MIPS 404 - American Society of Anesthesiologists (ASA)

Physician anesthesiologists play an important role in helping people who smoke to quit – especially on the patient’s procedure day. 

Physician anesthesiologists may report MIPS #404 - Anesthesiology Smoking Abstinence as part of the Merit-based Incentive Payment System (MIPS) Quality Component. Participants in AQI NACOR may also report the measure to benchmark local results regardless of a practice's participation in national payment programs.

In general, the measure requires an anesthesiologist or their proxy to instruct the patient in the days leading up to their elective procedure to abstain from smoking on the day of their procedure. The anesthesiologist then records if the patient smoked on the day of their procedure.

Although evidence suggests that the longer the duration of abstinence the better, there is also evidence that even brief abstinence (e.g., abstaining from smoking on the morning of surgery) can dramatically reduce both nicotine and carbon monoxide levels and reduce risks for complications such as intraoperative myocardial ischemia.

For information on how to report the measure, please visit the CMS Quality Payment Program website and download the measure specification. MIPS #404 is reportable via the Qualified Registry and the Qualified Clinical Data Registry reporting mechanisms.

Please contact the ASA Department of Quality and Regulatory Affairs (QRA) at qra@asahq.org for additional information.


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