2017 MIPS Measure #091: Acute Otitis Externa (AOE): Topical Therapy

Valid Data Submission Method(s) Measure Type High Priority Measure? NQS Domain Specialty Measure Sets
Claims, Registry Process Yes Effective Clinical Care Emergency Medicine, Otolaryngology, Pediatrics

Measure Description

Percentage of patients aged 2 years and older with a diagnosis of AOE who were prescribed topical preparations

Instruction

This measure may be reported based on the actions of the reporting eligible clinician who performs the quality action, described in the measure, based on services provided within measure-specific denominator coding. This measure is to be reported once for each occurrence of AOE during the performance period. Each unique occurrence is defined as a 30-day period from onset of AOE. Claims data will be analyzed to determine unique occurrences. If multiple claims are submitted within that 30-day period, only one instance of reporting will be counted.

Eligible clinicians who report on this measure may also find Measure #93: Acute Otitis Externa: Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use to be clinically relevant. The measure developer intended for measures #91: Acute Otitis Externa (AOE): Topical Therapy and #93: Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy- Avoidance of Inappropriate Use to be paired measures, as they can both be implemented to measure care provided to patients diagnosed with diffuse, uncomplicated AOE.

Denominator

All patients aged 2 years and older with a diagnosis of AOE

Denominator Criteria (Eligible Cases):
Patients aged ≥ 2 years on date of encounter
AND
Diagnosis for AOE (ICD-10-CM): H60.00, H60.01, H60.02, H60.03, H60.10, H60.11, H60.12, H60.13, H60.311, H60.312, H60.313, H60.319, H60.321, H60.322, H60.323, H60.329, H60.331, H60.332, H60.333, H60.339, H60.391, H60.392, H60.393, H60.399, H60.501, H60.502, H60.503, H60.509, H60.511, H60.512, H60.513, H60.519, H60.521, H60.522, H60.523, H60.529, H60.531, H60.532, H60.533, H60.539, H60.541, H60.542, H60.543, H60.549, H60.551, H60.552, H60.553, H60.559, H60.591, H60.592, H60.593, H60.599, H61.90, H61.91, H61.92, H61.93, H62.40, H62.41, H62.42, H62.43, H62.8X1, H62.8X2, H62.8X3, H62.8X9
AND
Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99281, 99282, 99283, 99284, 99285, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350
WITHOUT
Telehealth Modifier: GQ, GT

Numerator

Patients who were prescribed topical preparations
Definition:
Prescribed – May include prescription given to the patient for topical preparations at one or more visits during the episode of AOE OR patient already receiving topical preparations as documented in the current medication list.

Numerator Options:
Performance Met: Topical preparations (including OTC) prescribed for acute otitis externa (4130F)
OR
Denominator Exception: Documentation of medical reason(s) for not prescribing topical preparations (including OTC) for acute otitis externa (eg, coexisting acute otitis media, tympanic membrane perforation) (4130F with 1P)
OR
Denominator Exception: Documentation of patient reason(s) for not prescribing topical preparations (including OTC) for acute otitis externa (4130F with 2P)
OR
Performance Not Met: Topical preparations (including OTC) for acute otitis externa (AOE) not prescribed, reason not otherwise specified (4130F with 8P)

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