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REGCLR3: Bunion Outcome - Adult and Adolescent

Measure Description:

Percentage of patients with a who have a hallux valgus (bunion) deformity causing pain that receive an intervention and have clinically significant reduction in pain as a result of that intervention

Denominator:

All patients aged 18 and older on the date of initial encounter for one of the diagnosis codes associated with this measure. (M20.11, M20.12, M20.21, M20.22, M20.5X2, M20.31, M20.32, Q74.2, Q66.6, Q66.3)
AND
Are provided an intervention to address their pain
Interventions include:
Surgical Interventions
Shoe wear modifications
Orthotics
Physical Therapy
AND
Report a level of pain of 3 or more on a scale of 1 – 10 on the initial visit

Numerator:

Patients in the denominator received an intervention as defined in the denominator.
DEFINITION
Pain Evaluation – Consists of a documented evaluation of patient reported pain level utilizing a standardized pain scale.
Performance Met Numerator
(GCL31) 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
(GCL32) Performance Not Met Numerator 4 Pain level not documented
(GCL33) Performance Not Met Numerator 5 Pain not decreased by 50% or more.

Denominator Exclusions:

(GCL34) Clinician documented that the patient was not an eligible candidate for evaluation of bunion 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.
(GCL35) Patients who have been prescribed Opioids
(GCL36)Patient who fail to return for follow up (a 2nd visit)

Denominator Exceptions: (GCL37) Clinician documented that patient was not an eligible candidate for treatment of hallux deformity 

Numerator Exclusions: None

NQS Domain: Effective Clinical Care

High Priority: Yes

Measure Type: Patient Reported Outcome (PRO)

Meaningful Measure Area: Functional Outcomes

Meaningful Measure Area Rationale: Reduction of pain aligns with patient goals

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): Patient who have a complete evaluation for treatment of Hallux Valgus and experience a decrease in Hallux Valgus Pain

Overall Performance Rate: 1st Performance Rate

Care Setting: Ambulatory Care: Clinician Office/Clinic

Includes Telehealth?: No