Measure Title
Social Role Functioning Assessment utilizing PROMIS Adult Ability to Participate in Social Roles and Activities
Measure Description
The percentage of adult patients (18 years of age or older) who report concerns related to their psychosocial function and who have completed a standardized assessment utilizing the PROMIS Adult Ability to Participate in Social Roles and Activities during measurement period.
Denominator
Patients aged ≥ 18 years
AND
Diagnosis for mood disorders (ICD-10-CM): F31.0, F31.1, F31.2, F31.3, F31.4, F31.5, F31.6, F31.7, F31.8, F31.9, F32.0, F32.1, F32.2, F32.3, F32.4, F32.5, F32.8, F32.9, F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42, F33.8, F33.9, F34.0, F34.1, F34.8, F34.9
OR
Diagnosis for anxiety and/or trauma disorders: F40.1 Social phobias; F40.10 Social phobia, unspecified; F40.11 Social phobia, generalized; F41.0 Panic disorder without agoraphobia; F41.1 Generalized anxiety disorder; F41.3 other mixed anxiety disorders; F41.8 other specified anxiety disorders; F41.9 anxiety disorder unspecified; F43.1 Post-traumatic stress disorder (PTSD); F43.10 Post-traumatic stress disorder, unspecified; F43.11 Post-traumatic stress disorder, acute; F43.12 Post-traumatic stress disorder, chronic
OR
Diagnosis for psychosis disorders: F20.0 – Paranoid schizophrenia
F20.1 – Disorganized schizophrenia
F20.2 – Catatonic schizophrenia
F20.3 – Undifferentiated schizophrenia
F20.5 – Residual schizophrenia
F20.81 – Schizophreniform disorder
F20.89 – Other schizophrenia
F20.9 – Schizophrenia, unspecified
F23 – Brief psychotic disorder
F25.0 – Schizoaffective disorder, bipolar type
F25.1 – Schizoaffective disorder, depressive type
F25.8 – Other schizoaffective disorders
F25.9 – Schizoaffective disorder, unspecified
F28 – Other psychotic disorder not due to a substance or known physiological condition
AND
Patient encounter during the denominator identification period (CPT or HCPCS):
0362T, 0373T, 90785, 90791, 90792, 90832,90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90875, 90876, 96110, 96112, 96113, 96116, 96121, 96127, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146, 96156, 96158, 96159, 96164, 96165, 96167, 96170, 96171, 96178, 97129, 97130, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 98966, 98967, 98968, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215,99354, 99355, 99406, 99407, 99408, 99409, 99446, 99447, 99448, 99449, 99484, 99492, 99493, 99494, G2011, G2061, G2062, G2063, G0396, G0397, G0402, G0438, G0439
AND
Numerator
Adult patients (18 years of age or older) included in the denominator who have at least one completed administration of the PROMIS Adult Ability to Participate in Social Roles and Activities short form or computer adaptive test during a four month measurement period. If the T-score is equal to or less than 40, this suggests a probable difficulty with social role function and ability to effectively participate in one’s usual role, which requires documentation of an appropriate follow-up plan such as further evaluation or referral to treatment.
Denominator Exclusions
- Patients who die OR
• Are enrolled in hospice in the measurement year (PRO2013.1Y1 ) OR
• Are unable to complete the PROMIS adult Ability to Participate in Social Roles and Activities measure due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, AND a suitable recorder (e.g., advocate) is not available (PRO2013.1Y2)
Denominator Exceptions
• None
NQF Number
N/A
NQS Domain
Effective Clinical Care
High Priority
Yes
High Priority Type
Outcome
Measure Type
Patient Reported Outcome
Meaningful Measure Area
Prevention, Treatment, and Management of Mental Health
Inverse Measure
No
Proportional Measure
Yes
Continuous Variable Measure
No
Ratio Measure
No
Number of performance rates to be submitted
1
Measure Risk-Adjusted?
No
Care Setting
Ambulatory, Ambulatory Care: Clinician Office/Clinic, Ambulatory Care: Hospital, Home Care, Hospital, Hospital Inpatient, Hospital Outpatient, Long Term Care, Nursing Home, Outpatient Services, Rehabilitation Facility, Rehabilitation Facility: Inpatient
Includes Telehealth?
Yes
Stay updated with the latest news regarding MACRA and MIPS
The Healthmonix Advisor is a free news source that connects you to the latest in the value-based care industry!