Measure ID: REGCLR2 - 2023
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. DEFINITION Pain Evaluation – Consists of a documented evaluation of patient reported pain level utilizing a standardized pain scale. Performance Met Numerator Pain Decreased Significantly within 4 weeks of the injection (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 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 did not return for follow up. Patient who are prescribed opioids for pain control.
Denominator Exceptions: None
Numerator Exclusions: None
NQF ID : N/A
High Priority: Yes
Measure Type : Patient-Reported Outcome-based Performance Measure (PRO-PM)
Care Setting: Ambulatory Care: Clinician Office/Clinic
Includes Telehealth?: Yes
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
Traditional vs Inverse measure: Traditional
Proportional, continuous variable, and/or ratio measure indicator: Proportional
Risk-Adjusted : No
Submission Pathway: Traditional MIPS