| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Claims, Registry | Process | Yes | Person and Caregiver-Centered Experience and Outcomes | Internal Medicine, Orthopedic Surgery, Physical Medicine, Preventive Medicine, General Practice/Family Medicine |
Measure Description
Percentage of patient visits for patients aged 21 years and older with a diagnosis of osteoarthritis (OA) with assessment for function and pain
Instruction
This measure is to be reported at each denominator eligible visit occurring during the performance period for patients with osteoarthritis seen during the performance period. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.
Denominator
All patient visits for patients aged 21 years and older with a diagnosis of OA
Denominator Criteria (Eligible Cases):
Patients aged ≥ 21 years on date of encounter
AND
Diagnosis for osteoarthritis (OA) (ICD-10-CM): M15.0, M15.1, M15.2, M15.3, M15.4, M15.8, M15.9, M16.0, M16.10, M16.11, M16.12, M16.2, M16.30, M16.31, M16.32, M16.4, M16.50, M16.51, M16.52, M16.6, M16.7, M16.9, M17.0, M17.10, M17.11, M17.12, M17.2, M17.30, M17.31, M17.32, M17.4, M17.5, M17.9, M18.0, M18.10, M18.11, M18.12, M18.2, M18.30, M18.31, M18.32, M18.4, M18.50, M18.51, M18.52, M18.9, M19.011, M19.012, M19.019, M19.021, M19.022, M19.029, M19.031, M19.032, M19.039, M19.041, M19.042, M19.049, M19.071, M19.072, M19.079, M19.111, M19.112, M19.119, M19.121, M19.122, M19.129, M19.131, M19.132, M19.139, M19.141, M19.142, M19.149, M19.171, M19.172, M19.179, M19.211, M19.212, M19.219, M19.221, M19.222, M19.229, M19.231, M19.232, M19.239, M19.241, M19.242, M19.249, M19.271, M19.272, M19.279, M19.90, M19.91, M19.92, M19.93
AND
Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
Numerator
Patient visits with assessment for level of function and pain documented (may include the use of a standardized scale or the completion of an assessment questionnaire, such as an SF-36, AAOS Hip & Knee Questionnaire)
NUMERATOR NOTE: For the purposes of this measure, the method for assessing function and pain is left up to the discretion of the individual eligible clinician and based on the needs of the patient. The assessment may be done via a validated instrument (though one is not required) that measures pain and various functional elements including a patient’s ability to perform activities of daily living (ADLs).
Numerator Options:
Performance Met: Osteoarthritis symptoms and functional status assessed (may include the use of a standardized scale or the completion of an assessment questionnaire, such as the SF-36, AAOS Hip & Knee Questionnaire) (1006F)
OR
Performance Not Met: Osteoarthritis symptoms and functional status not assessed, reason not otherwise specified (1006F with 8P)