Product Lines:
Advantage MD, Dual Eligible Special Needs Plans (D-SNP).

Eligible Population:
Members age 66 years of age and older by December 31 of the measurement year.

Definition:
The percentage of adults 66–80 years of age with advanced illness, an indication of frailty or who are receiving palliative care, and adults 81 years of age and older who had advance care planning during the measurement year.

Continuous Enrollment:
The measurement year.

Best Practice and Measure Tips

• Have a discussion or documentation about preferences for resuscitation, life-sustaining treatment and end of life care.

Measure Exclusions

Required Exclusion:

• Members in hospice or using hospice services anytime during the measurement year.
• Members who died any time during the measurement year.

Measure Codes

Evidence of advance care planning during the measurement year.

• Advance Care Planning
  • CPT: 99483, 99497
  • CPT- CAT- II: 1123F, 1124F, 1157F,1158F
  • HCPCS: S0257
  • ICD-10-CM: Z66 Do not resuscitate