Measure ID : REGCLR2
Measure Title : Tendinitis/ Enthesopathy- Injection Treatment Outcomes for Adults
Measure Description:
Percentage of patients aged 18 or older with a diagnosis of Tendinitis that have a reduction in pain after injection therapy
Denominator:
All patients aged 18 years and older who report pain greater than 3 on a scale of 1 to 10 on date of initial encounter for treatment of conditions in the diagnosis
AND
Have not responded adequately to conservative care
AND
Diagnosis for any tendinitis and/or enthesopathy
ICD Codes
M65.261 M65.262, M65.27, M65.271, M65.272, M76.61, M76.62 , M76.71 , M76.72 , M76.811 , M76.812 , M76.821 , M76.822 , M76.891 , M76.892 , , M77.32 , M77.41 , M77.42 , M77.51 , M77.52
AND
Patients who received an injection identified as CPT 20550-Injection(s); single tendon sheath, or ligament, aponeurosis and/or CPT 20551-Injection(s); single tendon origin/insertion during the reporting period
Numerator:
Patients in the denominator received an injection identified as CPT 20550-Injection(s); single tendon sheath, or ligament, aponeurosis or CPT 20551 Injection(s); single tendon origin/insertion and experienced a decrease in pain of 2 Points or more
DEFINITION
Pain Evaluation – Consists of a documented evaluation of patient reported pain level utilizing a standardized pain scale.
Performance Met Numerator
(GCL21) 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)
OR
(GCL22) Performance Not Met Numerator 4 Pain level not documented
(GCL23) Performance Not Met Numerator 5 Pain not decreased by 50% or more.
Denominator Exclusions:
(GCL42) Clinician documented that the patient did not return for follow up.
(GCL25) Patient who are prescribed opioids for pain control.
Denominator Exceptions: None
Numerator Exclusions: None
NQF ID : N/A
NQS Domain: Effective Clinical Care
High Priority: Yes
Measure Type: Outcome
Meaningful Measure Area: Functional Outcomes
Meaningful Measure Area Rationale: A Decrease in Pain results in improved Functionality for the Patient
Inverse Measure: No
Proportional Measure: Yes
Continuous Variable Measure: No
Ratio Measure: No
If Continuous Variable and/or Ratio is chosen, what would be the range of the score(s)?: N/A
Number of performance rates to be submitted: 1
Performance Rate Description(s): Percentage of patients aged 18 years and older who report pain greater than 3 on a scale of 1 to 10 on date of initial encounter for treatment of conditions in the diagnosis
Overall Performance Rate: 1st Performance Rate
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth?: Yes
Risk Adjusted Status : No