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2021 ECPR46: Avoidance of Opiates for Low Back Pain or Migraines


Measure Description

Percentage of Patients with Low Back Pain and/or Migraines Who Were Not Prescribed an Opiate


  • Any patient ≥ 18 years of age evaluated by the Eligible Professional in the Emergency Department or Urgent Care Clinic (E/M Codes 99201-99205, 99212-99215, 99281- 99285, 99291-99292 AND Place of Service Indicator: 11, 19, 20, 22 or 23) PLUS
  • Diagnosis of low back pain OR
    • ICD-10: M54.5
  • Diagnosis of migraine ICD-10: G43.001, G43.009, G43.011, G43.019, G43.101, G43.109, G43.111, G43.119, G43.401, G43.409, G43.411, G43.419, G43.501, G43.509, G43.511, G43.519, G43.601, G43.609, G43.611, G43.619, G43.701, 43.709, G43.711, G43.719, G43.A0, G43.A1, G43.B0, G43.B1, G43.C0, G43.C1, G43.D0, G43.D1, G43.801, G43.809, G43.811, G43.819, G43.821, G43.829, G43.831, G43.839, G43.901, G43.909, G43.911, G43.919 PLUS
  • Disposition of Discharged


Patients who were not prescribed an opiate

Numerator Options:

  • Performance Met (VE263): Opiate not prescribed
  • Medical Performance Exclusion (Denominator Exception) (VE264): Opiate prescribed for medical reason documented by the Eligible Professional (e.g., headache pain refractory to other medications, severe headache, suspected or diagnosed herniated disk, fracture, sciatica, radiculopathy)
  • Performance Not Met (VE265): Opiate prescribed, reason not specified

Numerator Exclusions


NQF ID Number


NQS Domain

Effective Clinical Care

High Priority Measure


Includes Telehealth?


Inverse Measure


Proportional Measure


Continuous Variable Measure


Ratio Measure


Number of performance rates to be calculated and submitted


Risk-Adjusted Status?


Meaningful Measure

Prevention and Treatment of Opioid and Substance Use Disorders

Measure Type


Care Settings

Multiple Care Settings

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