Osteoporosis management in Perform bone mineral Physician codes women who had a fracture density testing within 180 Osteoporosis therapy medication injections – (OMW) days of fracture date. HCPCS: J0630, J0897, J1740, J3110, J3487, J3488, J3489 Weight = 1 Percentage of females 67 to 85 Radiology codes years old who suffered a fracture Bone mineral density test and had either a bone mineral and/or CPT: 76977, 77078, 77080, 77081, 77082, 77085, 77086 density (BMD) test or prescription HCPCS: G0130 to treat or prevent osteoporosis in ICD-10-CM procedure: BP48ZZ1, BP49ZZ1, BP4GZZ1, the six months after the fracture BP4HZZ1, BP4LZZ1, BP4MZZ1, BP4NZZ1, BP4PZZ1, BQ00ZZ1, Prescribe a medication to BQ01ZZ1, BQ03ZZ1, BQ04ZZ1, BR00ZZ1, BR07ZZ1, BR09ZZ1, To exclude: Either a BMD within treat or prevent BR0GZZ1 24 months or drug treatment for osteoporosis within 180 NDC codes osteoporosis within 12 months days (six months) after the are several NDC codes for prescriptions to treat prior to the fracture date fracture. osteoporosis based on pharmacy claims received by Humana. NCQA posts a comprehensive list of these NDC codes on its website each year. Description: Bisphosphonates Alendronate Ibandronate ▪ ▪ Alendronate-cholecalciferol Risedronate ▪ ▪ Calcium carbonate-risedronate Zoledronic acid ▪ ▪ Description: Other agents Calcitonin Raloxifene ▪ Denosumab Teriparatide ▪ Additional information The following codes identify fractures (eligible members) S2360
Osteoporosis management in women who had a fracture (OMW) Weight = 1 Percentage of females 67 to 85 years old who suffered a fracture and had either a bone mineral density (BMD) test or prescription to treat or prevent osteoporosis in the six months after the fracture To exclude: Either a BMD within 24 months or drug treatment for osteoporosis within 12 months prior to the fracture date Perform bone mineral density testing within 180 days of fracture date. and/or Prescribe a medication to treat or prevent osteoporosis within 180 days (six months) after the fracture. Physician codes Osteoporosis therapy – medication injections HCPCS: J0630, J0897, J1740, J3110, J3487, J3488, J3489 Radiology codes Bone mineral density test CPT: 76977, 77078, 77080, 77081, 77082, 77085, 77086 HCPCS: G0130 ICD-10-CM procedure: BP48ZZ1, BP49ZZ1, BP4GZZ1, BP4HZZ1, BP4LZZ1, BP4MZZ1, BP4NZZ1, BP4PZZ1, BQ00ZZ1, BQ01ZZ1, BQ03ZZ1, BQ04ZZ1, BR00ZZ1, BR07ZZ1, BR09ZZ1, BR0GZZ1 NDC codes are several NDC codes for prescriptions to treat osteoporosis based on pharmacy claims received by Humana. NCQA posts a comprehensive list of these NDC codes on its website each year. Description: Bisphosphonates ▪ Alendronate ▪ Ibandronate ▪ Alendronate-cholecalciferol ▪ Risedronate ▪ Calcium carbonate-risedronate ▪ Zoledronic acid Description: Other agents Calcitonin ▪ Raloxifene Denosumab ▪ Teriparatide Additional information The following codes identify fractures (eligible members) S2360
2017-Humana-Medicare-HEDIS-Guide.docx