NQF 0052: Low Back Pain: Use of Imaging Studies

Measure: Record percentage of patients with a diagnosis of Low Back Pain who did not have an imaging study (plain x-ray, MRI, CT scan) within 28 days of diagnosis.
Numerator: Patients who meet the denominator criteria and did not have an imaging study-spinal performed within 28 days after the date of the first active diagnosis of Lower Back Pain.
Denominator: All patients aged 18 - 50 with at least one encounter during the measurement period with an initial diagnosis of Low Back Pain during the measurement period.
Exclusion: Patients with a diagnosis of Cancer any time in their history or patients with a diagnosis of recent Trauma, IV Drug Abuse, or Neurologic Impairment during the 12-month period prior to the outpatient or emergency department visit.    Also patients with a diagnosis of Low Back Pain within the 180 days prior to the outpatient or emergency department visit.
NQS Domain: Efficient Use of Healthcare Resources

In ChartMaker Clinical:

In order to qualify for this measure, the provider must have seen the patient, age 18-50,  at least one time during the reporting period and have the appropriate information documented in the chart:

Required Data Elements for the Denominator*:

One of the following:

• Office Visit Encounter or Face-to-Face Interaction Code within the first 337 days of the measurement period and must be the first visit for low back pain during the measurement period
Office Visit Encounter Codes:
CPT:   
CodeDescription
99201Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99202Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 20 minutes are spent face-to-face with the patient and/or family.
99203Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
99204Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 45 minutes are spent face-to-face with the patient and/or family.
99205Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 60 minutes are spent face-to-face with the patient and/or family.
99212Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A problem focused history; A problem focused examination; Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.
99213Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
99214Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
99215Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A comprehensive history; A comprehensive examination; Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 40 minutes are spent face-to-face with the patient and/or family.
Face-to-Face Interaction Codes:
SNOMED: 
CodeDescription
12843005Subsequent hospital visit by physician (procedure)
18170008Subsequent nursing facility visit (procedure)
185349003Encounter for "check-up" (procedure)
185463005Visit out of hours (procedure)
185465003Weekend visit (procedure)
19681004Nursing evaluation of patient and report (procedure)
207195004History and physical examination with evaluation and management of nursing facility patient (procedure)
270427003Patient-initiated encounter (procedure)
270430005Provider-initiated encounter (procedure)
308335008Patient encounter procedure (procedure)
390906007Follow-up encounter (procedure)
406547006Urgent follow-up (procedure)
439708006Home visit (procedure)
87790002Follow-up inpatient consultation visit (procedure)
90526000Initial evaluation and management of healthy individual (procedure)
• Emergency Department Visit Code within the first 337 days of the measurement period and must be the first visit for low back pain during the measurement period
CPT: 
CodeDescription
99281Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor.
99282Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity.
99283Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity.
99284Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity, and require urgent evaluation by the physician physicians, or other qualified health care professionals but do not pose an immediate significant threat to life or physiologic function.
99285Emergency department visit for the evaluation and management of a patient, which requires these 3 key components within the constraints imposed by the urgency of the patient's clinical condition and/or mental status: A comprehensive history; A comprehensive examination; and Medical decision making of high complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of high severity and pose an immediate significant threat to life or physiologic function.

AND

• FIRST Occurrence of Low Back Pain Diagnosis Code (with attached SNOMED) during the encounter listed above
ICD-9:   
CodeDescription
721.3Lumbosacral spondylosis without myelopathy
722.1Displacement of lumbar intervertebral disc without myelopathy
722.32Schmorl's nodes, lumbar region
722.52Degeneration of lumbar or lumbosacral intervertebral disc
722.93Other and unspecified disc disorder, lumbar region
724.02Spinal stenosis, lumbar region, without neurogenic claudication
724.03Spinal stenosis, lumbar region, with neurogenic claudication
724.2Lumbago
724.3Sciatica
724.5Backache, unspecified
724.6Disorders of sacrum
724.7Unspecified disorder of coccyx
738.5Other acquired deformity of back or spine
739.3Nonallopathic lesions, lumbar region
739.4Nonallopathic lesions, sacral region
846Sprain of lumbosacral (joint) (ligament)
846.1Sprain of sacroiliac ligament
846.2Sprain of sacrospinatus (ligament)
846.3Sprain of sacrotuberous (ligament)
846.8Sprain of other specified sites of sacroiliac region
846.9Sprain of unspecified site of sacroiliac region
847.2Sprain of lumbar
ICD-10:   
CodeDescription
M43.27Fusion of spine, lumbosacral region
M43.28Fusion of spine, sacral and sacrococcygeal region
M46.46Discitis, unspecified, lumbar region
M46.47Discitis, unspecified, lumbosacral region
M47.26Other spondylosis with radiculopathy, lumbar region
M47.27Other spondylosis with radiculopathy, lumbosacral region
M47.28Other spondylosis with radiculopathy, sacral and sacrococcygeal region
M47.816Spondylosis without myelopathy or radiculopathy, lumbar region
M47.817Spondylosis without myelopathy or radiculopathy, lumbosacral region
M47.818Spondylosis without myelopathy or radiculopathy, sacral and sacrococcygeal region
M47.896Other spondylosis, lumbar region
M47.897Other spondylosis, lumbosacral region
M47.898Other spondylosis, sacral and sacrococcygeal region
M48.06Spinal stenosis, lumbar region
M48.07Spinal stenosis, lumbosacral region
M51.26Other intervertebral disc displacement, lumbar region
M51.27Other intervertebral disc displacement, lumbosacral region
M51.36Other intervertebral disc degeneration, lumbar region
M51.37Other intervertebral disc degeneration, lumbosacral region
M51.46Schmorl's nodes, lumbar region
M51.47Schmorl's nodes, lumbosacral region
M51.86Other intervertebral disc disorders, lumbar region
M51.87Other intervertebral disc disorders, lumbosacral region
M53.2X7Spinal instabilities, lumbosacral region
M53.2X8Spinal instabilities, sacral and sacrococcygeal region
M53.3Sacrococcygeal disorders, not elsewhere classified
M53.86Other specified dorsopathies, lumbar region
M53.87Other specified dorsopathies, lumbosacral region
M53.88Other specified dorsopathies, sacral and sacrococcygeal region
M54.30Sciatica, unspecified side
M54.31Sciatica, right side
M54.32Sciatica, left side
M54.40Lumbago with sciatica, unspecified side
M54.41Lumbago with sciatica, right side
M54.42Lumbago with sciatica, left side
M54.5Low back pain
M54.89Other dorsalgia
M54.9Dorsalgia, unspecified
M99.03Segmental and somatic dysfunction of lumbar region
M99.04Segmental and somatic dysfunction of sacral region
M99.23Subluxation stenosis of neural canal of lumbar region
M99.33Osseous stenosis of neural canal of lumbar region
M99.43Connective tissue stenosis of neural canal of lumbar region
M99.53Intervertebral disc stenosis of neural canal of lumbar region
M99.63Osseous and subluxation stenosis of intervertebral foramina of lumbar region
M99.73Connective tissue and disc stenosis of intervertebral foramina of lumbar region
S33.6XXASprain of sacroiliac joint, initial encounter
S33.8XXASprain of other parts of lumbar spine and pelvis, initial encounter
S33.9XXASprain of unspecified parts of lumbar spine and pelvis, initial encounter
SNOMED:   
CodeDescription
161894002Complaining of low back pain (finding)
202794004Lumbago with sciatica (finding)
247368002Posterior compartment low back pain (finding)
267067009Lumbar ache - renal (finding)
267982002Pain in lumbar spine (finding)
275316003On examination - lumbar pain on palpation (finding)
278860009Chronic low back pain (finding)
278862001Acute low back pain (finding)
279039007Low back pain (finding)
279040009Mechanical low back pain (finding)
279041008Lumbar trigger point syndrome (finding)
279042001Lumbar segmental dysfunction (finding)
279063004Lumbar facet joint pain (finding)
298674008Lumbar spine - painful on movement (finding)
300957005Postural low back pain (finding)
301408007Tenderness of left lumbar (finding)

Required Data Elements for the Numerator*:

NOT one of the following within 28 days after the first occurrence of low back pain during the measurement period:

• CT Scan of Lower Spine LOINC Code
LOINC:  
Code Description
24963-1 Spine Lumbar CT
24964-9 Spine Lumbar CT W contrast IV
24965-6 Spine Lumbar CT W contrast IT
30620-9 Spine Lumbar CT WO contrast
36058-6 Sacrum CT
36069-3 Spine Lumbar X-ray tomograph
36110-5 Spine Lumbar CT limited WO contrast
36245-9 Sacrum CT W contrast IV
36390-3 Sacrum CT W and WO contrast IV
36402-6 Spine Lumbar CT W and WO contrast IV
36520-5 Sacrum CT WO contrast
37232-6 Spine Lumbosacral Junction CT
37288-8 Spine Lumbosacral Junction CT WO contrast
37509-7 Spine Lumbar CT W contrast intradisc
37653-3 Sacrum X-ray tomograph
44114-7 Spine Lumbar CT W and WO contrast IT
69116-2 Sacrum and Coccyx CT
70928-7 Spine Lumbar CT stereotactic
• MRI of Lower Spine LOINC Code
LOINC:  
Code Description
24967-2 Spine Lumbar MRI W and WO contrast IV
24968-0 Spine Lumbar MRI
24977-1 Spine Lumbar MRI W anesthesia
30678-7 Spine Lumbar MRI W contrast IV
30679-5 Spine Lumbar MRI WO contrast
30854-4 Spine Cervical and Thoracic and Lumbar MRI WO contrast
30855-1 Spine Cervical and Thoracic and Lumbar MRI W and WO contrast IV
36059-4 Sacrum MRI
36060-2 Sacrum and Coccyx MRI
36100-6 Spine Lumbar MRI limited W contrast IV
36111-3 Spine Lumbar MRI limited WO contrast
36246-7 Sacrum MRI W contrast IV
36247-5 Sacrum and Coccyx MRI W contrast IV
36391-1 Sacrum MRI W and WO contrast IV
36392-9 Sacrum and Coccyx MRI W and WO contrast IV
36521-3 Sacrum MRI WO contrast
36522-1 Sacrum and Coccyx MRI WO contrast
38060-0 Spine.lumbosacral+Cervical+Thoracic MRI sagittal
38061-8 Spine Cervical and Spine Thoracic and Spine Lumbar and Sacrum MRI W contrast IV
42698-1 Spine Cervical and Thoracic and Lumbar MRI
48436-0 Spine Lumbar MRI W contrast IT
48452-7 Spine Lumbar MRI W and WO contrast IT
• X-Ray of Lower Spine LOINC Code
LOINC:  
Code Description
24665-2 Sacrum and Coccyx X-ray
24929-2 Spine Thoracic and Lumbar X-ray scoliosis W flexion and W extension
24930-0 Spine Thoracic and Lumbar X-ray scoliosis
24969-8 Spine Lumbar X-ray lateral
24970-6 Spine Lumbar X-ray AP and lateral
24971-4 Spine Lumbar X-ray W flexion and W extension
24972-2 Spine Lumbar X-ray
24975-5 Spine.lumbar and Sacroiliac joint - bilateral X-ray
24984-7 Spine Thoracic and Lumbar X-ray 2 views
30713-2 Spine X-ray W right bending and W left bending
30714-0 Spine Thoracic and Lumbar X-ray scoliosis AP
30715-7 Spine Thoracic and Lumbar X-ray scoliosis AP and lateral
30716-5 Spine Thoracic and Lumbar X-ray scoliosis lateral
30717-3 Spine Thoracic and Lumbar X-ray scoliosis standing
30773-6 Spine Lumbar X-ray Single view
30774-4 Spine Lumbar X-ray Single view portable
30775-1 Spine Lumbar X-ray 3 views
30776-9 Spine Lumbar X-ray 3 views portable
30777-7 Spine Lumbar X-ray AP single view
30778-5 Spine Lumbar X-ray oblique single view
30797-5 Spine Lumbar X-ray 5 views
30883-3 Coccyx X-ray
30884-1 Sacrum X-ray
36332-5 Spine Lumbar X-ray 4 views
36647-6 Coccyx X-ray 2 views
36670-8 Spine Lumbar X-ray 2 views
36674-0 Spine Lumbar X-ray 2 views portable
36681-5 Spine Lumbar X-ray 7 views
36688-0 Coccyx X-ray AP and lateral
36735-9 Spine Lumbar X-ray AP and lateral and oblique
36946-2 Spine Lumbar X-ray 2 views standing
36949-6 Spine Lumbar X-ray 3 views standing
36990-0 Spine Lumbar X-ray lateral crosstable
36992-6 Spine Lumbar X-ray lateral crosstable portable
37003-1 Spine Lumbar X-ray lateral standing
37009-8 Spine Lumbar X-ray left oblique
37011-4 Spine Lumbar X-ray right oblique
37073-4 Spine Lumbar X-ray 5 views standing
37078-3 Spine Lumbar X-ray AP and lateral portable
37101-3 Spine Lumbar X-ray AP and lateral and oblique and spot
37105-4 Spine Lumbar X-ray AP and lateral and spot
37132-8 Spine Lumbar X-ray lateral W flexion and W extension
37172-4 Spine Lumbar X-ray portable
37208-6 Spine Lumbar X-ray standing
37256-5 Pelvis and Spine Lumbar X-ray 3 views
37257-3 Spine Lumbar and Sacroiliac Joint X-ray 3 views
37259-9 Spine Lumbar and Sacrum X-ray 3 views
37260-7 Spine Lumbar and Sacrum and Coccyx X-ray 3 views
37261-5 Spine Lumbar and Sacrum and Sacroiliac Joint and Coccyx X-ray 3 views
37300-1 Spine Lumbosacral Junction X-ray true AP
37340-7 Spine Lumbar and Sacrum X-ray
37341-5 Spine Lumbar and Sacrum and Coccyx X-ray
37342-3 Spine Lumbar and Sacrum and Sacroiliac Joint and Coccyx X-ray
37351-4 Pelvis and Spine Lumbar X-ray 5 views
37353-0 Spine Lumbar and Sacroiliac Joint X-ray 5 views
37355-5 Spine Lumbar and Sacrum X-ray 5 views
37356-3 Spine Lumbar and Sacrum and Coccyx X-ray 5 views
37357-1 Spine Lumbar and Sacrum and Sacroiliac Joint and Coccyx X-ray 5 views
37515-4 Spine Lumbosacral Junction X-ray lateral spot
37516-2 Spine Lumbosacral Junction X-ray lateral spot standing
37651-7 Sacrum X-ray 2 views
37652-5 Sacrum X-ray AP and lateral
37658-2 Spine Thoracic and Lumbar X-ray 2 views scoliosis
37659-0 Spine Thoracic and Lumbar X-ray scoliosis AP standing
37660-8 Spine Thoracic and Lumbar X-ray scoliosis lateral standing
37974-3 Spine Thoracolumbar Junction X-ray AP and lateral
37975-0 Spine Thoracolumbar Junction X-ray
38008-9 Spine Cervical and Thoracic and Lumbar X-ray
38121-0 Spine Thoracic and Lumbar X-ray Single view
38123-6 Spine Thoracic and Lumbar X-ray AP and lateral
38124-4 Spine Thoracic and Lumbar X-ray standing
39049-2 Spine Thoracic and Lumbar X-ray AP single view
39061-7 Sacrum and Coccyx X-ray 3 views
39063-3 Spine Lumbar X-ray 5 views W flexion and W extension
39067-4 Spine Cervical and Thoracic and Lumbar X-ray AP and lateral
39333-0 Spine Lumbar X-ray AP and lateral standing
39340-5 Spine Lumbar X-ray lateral standing and W flexion and W extension
39367-8 Spine Thoracic and Lumbar X-ray scoliosis AP and lateral standing
42163-6 Spine Lumbar X-ray and oblique
42378-0 Spine Lumbar X-ray AP single view W left bending
42379-8 Spine Lumbar X-ray AP single view W right bending
42401-0 Spine Lumbar X-ray (AP W R-bending and W L-bending and WO bending) and Lateral
42403-6 Spine Lumbar X-ray AP W right bending and W left bending
42406-9 Spine Lumbar X-ray AP W and WO left bending
42407-7 Spine Lumbar X-ray AP W and WO right bending
42408-5 Spine Lumbar X-ray AP W right bending and W left bending and WO bending
42410-1 Spine Lumbar X-ray AP and lateral and oblique and spot standing
42411-9 Spine Lumbar X-ray (AP^W R-bending and W L-bending) and (lateral^W flexion and W extension)
42413-5 Spine Lumbar X-ray W right bending and W left bending
42424-2 Spine Thoracic and Lumbar X-ray scoliosis AP and lateral sitting
42425-9 Spine Thoracic and Lumbar X-ray scoliosis AP standing and W right bending and W left bending and WO bending
42426-7 Spine Thoracic and Lumbar X-ray scoliosis AP sitting
42427-5 Spine Thoracic and Lumbar X-ray scoliosis lateral sitting
42428-3 Spine Thoracic and Lumbar X-ray scoliosis AP standing and in brace
42429-1 Spine Thoracic and Lumbar X-ray scoliosis AP standing and W right bending
42472-1 Spine Thoracic and Lumbar X-ray scoliosis AP in traction
42690-8 Spine X-ray W flexion and W extension
42692-4 Spine Thoracic and Lumbar X-ray
43569-3 Spine Thoracic and Lumbar X-ray scoliosis AP upright and supine
43784-8 Spine Cervical and Thoracic and Lumbar X-ray 2 views
43791-3 Spine Lumbar X-ray oblique
44178-2 Spine Lumbar X-ray oblique view and (views W right bending and W left bending)
44179-0 Sacrum and Coccyx X-ray 2 views
44194-9 Spine X-ray GE 4 views W right bending and W left bending
44196-4 Spine Lumbar X-ray GE 5 views W right bending and W left bending
44203-8 Spine Cervical and Thoracic and Lumbar X-ray portable
44206-1 Spine Thoracic and Lumbar X-ray scoliosis single view
46340-6 Spine Lumbosacral Junction X-ray
47382-7 Spine Lumbar X-ray GE 4 views
47984-0 Pelvis and Spine Lumbar X-ray
48469-1 Spine Lumbar X-ray 2 or 3 views
48473-3 Spine Lumbar and Sacrum X-ray 4 views
69264-0 Sacrum X-ray standing
69273-1 Spine Thoracolumbar Junction X-ray 2 views

EXCLUSION DETAILS:

Exclusion includes patients with a diagnosis of Cancer any time in their history or patients with a diagnosis of recent Trauma, IV Drug Abuse, or Neurologic Impairment during the 12-month period prior to the outpatient visit.    It also excludes patients with a diagnosis of Low Back Pain within the 180 days prior to the outpatient visit. In order to meet the requirements for this exclusion, the appropriate information must be documented in the chart:  

At least one of the following:

• Low Back Pain Diagnosis Exclusion Code (with attached SNOMED) with Date of Onset within 180 days prior to the first visit for low back pain during the measurement period

Please reference the list of Diagnosis codes included in the denominator requirements above.  The patient will be excluded if the date of onset is within 180 days prior to their outpatient visit.

• Cancer Diagnosis Code (with attached SNOMED) prior to the start of the measurement period
• IV Drug Abuse Code (with attached SNOMED) within 365 days of the start of or during the measurement period
ICD-9:  
CodeDescription
304.00Opioid type dependence, unspecified
304.01Opioid type dependence, continuous
304.02Opioid type dependence, episodic
304.03Opioid type dependence, in remission
304.10Sedative, hypnotic or anxiolytic dependence, unspecified
304.11Sedative, hypnotic or anxiolytic dependence, continuous
304.12Sedative, hypnotic or anxiolytic dependence, episodic
304.13Sedative, hypnotic or anxiolytic dependence, in remission
304.20Cocaine dependence, unspecified
304.21Cocaine dependence, continuous
304.22Cocaine dependence, episodic
304.23Cocaine dependence, in remission
304.40Amphetamine and other psychostimulant dependence, unspecified
304.41Amphetamine and other psychostimulant dependence, continuous
304.42Amphetamine and other psychostimulant dependence, episodic
304.43Amphetamine and other psychostimulant dependence, in remission
305.40Sedative, hypnotic or anxiolytic abuse, unspecified
305.41Sedative, hypnotic or anxiolytic abuse, continuous
305.42Sedative, hypnotic or anxiolytic abuse, episodic
305.43Sedative, hypnotic or anxiolytic abuse, in remission
305.50Opioid abuse, unspecified
305.51Opioid abuse, continuous
305.52Opioid abuse, episodic
305.53Opioid abuse, in remission
305.60Cocaine abuse, unspecified
305.61Cocaine abuse, continuous
305.62Cocaine abuse, episodic
305.63Cocaine abuse, in remission
305.70Amphetamine or related acting sympathomimetic abuse, unspecified
305.71Amphetamine or related acting sympathomimetic abuse, continuous
305.72Amphetamine or related acting sympathomimetic abuse, episodic
305.73Amphetamine or related acting sympathomimetic abuse, in remission
ICD-10:  
CodeDescription
F11.10Opioid abuse, uncomplicated
F11.120Opioid abuse with intoxication, uncomplicated
F11.121Opioid abuse with intoxication delirium
F11.122Opioid abuse with intoxication with perceptual disturbance
F11.129Opioid abuse with intoxication, unspecified
F11.14Opioid abuse with opioid-induced mood disorder
F11.150Opioid abuse with opioid-induced psychotic disorder with delusions
F11.151Opioid abuse with opioid-induced psychotic disorder with hallucinations
F11.159Opioid abuse with opioid-induced psychotic disorder, unspecified
F11.181Opioid abuse with opioid-induced sexual dysfunction
F11.182Opioid abuse with opioid-induced sleep disorder
F11.188Opioid abuse with other opioid-induced disorder
F11.19Opioid abuse with unspecified opioid-induced disorder
F11.20Opioid dependence, uncomplicated
F11.21Opioid dependence, in remission
F11.220Opioid dependence with intoxication, uncomplicated
F11.221Opioid dependence with intoxication delirium
F11.222Opioid dependence with intoxication with perceptual disturbance
F11.229Opioid dependence with intoxication, unspecified
F11.23Opioid dependence with withdrawal
F11.24Opioid dependence with opioid-induced mood disorder
F11.250Opioid dependence with opioid-induced psychotic disorder with delusions
F11.251Opioid dependence with opioid-induced psychotic disorder with hallucinations
F11.259Opioid dependence with opioid-induced psychotic disorder, unspecified
F11.281Opioid dependence with opioid-induced sexual dysfunction
F11.282Opioid dependence with opioid-induced sleep disorder
F11.288Opioid dependence with other opioid-induced disorder
F11.29Opioid dependence with unspecified opioid-induced disorder
F13.10Sedative, hypnotic or anxiolytic abuse, uncomplicated
F13.120Sedative, hypnotic or anxiolytic abuse with intoxication, uncomplicated
F13.121Sedative, hypnotic or anxiolytic abuse with intoxication delirium
F13.129Sedative, hypnotic or anxiolytic abuse with intoxication, unspecified
F13.14Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced mood disorder
F13.150Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
F13.151Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations
F13.159Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified
F13.180Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced anxiety disorder
F13.181Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sexual dysfunction
F13.182Sedative, hypnotic or anxiolytic abuse with sedative, hypnotic or anxiolytic-induced sleep disorder
F13.188Sedative, hypnotic or anxiolytic abuse with other sedative, hypnotic or anxiolytic-induced disorder
F13.19Sedative, hypnotic or anxiolytic abuse with unspecified sedative, hypnotic or anxiolytic-induced disorder
F13.20Sedative, hypnotic or anxiolytic dependence, uncomplicated
F13.21Sedative, hypnotic or anxiolytic dependence, in remission
F13.220Sedative, hypnotic or anxiolytic dependence with intoxication, uncomplicated
F13.221Sedative, hypnotic or anxiolytic dependence with intoxication delirium
F13.229Sedative, hypnotic or anxiolytic dependence with intoxication, unspecified
F13.230Sedative, hypnotic or anxiolytic dependence with withdrawal, uncomplicated
F13.231Sedative, hypnotic or anxiolytic dependence with withdrawal delirium
F13.232Sedative, hypnotic or anxiolytic dependence with withdrawal with perceptual disturbance
F13.239Sedative, hypnotic or anxiolytic dependence with withdrawal, unspecified
F13.24Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced mood disorder
F13.250Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder with delusions
F13.251Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder with hallucinations
F13.259Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced psychotic disorder, unspecified
F13.26Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced persisting amnestic disorder
F13.27Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced persisting dementia
F13.280Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced anxiety disorder
F13.281Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced sexual dysfunction
F13.282Sedative, hypnotic or anxiolytic dependence with sedative, hypnotic or anxiolytic-induced sleep disorder
F13.288Sedative, hypnotic or anxiolytic dependence with other sedative, hypnotic or anxiolytic-induced disorder
F13.29Sedative, hypnotic or anxiolytic dependence with unspecified sedative, hypnotic or anxiolytic-induced disorder
F14.10Cocaine abuse, uncomplicated
F14.120Cocaine abuse with intoxication, uncomplicated
F14.121Cocaine abuse with intoxication with delirium
F14.122Cocaine abuse with intoxication with perceptual disturbance
F14.129Cocaine abuse with intoxication, unspecified
F14.14Cocaine abuse with cocaine-induced mood disorder
F14.150Cocaine abuse with cocaine-induced psychotic disorder with delusions
F14.151Cocaine abuse with cocaine-induced psychotic disorder with hallucinations
F14.159Cocaine abuse with cocaine-induced psychotic disorder, unspecified
F14.180Cocaine abuse with cocaine-induced anxiety disorder
F14.181Cocaine abuse with cocaine-induced sexual dysfunction
F14.182Cocaine abuse with cocaine-induced sleep disorder
F14.188Cocaine abuse with other cocaine-induced disorder
F14.19Cocaine abuse with unspecified cocaine-induced disorder
F14.20Cocaine dependence, uncomplicated
F14.21Cocaine dependence, in remission
F14.220Cocaine dependence with intoxication, uncomplicated
F14.221Cocaine dependence with intoxication delirium
F14.222Cocaine dependence with intoxication with perceptual disturbance
F14.229Cocaine dependence with intoxication, unspecified
F14.23Cocaine dependence with withdrawal
F14.24Cocaine dependence with cocaine-induced mood disorder
F14.250Cocaine dependence with cocaine-induced psychotic disorder with delusions
F14.251Cocaine dependence with cocaine-induced psychotic disorder with hallucinations
F14.259Cocaine dependence with cocaine-induced psychotic disorder, unspecified
F14.280Cocaine dependence with cocaine-induced anxiety disorder
F14.281Cocaine dependence with cocaine-induced sexual dysfunction
F14.282Cocaine dependence with cocaine-induced sleep disorder
F14.288Cocaine dependence with other cocaine-induced disorder
F14.29Cocaine dependence with unspecified cocaine-induced disorder
F15.10Other stimulant abuse, uncomplicated
F15.120Other stimulant abuse with intoxication, uncomplicated
F15.121Other stimulant abuse with intoxication delirium
F15.122Other stimulant abuse with intoxication with perceptual disturbance
F15.129Other stimulant abuse with intoxication, unspecified
F15.14Other stimulant abuse with stimulant-induced mood disorder
F15.150Other stimulant abuse with stimulant-induced psychotic disorder with delusions
F15.151Other stimulant abuse with stimulant-induced psychotic disorder with hallucinations
F15.159Other stimulant abuse with stimulant-induced psychotic disorder, unspecified
F15.180Other stimulant abuse with stimulant-induced anxiety disorder
F15.181Other stimulant abuse with stimulant-induced sexual dysfunction
F15.182Other stimulant abuse with stimulant-induced sleep disorder
F15.188Other stimulant abuse with other stimulant-induced disorder
F15.19Other stimulant abuse with unspecified stimulant-induced disorder
F15.20Other stimulant dependence, uncomplicated
F15.21Other stimulant dependence, in remission
F15.220Other stimulant dependence with intoxication, uncomplicated
F15.221Other stimulant dependence with intoxication delirium
F15.222Other stimulant dependence with intoxication with perceptual disturbance
F15.229Other stimulant dependence with intoxication, unspecified
F15.23Other stimulant dependence with withdrawal
F15.24Other stimulant dependence with stimulant-induced mood disorder
F15.250Other stimulant dependence with stimulant-induced psychotic disorder with delusions
F15.251Other stimulant dependence with stimulant-induced psychotic disorder with hallucinations
F15.259Other stimulant dependence with stimulant-induced psychotic disorder, unspecified
F15.280Other stimulant dependence with stimulant-induced anxiety disorder
F15.281Other stimulant dependence with stimulant-induced sexual dysfunction
F15.282Other stimulant dependence with stimulant-induced sleep disorder
F15.288Other stimulant dependence with other stimulant-induced disorder
F15.29Other stimulant dependence with unspecified stimulant-induced disorder
SNOMED:   
CodeDescription
5602001Opioid abuse (disorder)
21647008Amphetamine dependence (disorder)
31956009Cocaine dependence (disorder)
64386003Sedative abuse (disorder)
75544000Opioid dependence (disorder)
78267003Cocaine abuse (disorder)
84758004Amphetamine abuse (disorder)
191819002Continuous opioid dependence (disorder)
191820008Episodic opioid dependence (disorder)
191821007Opioid dependence in remission (disorder)
191825003Hypnotic or anxiolytic dependence, continuous (disorder)
191826002Hypnotic or anxiolytic dependence, episodic (disorder)
191827006Hypnotic or anxiolytic dependence in remission (disorder)
191831000Cocaine dependence, continuous (disorder)
191832007Cocaine dependence, episodic (disorder)
191833002Cocaine dependence in remission (disorder)
191843004Amphetamine or psychostimulant dependence, continuous (disorder)
191844005Amphetamine or psychostimulant dependence, episodic (disorder)
191845006Amphetamine or psychostimulant dependence in remission (disorder)
191905001Nondependent hypnotic or anxiolytic abuse, continuous (disorder)
191906000Nondependent hypnotic or anxiolytic abuse, episodic (disorder)
191907009Nondependent hypnotic or anxiolytic abuse in remission (disorder)
191909007Nondependent opioid abuse (disorder)
191912005Nondependent opioid abuse, continuous (disorder)
191913000Nondependent opioid abuse, episodic (disorder)
191914006Nondependent opioid abuse in remission (disorder)
191916008Nondependent cocaine abuse (disorder)
191918009Nondependent cocaine abuse, continuous (disorder)
191919001Nondependent cocaine abuse, episodic (disorder)
191920007Nondependent cocaine abuse in remission (disorder)
191924003Nondependent amphetamine or psychostimulant abuse, continuous (disorder)
191925002Nondependent amphetamine or psychostimulant abuse, episodic (disorder)
231461004Hypnotic or anxiolytic abuse (disorder)
231462006Barbiturate abuse (disorder)
231470001Anxiolytic dependence (disorder)
231472009Barbiturate dependence (disorder)
231473004Benzodiazepine dependence (disorder)
231474005Diazepam dependence (disorder)
231475006Librium dependence (disorder)
231477003Heroin dependence (disorder)
231478008Methadone dependence (disorder)
231479000Morphine dependence (disorder)
231480002Opium dependence (disorder)
268640002Hypnotic or anxiolytic dependence (disorder)
268647004Nondependent hypnotic or anxiolytic abuse (disorder)
268648009Nondependent amphetamine or other psychostimulant abuse (disorder)
414874007Nondependent amphetamine or psychostimulant abuse in remission (disorder)
426001001Fentanyl dependence (disorder)
426873000Methamphetamine dependence (disorder)
427205009Amphetamine abuse, continuous (disorder)
427327003Sedative dependence (disorder)
429692000Amphetamine abuse, episodic (disorder)
1081000119105Opioid dependence, on agonist therapy (disorder)
• Neurologic Impairment Diagnosis Code (with attached SNOMED) within 365 days of the start of or during the measurement period
ICD-9:  
CodeDescription
344.60Cauda equina syndrome without mention of neurogenic bladder
729.2Neuralgia, neuritis, and radiculitis, unspecified
ICD-10:  
CodeDescription
G83.4Cauda equina syndrome
M54.10Radiculopathy, site unspecified
M79.2Neuralgia and neuritis, unspecified
SNOMED:   
CodeDescription
8663007Cauda equina syndrome without neurogenic bladder (disorder)
16269008Neuralgia (disorder)
82473003Radiculitis (disorder)
84299009Neuritis (disorder)
112102006Atypical neuralgia (disorder)
192970008Cauda equina syndrome (disorder)
192971007Cauda equina syndrome not affecting bladder (disorder)
• Trauma Diagnosis Code (with attached SNOMED) within 365 days of the start of or during the measurement period

*ADDITIONAL INFORMATION:

• The LOINC code needs to be linked to a procedure code

• The patient must be at least 18 years and younger than 50 years prior to the start of the measurement period.

• It is recommended that if the first diagnosis of low back pain occurs during an Emergency Department visit, that the date is documented using the appropriate procedure code (in the order date field). The diagnosis code must also have a start date that reflects the same date.

• It is recommended that the MRI, CT and X-Ray Codes (with attached LOINC Codes) are set up in the Health Maintenance (or other Health History) procedure checklist for documentation of procedures done outside of the office.

• When documenting the date of the MRI,  CT or X-Ray of the Lower Back, enter the actual date of the test in the order date area procedure details screen.  

•  A Diagnosis Code needs to be updated to the most recent date of applicable treatment

• The only data used to determine the denominator is data from the ChartMaker Clinical Module. If a patient encounter was not entered into the ChartMaker Clinical Module, that encounter is not included in the denominator for the statistical calculations on the Meaningful Use Dashboard. Please add these additional patients to the denominator and recalculate the percentage for Attestation purposes

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