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MEX5 - 2023

Measure ID: MEX5 - 2023

Measure Title: Hammer Toe Outcome

Measure Description:

Percentage of patients with a who have a lesser toe deformity (hammer and claw toes) causing pain that receive an intervention and have clinically significant reduction in pain as a result of that intervention.


All patients aged 18 and older on the date of initial encounter for one of the diagnosis codes associated with this measure. (Q66.89, M20.41, M20.42, M20.51, M20.5x2, M20.61, M20.62)
Are provided an intervention to address their pain
Interventions include:
Surgical Interventions
Shoe wear modifications
Physical Therapy
Report a level of pain of 3 or more on a scale of 1 – 10 on the initial visit


Patients in the denominator received an intervention as defined in the denominator.
Pain Evaluation – Consists of a documented evaluation of patient reported pain level utilizing a standardized pain scale.
Performance Met Numerator
Pain Decreased Significantly (second value equal to or less than 50% of the initial value) (BMC Med. 2017; 15: 35.
Published online 2017 Feb 20. doi: 10.1186/s12916-016-0775-3)
Performance Not Met Numerator 4 Pain level not documented
Performance Not Met Numerator 5 Pain not decreased by 50% or more.

Denominator Exclusions:

Clinician documented that the patient was not an eligible candidate for evaluation of lesser toe pain. For example, the patient has condition that would not allow them to accurately respond to a pain level exam or the patient has previously documented peripheral neuropathy with loss of protective sensation.
Patients who have been prescribed Opioids
Patient who fail to return for follow up (a 2nd visit)

Denominator Exceptions: Clinician documented that patient was not an eligible candidate for treatment of hammer toe 183B

Numerator Exclusions: None


High Priority: Yes

Measure Type: Patient-Reported Outcome-based Performance Measure (PRO-PM)

Care Setting: Ambulatory Care: Clinician Office/Clinic

Includes Telehealth?: No

Number of performance rates to be submitted: 1

Performance Rate Description(s): Proper Evaluation of a Hammer Toe is critical to proper treatment. Percentage of patients who are evaluated for a hammer toe and experience a decrease in pain

Traditional vs Inverse measure: Traditional

Proportional, continuous variable, and/or ratio measure indicator: Proportional

Risk-Adjusted: No

Submission Pathway: Traditional MIPS