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U.S. Department of Health and Human Services
Clinical Reporting System (CRS)

CRS 2017 (v17.0 and v17.1)

CRS VERSION 17.1

CRS Version 17.1 was released on June 20, 2017.

Key enhancements included in CRS Version 17.1 are shown below.

  • Logic Changes to National GPRA/GPRAMA Report Measures
    • GPRA Developmental Measures:
      • Added the following new GPRA Developmental measures:
        • Access to Dental Service (Patients with a dental visit during the Report Period who had a dental exam)
        • Dental Sealants (Patients with a dental visit during the Report Period who have intact dental sealants)
        • Topical Fluoride (Patients with a dental visit during the Report Period who had a fluoride application)
        • Adult Immunizations (Pregnant patients with a visit during their third trimester who had a Tdap during their third trimester)
      • Updated codes and/or logic in the following measures: Diabetes: Blood Pressure Control; Access to Dental Service; Adult Immunizations; Childhood Immunizations.
    • Diabetes: Glycemic Control: (1) Updated Poor Control to be >9 instead of >9.5. (2) Added logic for CPT 3046F to indicate A1c > 9.
    • Diabetes: Blood Pressure Control: Added Clinic Code 79 (Triage) to BP exclusions.
    • Statin Therapy to Reduce Cardiovascular Disease Risk in Patients with Diabetes: (1) Changed logic to include prescriptions written prior to the Report Period with enough days' supply to overlap the Report Period. (2) Added ICD-10 codes I12.0, I13.11, I13.2, N18.5, N19. to ESRD definition.
    • Diabetes: Nephropathy Assessment: Added ICD-10 codes I12.0, I13.11, I13.2, N18.5, N19. to ESRD definition.
    • Access to Dental Service: Added age breakdowns 0-2, 3-5, 6-9, 10-12, 13-15, 16-21 and removed 6-21.
    • Dental Sealants: Added age breakdown of age 2 and removed 2-5 and 5-19.
    • Topical Fluoride: (1) Added ICD-10 code Z29.3 to Topical Fluoride definition. (2) Added age breakdowns: 1-2, 3-5, 1-5, 6-9, 10-12, 13-15.
    • Influenza: Added CVX code 171 and CPT code 90674 to Influenza definition.
    • Childhood Immunizations: Added CPT code 90739 to Hep B definition. (2) Added CPT code 90697 to DTaP, IPV, Hib, and Hep B definitions.
    • Cancer Screening: Mammogram Rates: Added CPT codes 77065 through 77067 to Mammogram definition.
    • Alcohol Screening: Added new measures for AC+BH 9-75 and User Population 9-75.
    • Antidepressant Medication Management: Updated BGP HEDIS ANTIDEPRESSANT MEDS taxonomy.
    • Controlling High Blood Pressure - Million Hearts: (1) Added ICD-10 codes I12.0, I13.11, I13.2, N18.5, N19. to ESRD definition. (2) Added Clinic Code 79 (Triage) to BP exclusions.
    • Statin Therapy for the Prevention and Treatment of Cardiovascular Disease: (1) Changed logic to include prescriptions written prior to the Report Period with enough days' supply to overlap the Report Period. (2) Added ICD-10 codes I12.0, I13.11, I13.2, N18.5, N19. to ESRD definition.
    • Breastfeeding Rates: Updated age range of 2 months to be 38-89 days.

CRS Version 17.0

CRS Version 17.0 was released on September 29, 2016.

Key enhancements included in CRS Version 17.0 are shown below.

  • Logic Changes to National GPRA/GPRAMA Report Measures
    • Key changes to GPRA/GPRAMA Measures:
      • Replaced Alcohol Screening (FAS Prevention) GRPA measure with Universal Alcohol Screening (ages 12 through 75) measure
      • Added new GPRA measure for Screening, Brief Intervention, and Referral to Treatment (SBIRT)
      • Added new GPRA measure for Depression Screening (ages 12 through 17)
      • Added new GPRA measures for Antidepressant Medication Management (patients with Acute Phase Treatment and patients with Continuation Phase Treatment)
      • Replaced Comprehensive CVD-Related Assessment GPRA measure with Statin Therapy for the Prevention and Treatment of Cardiovascular Disease measure
    • GPRA Developmental Measures:
      • Added the following new GPRA Developmental measures:
        • Diabetes: Glycemic Control (Active Diabetic denominator includes Problem List entries)
        • Adult Immunizations (Composite measure for age 19 and older with age-appropriate immunizations)
        • HIV Screening: (New measures for male patients age 25 through 45 with positive result and HIV screening ever)
        • Chlamydia Testing (New refusal measures)
        • Sexually Transmitted Infection (STI) Screening (New refusal measures)
      • Removed topics:
        • Alcohol Screening
        • Screening, Brief Intervention, and Referral to Treatment (SBIRT)
        • Depression Screening
        • Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
      • Updated codes and/or logic in the following measures: Childhood Immunizations; Colorectal Cancer Screening (Revised Logic #2-USPSTF); Comprehensive Cancer Screening; HIV Screening; Hepatitis C Screening; Optometry; Visit Statistics.
    • Statin Therapy to Reduce Cardiovascular Disease Risk in Patients with Diabetes: (1) Added logic to CVD definitions to look at the Problem List. (2) Added SNOMED data set PXRM ISCHEMIC HEART DISEASE to CHD definition (for Problem List only). (3) Added SNOMED data set PXRM BGP AMI to AMI definition (for Problem List only). (4) Added SNOMED data set PXRM BGP IVD to IVD definition (for Problem List only). (5) Added SNOMED data set PXRM BGP ISCHEMIC STROKE TIA to ischemic stroke/TIA definition (for Problem List only). (6) Added logic to Acute Alcoholic Hepatitis definition to look at the Problem List. (7) Added SNOMED data set PXRM BGP ACUTE ETOH HEPATITIS to acute alcoholic hepatitis definition (for Problem List only). (8) Added logic to Myopathy/Myalgia definition to look at the Problem List. (9) Added SNOMED data set PXRM BGP MYOPATHY MYALGIA to myopathy/myalgia definition (for Problem List only). (10) Updated adverse drug reaction/documented statin allergy logic to clarify that Problem List entry status is not Deleted. (11) Added SNOMED data set PXRM BGP ADR STATIN to statin adverse reaction definition (for Problem List only). (12) Added logic to cirrhosis of the liver definition to look at the Problem List. (13) Added SNOMED data set PXRM BGP CIRRHOSIS to cirrhosis of the liver definition (for Problem List only). (14) Added logic to ESRD definition to look at the Problem List. (15) Added SNOMED data set PXRM END STAGE RENAL DISEASE to ESRD definition (for Problem List only).
    • Diabetes: Nephropathy Assessment: (1) Added logic to ESRD definition to look at the Problem List. (2) Added SNOMED data set PXRM END STAGE RENAL DISEASE to ESRD definition (for Problem List only). (3) Removed LOINC codes 24362-6, 45066-8, and 50261-7 from BGP ESTIMATED GFR LOINC taxonomy.
    • Diabetic Retinopathy: (1) Removed ICD-10 codes H54.10-H54.12 from bilateral blindness definition. (2) Changed logic for bilateral blindness to include inactive problems on the Problem List. (3) Added SNOMED data set PXRM BGP BILAT BLINDNESS and PXRM BGP BLINDNESS UNSPECIFIED with Laterality equal to Bilateral to bilateral blindness definition (for Problem List only). (4) Added SNOMED data sets PXRM BGP LEFT EYE BLIND, PXRM BGP BLINDNESS UNSPECIFIED with Laterality equal to Left, PXRM BGP RIGHT EYE BLIND, and PXRM BGP BLINDNESS UNSPECIFIED with Laterality equal to Right to bilateral blindness definition (for Problem List only).
    • Childhood Immunizations: (1) Added SNOMED data set PXRM BGP POLIO to IPV evidence of disease definition (for Problem List only). (2) Added SNOMED data set PXRM BGP MEASLES to measles evidence of disease definition (for Problem List only). (3) Added SNOMED data set PXRM BGP RUBELLA to rubella evidence of disease definition (for Problem List only). (4) Added SNOMED data set PXRM BGP HEPATITIS A to Hepatitis A evidence of disease definition (for Problem List only). (5) Added SNOMED data set PXRM BGP HEPATITIS B to Hepatitis B evidence of disease definition (for Problem List only). (6) Added SNOMED data set PXRM BGP VARICELLA to varicella evidence of disease definition (for Problem List only).
    • Cancer Screening: Pap Smear Rates: (1) Removed ICD-10 code Z90.711 from hysterectomy definition. (2) Updated hysterectomy definition to include inactive Problem List items. (3) Added SNOMED data set PXRM BGP HYSTERECTOMY DX to hysterectomy definition (for Problem List only).
    • Cancer Screening: Mammogram Rates: (1) Added logic to look at the Problem List for bilateral and unilateral mastectomies. (2) Added SNOMED data set PXRM BGP BILAT MASTECTOMY to bilateral mastectomy definition (for Problem List only). (3) Added SNOMED data set PXRM BGP RIGHT MASTECTOMY to right mastectomy definition (for Problem List only). (4) Added SNOMED data set PXRM BGP LEFT MASTECTOMY to left mastectomy definition (for Problem List only).
    • Colorectal Cancer Screening: (1) Added logic to colorectal cancer screening definition to look at the Problem List. (2) Added SNOMED data set PXRM COLORECTAL CANCER to colorectal cancer definition (for Problem List only). (3) Added LOINC code 80372-6 to BGP FOBT LOINC CODES taxonomy.
    • Tobacco Use and Exposure Assessment: (1) Added SNOMED data set PXRM BGP TOBACCO SCREENED to tobacco-related diagnosis definition (for Problem List only). (2) Added SNOMED data set PXRM BGP CURRENT TOBACCO to tobacco user definition (for Problem List only). (3) Added SNOMED data set PXRM BGP TOBACCO SMOKER to smoker definition (for Problem List only). (4) Added SNOMED data set PXRM BGP TOBACCO SMOKELESS to smokeless definition (for Problem List only).
    • Tobacco Cessation: (1) Added SNOMED data set PXRM BGP QUIT TOBACCO to quit tobacco definition (for Problem List only). (2) Added SNOMED data set PXRM BGP CURRENT TOBACCO to tobacco user definition (for Problem List only).
    • Alcohol Screening: (1) Changed topic to Alcohol Screening from Alcohol Screening (FAS Prevention). (2) Moved measures from GPRA Developmental report to Selected Measures report. (3) Changed GPRA measure to Universal Alcohol Screening measure. (4) Removed User Pop FAS measures. (5) Added new measure with User Pop denominator. (6) Added SNOMED data set PXRM BGP ETOH RELATED DX to alcohol-related diagnosis definition (for Problem List only).
    • Screening, Brief Intervention, and Referral to Treatment (SBIRT): (1) Made BNI/BI measure new GPRA measure. (2) Added new measure with User Pop denominator.
    • Intimate Partner (Domestic) Violence Screening: Added SNOMED data set PXRM BGP IPV DV DX to IPV/DV diagnosis definition (for Problem List only).
    • Depression Screening: (1) Added measures for ages 12 through 17. (2) Created new GPRA measure for age 12 through 17. (3) Added PHQT to depression screening definition.
    • Antidepressant Medication Management: Made two measures new GPRA measures.
    • Controlling High Blood Pressure - Million Hearts: (1) Added logic to ESRD definition to look at the Problem List. (2) Added SNOMED data set PXRM END STAGE RENAL DISEASE to ESRD definition (for Problem List only). (3) Added SNOMED data set PXRM ESSENTIAL HYPERTENSION to hypertension definition (for Problem List only).
    • Comprehensive Cardiovascular disease (CVD)-Related Assessment: Removed from all reports.
    • Statin Therapy for the Prevention and Treatment of Cardiovascular Disease: New GPRA measure.
    • HIV Screening: (1) Changed logic for HIV to include inactive problems on the Problem List. (2) Added SNOMED data set PXRM HIV to HIV diagnosis definition (for Problem List only).

CRS 2017 DOCUMENTATION