Osteoporosis Management in Women Who Had a Fracture (OMW)
HEDIS Measure
Osteoporosis Management in Women Who Had a Fracture (OMW)
Line of business: Medicare
Data Collection Method: Administrative (Claims)
Bone Mineral Density (BMD) Test Only
Supplemental Data Submission
- Standard – Electronic Clinical Data System (ECDS) Layout
Measure Description
The percentage of women 67–85 years of age who suffered a fracture and who had either a bone mineral density (BMD) test or prescription for a drug to treat osteoporosis in the six months after the fracture.
Numerator Compliance
Appropriate testing or treatment for osteoporosis after the fracture defined by any of the following criteria:
- A BMD test in any setting, on the IESD or in the 180-day (6-month) period after the IESD.
- If the IESD was an inpatient stay, a BMD test during the inpatient stay.
- Osteoporosis therapy on the IESD or in the 180-day (6- month) period after the IESD.
- If the IESD was an inpatient stay, long-acting osteoporosis therapy during the inpatient stay.
- A dispensed prescription to treat osteoporosis on the IESD or in the 180-day (6-month) period after the IESD.
Intake Period - A 12-month (1 year) window that begins on July 1 of the year prior to the measurement year and ends on June 30 of the measurement year. The intake period is used to capture the first fracture.
Episode Date - The date of service for an eligible encounter during the intake period with a diagnosis of fracture.
For an outpatient, observation or ED visit, the episode date is the date ofservice.
- For an inpatient stay, the episode date is the date of discharge.
- For direct transfers, the episode date is the discharge date from the lastadmission.
IESD - Index Episode Start Date. The earliest episode date during the intake period that meets all eligible population criteria.
Best Practices
- Reference The American College of Obstetricians and Gynecologists' Osteoporosis FAQ: www.acog.org/en/Patient%20Resources/FAQs Women's Health/Osteoporosis
- Reference Healthy People gov's Osteoporosis to Prevent Fracture: Screening https://www.healthypeople.gov/2020/tools- resources/evidence-basedresource/osteoporosis-to-prevent- fractures-screening
OSTEOPOROSIS MEDICATIONS
Description | Prescriptions |
---|---|
Bisphosphonates | Alendronate, Alendronate-cholecalciferol, Ibandronate, Risedronate, Zoledronic acid |
Other agents | Abaloparatide, Denosumab, Raloxifene, Romosozumab, Teriparatide |
Quality Value Set Directory Coding Tips
Bone Mineral Density Tests
CPT
- 76977
- 77078
- 77080
- 77081
- 77085
- 77086
ICD10PCS
- BP48ZZ1
- BP49ZZ1
- BP4GZZ1
- BP4HZZ1
- BP4LZZ1
- BP4MZZ1
- BP4NZZ1
- BP4PZZ1
- BQ00ZZ1
- BQ01ZZ1
- BQ03ZZ1
- BQ04ZZ1
- BR00ZZ1
- BR07ZZ1
- BR09ZZ1
- BR0GZZ1
ICD9PCS
- 88.98
SNOMED CT US Edition
-
22059005
- 312681000
- 385342005
- 391057001
- 391058006
- 391059003
- 391060008
- 391061007
- 391062000
- 391063005
- 391064004
- 391065003
- 391066002
- 391069009
- 391070005
- 391071009
- 391072002
- 391073007
- 391074001
- 391076004
- 391078003
- 391079006
- 391080009
- 391081008
- 391082001
- 440083004
- 440099005
- 440100002
- 449781000
- 707218004
- 4211000179102
Osteoporosis Medication Therapy
HCPCS
- J0897
- J1740
- J3110
- J3111
- J3489