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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