| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Claims, Registry | Efficiency | Yes | Efficiency and Cost Reduction | Emergency Medicine |
Measure Description
Percentage of emergency department visits for patients aged 2 through 17 years who presented within 24 hours of a minor blunt head trauma with a Glasgow Coma Scale (GCS) score of 15 and who had a head CT for trauma ordered by an emergency care provider who are classified as low risk according to the Pediatric Emergency Care Applied Research Network (PECARN) prediction rules for traumatic brain injury
Instruction
This measure is to be reported for each denominator eligible visit for patients aged 2 through 17 years who present to the emergency department with a minor blunt head trauma during the performance period. It is anticipated that eligible clinicians who provide care in the emergency department will submit this measure.
Denominator
All emergency department visits for patients aged 2 through 17 years who presented within 24 hours of a minor blunt head trauma with a Glasgow Coma Scale (GCS) score of 15 and who had a head CT for trauma ordered by an emergency care provider*
DENOMINATOR NOTE: *This measure looks to determine if an emergency care provider ordered head CT services typically provided under CPT code 70450.
Definitions:
Presented within 24 hours – The 24 hour timeframe is based on the time of injury reported by the patient or guardian
Minor Blunt Head Trauma – Includes only non-penetrating injuries
Denominator Criteria (Eligible Cases):
Patients aged 2 through 17 years on date of encounter
AND
Diagnosis for minor blunt head trauma (ICD-10-CM): S00.03XA, S00.33XA, S00.431A, S00.432A, S00.439A, S00.531A, S00.532A, S00.83XA, S00.93XA, S02.0XXA, S02.101A, S02.102A, S02.109A, S02.110A, S02.111A, S02.112A, S02.113A, S02.118A, S02.119A, S02.11AA, S02.11BA, S02.11CA, S02.11DA, S02.11EA, S02.11FA, S02.11GA, S02.11HA, S02.19XA, S02.2XXA, S02.30XA, S02.31XA, S02.32XA, S02.400A, S02.401A, S02.402A, S02.40AA, S02.40BA, S02.40CA, S02.40DA, S02.40EA, S02.40FA, S02.411A, S02.412A, S02.413A, S02.42XA, S02.600A, S02.601A, S02.602A, S02.609A, S02.610A, S02.611A, S02.612A, S02.620A, S02.621A, S02.622A, S02.630A, S02.631A, S02.632A, S02.640A, S02.641A, S02.642A, S02.650A, S02.651A, S02.652A, S02.66XA, S02.670A, S02.671A, S02.672A, S02.69XA, S02.80XA, S02.81XA, S02.82XA, S02.91XA, S02.92XA, S06.0X0A, S06.0X1A, S06.0X2A, S06.0X3A, S06.0X4A, S06.0X9A, S06.1X0A, S06.1X1A, S06.1X2A, S06.1X3A, S06.1X4A, S06.1X9A, S06.2X0A, S06.2X1A, S06.2X2A, S06.2X3A, S06.2X4A, S06.2X9A, S06.300A, S06.301A, S06.302A, S06.303A, S06.304A, S06.309A, S06.340A, S06.341A, S06.342A, S06.343A, S06.344A, S06.349A, S06.350A, S06.351A, S06.352A, S06.353A, S06.354A, S06.359A, S06.360A, S06.361A, S06.362A, S06.363A, S06.364A, S06.369A, S06.4X0A, S06.4X1A, S06.4X2A, S06.4X3A, S06.4X4A, S06.4X9A, S06.5X0A, S06.5X1A, S06.5X2A, S06.5X3A, S06.5X4A, S06.5X9A, S06.6X0A, S06.6X1A, S06.6X2A, S06.6X3A, S06.6X4A, S06.6X9A, S06.810A, S06.811A, S06.812A, S06.813A, S06.814A, S06.819A, S06.820A, S06.821A, S06.822A, S06.823A, S06.824A, S06.829A, S06.890A, S06.891A, S06.892A, S06.893A, S06.894A, S06.899A, S06.9X0A, S06.9X1A, S06.9X2A, S06.9X3A, S06.9X4A, S06.9X9A, S09.10XA, S09.11XA, S09.19XA, S09.8XXA, S09.90XA, S09.92XA, S09.93XA, S10.0XXA, S10.83XA, S10.93XA
AND
Patient encounter during the performance period (CPT): 99281, 99282, 99283, 99284, 99285
AND
Patient presented within 24 hours of a minor blunt head trauma with a GCS score of 15 and had a head CT ordered for trauma by an emergency care provider: G9594
AND NOT
DENOMINATOR EXCLUSION:
Patient has documentation of ventricular shunt, brain tumor, coagulopathy, including thrombocytopenia: G9595
Numerator
Emergency department visits for patients who are classified as low risk according to the PECARN prediction rules for traumatic brain injury
Definition:
Low Risk for Traumatic Brain Injury according to PECARN predication rules –
Patients can be classified as low risk if all of the following are met:
•No signs of altered mental status (e.g., agitation, somnolence, repetitive questioning, slow responseto verbal communication)
•No signs of basilar skull fracture (signs include haemotympanum, “raccoon” eyes, cerebrospinal fluidleakage from the ear or nose, Battle’s sign)
•No loss of consciousness
•No vomiting
•No severe mechanism of injury (i.e., motor vehicle crash with patient ejection, death of anotherpassenger, or rollover; pedestrian or bicyclist without helmet struck by a motorized vehicle; falls ofmore than 5 feet; or head struck by a high-impact object)
•No severe headache
Numerator Instructions:
INVERSE MEASURE – A lower calculated performance rate for this measure indicates better clinical care or control. The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. Reporting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. For inverse measures, a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control.
Numerator Options:
Performance Met: Pediatric patient with minor blunt head trauma classified as low risk according to the PECARN prediction rules (G9593)
OR
Performance Not Met: Pediatric patient with minor blunt head trauma not classified as low risk according to the PECARN prediction rules (G9597)