list of actual problem names that would
exclude a patient from the diagnosis are listed below.
Acute Respiratory Failure
 Acute respiratory failure requiring reintubation  Acute respiratory failure  ARF  Acute‐on‐chronic respiratory failure Chronic Obstructive Pulmonary Disease  Acute infective exacerbation of chronic obstructive airways disease  Mild chronic obstructive pulmonary disease  Moderate chronic obstructive pulmonary disease  Severe chronic obstructive pulmonary disease  Chronic obstructive pulmonary disease with acute lower respiratory infection  End stage chronic obstructive airways disease  Chronic obstructive lung disease  Chronic airway obstruction  Chronic airflow obstruction  CAFL  CAO  Chronic airflow limitation  CAL  COPD  COLD  Chronic obstructive pulmonary disease  Acute exacerbation of chronic obstructive airways disease Cystic Fibrosis  Cystic fibrosis  CF  Mucoviscidosis  Cystic fibrosis with intestinal manifestations  Cystic fibrosis of pancreas  Fibrocystic disease of pancreas  Cystic fibrosis without meconium ileus  Cystic fibrosis with meconium ileus  Meconium ileus in cystic fibrosis  Cystic fibrosis of the lung Emphysema  Ruptured emphysematous bleb of lung  Pulmonary emphysema  Cystic‐bullous disease of the lung  Centriacinar emphysema  Centrilobular emphysema  Bronchial atresia with segmental pulmonary emphysema  Interstitial emphysema of lung  Chronic diffuse emphysema due to inhalation of chemical fumes AND/OR vapors  Congenital lobar emphysema  Vanishing lung  Bullous emphysema with collapse  Atrophic (senile) emphysema  Chronic emphysema due to chemical fumes 
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Acute bovine pulmonary emphysema AND edema (disorder) Gas bubble disease Pulmonary emphysema in alpha‐1 primary immunodeficiency deficiency Toxic emphysema Scar emphysema Paraseptal emphysema Compensatory emphysema Congenital emphysema Panacinar emphysema Panlobular emphysema Emphysematous bleb of lung Hemolytic anemia with emphysema AND cutis laxa Chronic bullous emphysema Segmental bullous emphysema Zonal bullous emphysema Acute vesicular emphysema Giant bullous emphysema Obstructive emphysema Numerator: Patients in the denominator who had a preferred asthma therapy (any of the following medications) during the
measurement period will be included in the numerator.
Full List of Preferred Asthma Therapies
Azmacort 75 mcg/inh inhalation aerosol
triamcinolone 75 mcg/inh inhalation aerosol
Aerospan 80 mcg/inh inhalation aerosol
flunisolide 80 mcg/inh inhalation aerosol
aminophylline 250 mg rectal suppository
Truphylline 250 mg rectal suppository
Dilor 200 mg oral tablet
dyphylline 200 mg oral tablet
Lufyllin 200 mg oral tablet
Neothylline 200 mg oral tablet
Dilor-400 oral tablet
dyphylline 400 mg oral tablet
Lufyllin-400 oral tablet
Neothylline 400 mg oral tablet
COPD 200 mg-200 mg oral tablet
Difil G 200 mg-200 mg oral tablet
Dilex-G 200 mg-200 mg oral tablet
Dilor-G 200 mg-200 mg oral tablet
Dyflex-G 200 mg-200 mg oral tablet
Dyline GG 200 mg-200 mg oral tablet
Dyphylline GG 200 mg-200 mg oral tablet
dyphylline-guaiFENesin 200 mg-200 mg oral
tablet
Dyphyllin-GG 200 mg-200 mg oral tablet
LGG 200 mg-200 mg oral tablet
Lufyllin-GG 200 mg-200 mg oral tablet
Bronkodyl 100 mg oral capsule
Elixophyllin 100 mg oral capsule
theophylline 100 mg oral capsule
Slo-Bid Gyrocaps 125 mg oral capsule, extended
release
Slo-Phyllin 125 oral capsule, extended release
TheoCap 125 mg oral capsule, extended release
theophylline 125 mg oral capsule, extended
release
Theovent 125 mg oral capsule, extended release
Theolair 125 mg oral tablet
theophylline 125 mg oral tablet
Theolair 250 mg oral tablet
theophylline 250 mg oral tablet
Quibron-T 300 mg oral tablet
theophylline 300 mg oral tablet
Theo-24 400 mg/24 hours oral capsule, extended
release
theophylline 400 mg/24 hours oral capsule,
extended release
theophylline-guaiFENesin 300 mg-180 mg oral
capsule
Quibron 300 oral capsule
Accolate 20 mg oral tablet
zafirlukast 20 mg oral tablet
zileuton 600 mg oral tablet
Zyflo 600 mg oral tablet
montelukast 10 mg oral tablet
Singulair 10 mg oral tablet
Theochron 100 mg oral tablet, extended release
Theo-Dur 100 mg oral tablet, extended release
theophylline 100 mg oral tablet, extended release
Theo-Time 100 mg oral tablet, extended release
Theo-X 100 mg oral tablet, extended release
Difil G 100 mg-100 mg/15 mL oral liquid
Dyfilin GG 100 mg-100 mg/15 mL oral liquid
Dy-G 100 mg-100 mg/15 mL oral liquid
Dyphyl GG 100 mg-100 mg/15 mL oral liquid
Dyphylline GG 100 mg-100 mg/15 mL oral liquid
dyphylline-guaiFENesin 100 mg-100 mg/15 mL
oral liquid
Dyphyllin-GG 100 mg-100 mg/15 mL oral liquid
Lufyllin-GG 100 mg-100 mg/15 mL oral liquid
montelukast 5 mg oral tablet, chewable
Singulair 5 mg oral tablet, chewable
Asbron G 300 mg-100 mg/15 mL oral liquid
Ed-Bron G 300 mg-100 mg/15 mL oral liquid
Equibron G 300 mg-100 mg/15 mL oral liquid
theophylline-guaiFENesin 300 mg-100 mg/15 mL
oral liquid
Theo G 300 mg-100 mg/15 mL oral liquid
budesonide 200 mcg/inh inhalation powder
Pulmicort Turbuhaler 200 mcg/inh inhalation
powder
Dylix 100 mg/15 mL oral elixir
dyphylline 100 mg/15 mL oral elixir
Lufyllin 100 mg/15 mL oral elixir
budesonide 1 mg/2 mL inhalation suspension
Pulmicort Respules 1 mg/2 mL inhalation
suspension
aminophylline 105 mg/5 mL oral solution
aminophylline/ePHEDrine/guaiFENesin/PHENob
arbital 130 mg-16 mg-100 mg-8 mg oral tablet
Mudrane GG oral tablet
aminophylline 200 mg oral tablet
aminophylline 25 mg/mL intravenous solution
D-G 300 mg-300 mg/15 mL oral liquid
Difil G Forte 300 mg-300 mg/15 mL oral liquid
Difil-G Forte 100 mg-100 mg/5 mL oral liquid
Dilex-G 300 mg-300 mg/15 mL oral liquid
Dilor-G 300 mg-300 mg/15 mL oral liquid
Dy-G 100 mg-100 mg/5 mL oral liquid
Dyline GG 300 mg-300 mg/15 mL oral liquid
dyphylline-guaiFENesin 100 mg-100 mg/5 mL
oral liquid
dyphylline-guaiFENesin 300 mg-300 mg/15 mL
oral liquid
Panfil G 300 mg-300 mg/15 mL oral liquid
Elixophyllin-GG 100 mg-100 mg/15 mL oral liquid
theophylline-guaiFENesin 100 mg-100 mg/15 mL
oral liquid
Broncomar GG 150 mg-90 mg/15 mL oral liquid
Glyceryl T 150 mg-90 mg/15 mL oral liquid
theophylline-guaiFENesin 150 mg-90 mg/15 mL
oral liquid
Q-B 150 mg-90 mg/15 mL oral liquid
Slo-Phyllin GG 150 mg-90 mg/15 mL oral liquid
Solu-Phyllin GG 150 mg-90 mg/15 mL oral liquid
Theocon 150 mg-90 mg/15 mL oral liquid
Theolate 150 mg-90 mg/15 mL oral liquid
Theomar G.G. 150 mg-90 mg/15 mL oral liquid
Theophyll-GG 150 mg-90 mg/15 mL oral liquid
montelukast 4 mg oral tablet, chewable
Singulair 4 mg oral tablet, chewable
theophylline 800 mcg/mL-D5% intravenous
solution
theophylline 1.6 mg/mL-D5% intravenous
solution
Slo-Bid Gyrocaps 200 mg oral capsule, extended
release
Theo-24 200 mg/24 hours oral capsule, extended
release
TheoCap 200 mg oral capsule, extended release
theophylline 200 mg oral capsule, extended
release
theophylline 200 mg/24 hours oral capsule,
extended release
theophylline 2 mg/mL-D5% intravenous solution
theophylline 3.2 mg/mL-D5% intravenous
solution
theophylline 400 mg/24 hours oral tablet,
extended release
Uni-Dur 400 mg/24 hours oral tablet, extended
release
Uniphyl 400 mg/24 hours oral tablet, extended
release
theophylline 4 mg/mL-D5% intravenous solution
theophylline 400 mg/100 mL-D5% intravenous
solution
Respbid 500 mg oral tablet, extended release
Theolair-SR 500 mg oral tablet, extended release
theophylline 500 mg oral tablet, extended release
Aerolate III 65 mg oral capsule, extended release
theophylline 65 mg oral capsule, extended
release
Slo-Bid Gyrocaps 75 mg oral capsule, extended
release
Theo-Dur Sprinkles 75 mg oral capsule,
extended release
theophylline 75 mg oral capsule, extended
release
Aquaphyllin 80 mg/15 mL oral solution
Asmalix 80 mg/15 mL oral solution
Elixophyllin 80 mg/15 mL oral elixir
Slo-Phyllin 80 oral syrup
Theoclear-80 oral syrup
Theolair 80 mg/15 mL oral solution
theophylline 80 mg/15 mL oral elixir
theophylline 80 mg/15 mL oral solution
theophylline 80 mg/15 mL oral syrup
Theosol-80 oral solution
Truxophyllin 80 mg/15 mL oral elixir
Truxophyllin 80 mg/15 mL oral solution (obsolete)
Slo-Bid Gyrocaps 300 mg oral capsule, extended
release
Theo-24 300 mg/24 hours oral capsule, extended
release
TheoCap 300 mg oral capsule, extended release
theophylline 300 mg oral capsule, extended
release
theophylline 300 mg/24 hours oral capsule,
extended release
Accolate 10 mg oral tablet
zafirlukast 10 mg oral tablet
aminophylline 100 mg oral tablet
Respbid 250 mg oral tablet, extended release
Theolair-SR 250 mg oral tablet, extended release
theophylline 250 mg oral tablet, extended release
Theochron 450 mg oral tablet, extended release
Theo-Dur 450 mg oral tablet, extended release
theophylline 450 mg oral tablet, extended release
Quibron-T/SR 300 mg oral tablet, extended
release
Theochron 300 mg oral tablet, extended release
Theo-Dur 300 mg oral tablet, extended release
Theolair-SR 300 mg oral tablet, extended release
theophylline 300 mg oral tablet, extended release
Theo-Time 300 mg oral tablet, extended release
Theo-X 300 mg oral tablet, extended release
Aerolate JR 130 mg oral capsule, extended
release
Theoclear L.A.-130 oral capsule, extended
release
theophylline 130 mg oral capsule, extended
release
Theochron 200 mg oral tablet, extended release
Theo-Dur 200 mg oral tablet, extended release
Theolair-SR 200 mg oral tablet, extended release
theophylline 200 mg oral tablet, extended release
Theo-Time 200 mg oral tablet, extended release
Theo-X 200 mg oral tablet, extended release
T-Phyl 200 mg oral tablet, extended release
theophylline 600 mg/24 hours oral tablet,
extended release
Uni-Dur 600 mg/24 hours oral tablet, extended
release
Uniphyl 600 mg/24 hours oral tablet, extended
release
budesonide 0.25 mg/2 mL inhalation suspension
Pulmicort Respules 0.25 mg/2 mL inhalation
suspension
Difil G 200 mg-300 mg oral tablet
Dyphylline GG ES 200 mg-300 mg oral tablet
dyphylline-guaiFENesin 200 mg-300 mg oral
tablet
budesonide 0.5 mg/2 mL inhalation suspension
Pulmicort Respules 0.5 mg/2 mL inhalation
suspension
montelukast 4 mg oral granule
Singulair 4 mg oral granule
Difil G 200 mg-400 mg oral tablet
Dilex-G 400 oral tablet
dyphylline-guaiFENesin 200 mg-400 mg oral
tablet
omalizumab 150 mg subcutaneous injection
Xolair 150 mg subcutaneous injection
aminophylline 225 mg oral tablet, extended
release
Phyllocontin 225 mg oral tablet, extended
release
aminophylline-guaiFENesin 111 mg-100 mg oral
tablet
Mudrane GG-2 111 mg-100 mg oral tablet
Asmanex Twisthaler 120 Dose 220 mcg/inh
inhalation aerosol powder
Asmanex Twisthaler 14 Dose 220 mcg/inh
inhalation aerosol powder
Asmanex Twisthaler 30 Dose 220 mcg/inh
inhalation aerosol powder
Asmanex Twisthaler 60 Dose 220 mcg/inh
inhalation aerosol powder
mometasone 200 mcg/inh inhalation aerosol
powder
mometasone 220 mcg/inh inhalation aerosol
powder
budesonide 180 mcg/inh inhalation powder
Pulmicort Flexhaler 180 mcg/inh inhalation
powder
budesonide 90 mcg/inh inhalation powder
Pulmicort Flexhaler 90 mcg/inh inhalation powder
Slo-Bid Gyrocaps 100 mg oral capsule, extended
release
Theo-24 100 mg/24 hours oral capsule, extended
release
theophylline 100 mg oral capsule, extended
release
theophylline 100 mg/24 hours oral capsule,
extended release
Slo-Bid Gyrocaps 50 mg oral capsule, extended
release
Theo-Dur Sprinkles 50 mg oral capsule,
extended release
theophylline 50 mg oral capsule, extended
release
zileuton 600 mg oral tablet, extended release
Zyflo CR 600 mg oral tablet, extended release
budesonide 32 mcg/inh nasal spray
Rhinocort Aqua 32 mcg/inh nasal spray
flunisolide 29 mcg/inh nasal spray
Nasarel 29 mcg/inh nasal spray
dyphylline-guaiFENesin 100 mg-50 mg/5 mL oral
syrup
Jay-Phyl 100 mg-50 mg/5 mL oral syrup
Panfil G 100 mg-50 mg/5 mL oral syrup
Dilex-G 200 oral syrup
dyphylline-guaiFENesin 100 mg-200 mg/5 mL
oral syrup
AeroBid 250 mcg/inh inhalation aerosol with
adapter
AeroBid-M 250 mcg/inh inhalation aerosol
flunisolide 250 mcg/inh inhalation aerosol
flunisolide 250 mcg/inh inhalation aerosol with
adapter
cromolyn 10 mg/mL inhalation solution
Intal 10 mg/mL inhalation solution
cromolyn 0.8 mg/inh inhalation aerosol with
adapter
Intal Inhaler 0.8 mg/inh inhalation aerosol with
adapter
cromolyn 20 mg/mL oral solution
Gastrocrom 20 mg/mL oral solution
cromolyn 100 mg oral capsule
Gastrocrom 100 mg oral capsule
Flovent HFA 44 mcg/inh inhalation aerosol
fluticasone CFC free 44 mcg/inh inhalation
aerosol
Flovent HFA 110 mcg/inh inhalation aerosol
fluticasone CFC free 110 mcg/inh inhalation
aerosol
Flovent HFA 220 mcg/inh inhalation aerosol
fluticasone CFC free 220 mcg/inh inhalation
aerosol
beclomethasone 0.042 mg/inh inhalation aerosol
beclomethasone 0.042 mg/inh inhalation aerosol
with adapter
Beclovent 0.042 mg/inh inhalation aerosol
Beclovent 0.042 mg/inh inhalation aerosol with
adapter
Vanceril 0.042 mg/inh inhalation aerosol with
adapter