eCQM / NQF #: CMS166v7 / 0052
Measure: Percentage of patients 18-50 years of age with a diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI, CT scan) within 28 days of the diagnosis.
Numerator: Patients without an imaging study conducted on the index episode start date or in the 28 days following the index episode start date.
Denominator: Patients 18-50 years of age with a diagnosis of Uncomplicated low back pain during a visit.
Denominator Exclusions: Exclude patients with a diagnosis of uncomplicated low back pain during the 180 days (6 months) prior to the index episode start date. Exclude patients with neurologic impairment, spinal infection, or diagnosis of IV drug abuse any time during the 12 months prior to the index episode start date through 28 days after the index episode start date. Exclude patients with trauma any time during the 90 days prior to the index episode start date through 28 days after the index episode start date. Exclude patients with a diagnosis of HIV or cancer any time in the patient's history through 28 days after the index episode start date. Exclude patients who had a major organ transplant any time in the patient's history through 28 days after the index episode start date. Exclude patients who had prolonged use of corticosteriods (at least 90 consecutive days) any time in the 12 months prior to the index episode start date. Exclude patients who were in hospice care during the measurement year.
Domain: Efficiency and Cost Reduction

 

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:

AND

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:

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:

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