Concurrent Use of Opioids and Benzodiazepines (CUOB, CMS Adult Core Set)

Percent of Medicaid members age 18 and older with concurrent use of prescription opioids and benzodiazepines. Patients with a cancer diagnosis, sickle cell disease diagnosis,
or in hospice or palliative care are excluded.

Measure Identifier: CMS_A_CUOB

Please see Report Details below for more information on selected subgroups, organizations, and aggregation.

Tables

Data


License Agreements and Acknowledgements

Utilizing the Technical Specifications and Resource Manual and Value Sets for the Adult and Child Core Set and data from this report indicates your agreement and acceptance of the following license agreements and acknowledgements.

The American Medical Association (AMA) and the American Hospital Association (AHA) permit the use of Current Procedural Terminology (CPT) and National Uniform Billing Committee (NUBC) UB-04 codes solely for the purpose of reporting state data on Medicaid and CHIP Core Set measures to the Centers for Medicare & Medicaid Services (CMS).
The National Committee for Quality Assurance (NCQA), the Pharmacy Quality Alliance (PQA), and the National Association of State Directors of Developmental Disabilities Services (NASDDDS)/Human Services Research Institute (HSRI) permit the use of their technical specifications solely for the purpose of reporting state data on Medicaid and CHIP Core Set measures to the Centers for Medicare & Medicaid Services (CMS).

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For Proprietary Codes in the Adult Core Set

CPT® codes copyright 2021 American Medical Association. All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the American Medical Association (AMA). The AMA assumes no liability for the data contained herein.  Applicable FARS/DFARS apply.

You, your employees and agents are authorized to use CPT only as agreed upon with the AMA internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid or other programs administered by the Centers for Medicare and Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

American Hospital Association Disclaimer

Copyright © 2022, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at (312) 893-6816Applicable FARS\DFARS Restrictions Apply to Government Use. Please click here to see all U.S. Government Rights Provisions.

Making copies or utilizing the content of the UB-04 Manual, including the codes and/or descriptions, for internal purposes, resale and/or to be used in any product or publication; creating any modified or derivative work of the UB-04 Manual and/or codes and descriptions; and/or making any commercial use of UB-04 Manual or any portion thereof, including the codes and/or descriptions, is only authorized with an express license from the American Hospital Association

Some measure specifications contain codding from LOINC® (http://loinc.org). The LOINC table, LOINC codes, LOINC panels and form file, LOINC linguistic variants file, LOINC/RSNA Radiology Playbook, and LOINC/IEEE Medical Device Code Mapping Table are copyright © 1995-2021, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and available at no cost under the license at http://loinc.org/terms-of-use.

“SNOMED” and “SNOMED CT” are registered trademarks of the International Health Terminology Standards Development Organisation (IHTSDO).

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CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT should be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

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CPT is provided “as is” without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with (INSERT NAME OF PROVIDING ENTITY) or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

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For Codes in the Public Domain used in the Adult Core Set measures:

The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is published by the World Health Organization (WHO). ICD-10-CM is an official Health Insurance Portability and Accountability Act standard.

The National Drug Code (NDC) Directory is published by the U.S. Food and Drug Administration and is made available under the Open Database License at http://opendatacommons.org/licenses/odbl/1.0/. Any rights in individual contents of the database are licensed under the Database Contents License at http://opendatacommons.org/licenses/dbcl/1.0/

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FOR THE CMS SCREENING FOR DEPRESSION AND FOLLOW-UP PLAN MEASURE:

These performance measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. PCPI disclaims all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications.

Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets.

CPT® contained in the Measure specifications is copyright 2004-2021 American Medical Association. LOINC® is copyright 2004-2021 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms® (SNOMED CT®) copyright 2004- 2020 International Health Terminology Standards Development Organisation. ICD-10 is copyright 2020 World Health Organization. All Rights Reserved.  THE MEASURE AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND.

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FOR THE PHARMACY QUALITY ALLIANCE (PQA) MEASURES:

PQA, Inc. retains all rights of ownership to the PQA measure specifications and value sets and can rescind or alter the measures at any time. No use of any PQA measure is authorized without prior PQA approval of such use. All uses of PQA measures are subject to such conditions as PQA specifies, and certain uses of the measures may be subject to a licensing agreement specifying the terms of use and the licensing fee. Users of the measure shall not have the right to alter, enhance, or otherwise modify the measures.

By agreeing to this statement, user accepts the following limitations of the use of the PQA measures: User acknowledges that the PQA measure specifications and value sets will only be used for the sole purpose of reporting state data on Medicaid and CHIP Core Set measures to CMS and will not be used for other purposes. Except for the purpose indicated above, the PQA measure specifications and value sets will not be used in any other commercial product, service, or value-added benefit. User also acknowledges that the PQA value sets will not be forwarded or provided to anyone outside of their organization.

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FOR THE USE OF PHARMACOTHERAPY FOR OPIOID USE DISORDER MEASURE:

The Use of Pharmacotherapy for Opioid Use Disorder (OUD) measure is maintained by The Lewin Group for Centers for Medicare & Medicaid Services (CMS) Programs through the Home and Community-Based Services (HCBS) Measures Development, Endorsement, Maintenance, and Alignment contract HHSM-500-2014-00033I, Task Order 75FCMC19F0004.

For Proprietary Codes:

Limited proprietary coding is contained in the measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. Lewin disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications. Professional organizations frequently update their codes. Code lists for calculation of this measure were accurate as of May 2021.

The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) is published by the World Health Organization (WHO). ICD-10-CM is an official Health Insurance Portability and Accountability Act standard.

Level II HCPCS codes in these specifications are approved and maintained jointly by the Alpha-Numeric Panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association.)

The National Drug Code (NDC) Directory is published by the U.S. Food and Drug Administration and is made available under the Open Database License at http://opendatacommons.org/licenses/odbl/1.0/.

Any rights in individual contents of the database are licensed under the Database Contents License at http://opendatacommons.org/licenses/dbcl/1.0/