Preventive Screenings
Breast Cancer Screening (BCS-E) applies to women in this age range.
What is 40–74?
For GSD, the most recent A1c must be at or below this percentage.
What is 9.0%?
FMC requires follow-up after an ED visit within this many days.
What is 7?
COA measures apply only to members of this type of plan.
What is a Special Needs Plan (SNP)?
CBP, GSD and PCR all carry this weight in the Stars program.
What is 3x?
A colonoscopy counts for COL-E in the year performed and this many years after.
What is nine?
CBP requires the LAST BP reading of the year to be below this value.
What is 140/90?
TRC medication reconciliation must occur within this many days of discharge.
What is 30?
This portion of the COA measure set was retired for MY25.
What is Pain Assessment?
CPT II 3072F means “low risk for retinopathy” and can close this diabetes measure.
What is the Eye Exam for Patients with Diabetes (EED)?
Having this procedure removes a member from Breast Cancer Screening eligibility.
What is a bilateral mastectomy?
KED requires both of these tests: one blood, one urine.
What are eGFR and uACR?
The PCR measure looks at readmissions within this many days of an acute inpatient or observation discharge.
What is 30 days?
For COA-F, assessment of ADLs counts if at least this many of the listed activities (bathing, dressing, eating, transferring, toileting, walking) were assessed.
What is five?
A patient needs BOTH of these to be excluded under the age 66+ exclusion.
What are frailty AND advanced illness?
The BCS-E compliance window runs this many months, from Oct. 1, 2024 to Dec. 31, 2026 for MY26.
What is 27 months?
The guide says to always do this if the first office BP reading is elevated.
What is repeat the blood pressure reading?
FMC applies to patients with multiple of these types of conditions, such as COPD, heart failure and CKD.
What are high-risk chronic conditions?
Both 1159F and 1160F must be documented to meet this Care for Older Adults measure.
What is COA-M (Medication Review)?
ESRD, Dialysis, Hospice, Palliative Care, PCOS, total Coloectomy, and Death.
What are Exclusions.
Although used clinically for breast cancer evaluation, these tests do not satisfy the BCS-E measure.
What are MRI, ultrasound, or biopsy?
If two separate urine tests are submitted for KED, they must be within this many days of each other.
What is four?
These four components follow “TRC-”
What are Notification of Inpatient Admission, Receipt of Discharge info, Patient Engagement, and Medication Reconciliation?
Typically the COA measures are completed at this type of office vist.
What is an Annual Wellness or Comprehensive Visit?
Besides hospice and death, OMW patients are removed from eligibility if they had a BMD test within this many months before the fracture.
What is 24 months?