Measure 176 – Rheumatoid Arthritis (RA): Tuberculosis Screening

Audit Criteria

When we’re reviewing your clinicians’ data, it may be helpful to know what we are looking for in order for us to verify to CMS that your data is accurate and complete. Measure 176 requires documentation that a patient with a diagnosis of rheumatoid arthritis received a tuberculosis (TB) screening and the results were interpreted up to 12 months prior to receiving a first course of therapy using a biologic disease-modifying anti-rheumatic drug (DMARD).

This documentation may be found in the patient’s medical record. The relevant document should be made available to the auditor for the patient requested.

 

What are the drug therapies this measure should be performed for prior to a prescription being written?

Biologic disease-modifying anti-rheumatic drug (DMARD) therapy includes:

  • Adalimunab
  • Etanercept
  • Infliximab
  • Abatacept
  • Anakinra
  • Rituximab
  • Certolizumab pegol (Cimizia)
  • Tocilizumab
  • Golimumab (Simponi)
  • Humira
  • Enbrel
  • Orencia
  • Remicade
  • Rituxan
  • Acetmra
  • Kineret
  • Xeljanz
  • Tofacitinib
  • Kevzara (Sarilumab)
  • Inflectra (Infliximab-dyyp)
  • Renflexis (Infliximab-abda)
  • Ixifi (Infliximab-qbtx)
  • Erelzi (Etanercept-szzs)
  • Amjevita (Adalimumab-atto)
  • Cyltezo (Adalimumab-adbm)