Table 1.

Description of Medicare PQRS Osteoporosis and Rheumatoid Arthritis Quality Measures Relevant in 2009

PQRS Measure number and construct	Criteria used to Define Eligible Population	Care Recommended by CMS PQRS Measure	Relevant HCPCS II Codes
Measure #39: Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older	Female patients aged 65 years and older	Had a central dual-energy X-ray absorptiometry (DXA) measurement ordered or performed at least once since age 60 or pharmacologic therapy prescribed within 12 months	3095F – DXA results available, DXA not ordered
			3096F – DXA ordered
			4005F – prescription osteoporosis medication ordered
Measure #40: Osteoporosis: Management Following Fracture	Patients aged 50 years and older with fracture of the hip, spine or distal radius	Central dual-energy X-ray absorptiometry (DXA) measurement ordered or performed or pharmacologic therapy prescribed	3095F – DXA results available, DXA not ordered
			3096F – DXA ordered
			4005F – prescription osteoporosis medication ordered
Measure #41: Osteoporosis: Pharmacologic Therapy	Patients aged 50 years and older with a diagnosis of osteoporosis	Pharmacologic therapy (other than minerals/vitamins) for osteoporosis prescribed	4005F – prescription osteoporosis medication ordered
#108: Disease Modifying Anti-Rheumatic Drug Therapy in Rheumatoid Arthritis	Patients 18 years and older with a diagnosis of RA	Prescribed, dispensed, or administered a disease modifying anti-rheumatic drug (DMARD) or biologic (at least 1 prescription or infusion)	4187 – DMARD prescribed
Measure #177: Rheumatoid Arthritis (RA): Periodic Assessment of Disease Activity	Patients 18 years and older with a diagnosis of RA	Assessment and classification of disease activity within 12 months	3470F – RA disease activity assessed
Measure #178: Rheumatoid Arthritis (RA): Functional Status Assessment	Patients 18 years and older with a diagnosis of RA	Functional status assessment was performed at least once within 12 months	1170F – RA functional status assessed

DXA = dual x-ray energy absorptiometry; RA = rheumatoid arthritis; DMARD = disease modifying anti-rheumatic drug; HCPCS = Healthcare Common Procedure Coding System