2021 MIPS Measure #222: Functional Status Change for Patients with Elbow, Wrist or Hand Impairments

Measure Description

A patient-reported outcome measure of risk-adjusted change in functional status for patients 14 years+ with elbow, wrist, or hand impairments. The change in functional status (FS) is assessed using the FOTO Elbow/Wrist/Hand FS patient-reported outcome measure (PROM). The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician level, and at the clinic level to assess quality. The measure is available as a computer adaptive test, for reduced patient burden, or a short form (static measure).

Instructions

This outcome measure is to be submitted once per Treatment Episode for all patients with a functional deficit related to the elbow, wrist or hand. This is an outcome measure and its calculation requires submitting of the patient’s FS PROM score, at a minimum, at the start (Initial Evaluation or Intake) and again at the conclusion (Discharge) of a Treatment Episode. The Initial Evaluation score is recorded during the first treatment encounter, and the Discharge score is recorded at or near the conclusion of the final treatment encounter. It is anticipated that Merit-based Incentive Payment System (MIPS) eligible clinicians providing treatment for functional elbow, wrist, or hand deficits will submit this measure.

Definitions:
Functional Deficit – Limitation or impairment of physical abilities/function resulting in evaluation and inclusion in a treatment plan of care.
Treatment Episode – A Treatment Episode is defined as beginning with an Initial Evaluation for a functional elbow, wrist or hand deficit, progressing through treatment without interruption (for example, a hospitalization or surgical intervention), and ending with Discharge, signifying that the treatment has been completed. A patient currently under clinical care for an elbow, wrist or hand deficit remains in a single Treatment Episode until the Discharge is conducted and documented by the MIPS eligible clinician.
Initial Evaluation – An Initial Evaluation is the first encounter for a functional deficit involving the elbow, wrist, or hand and includes an evaluation (CPT 97161, 97162, 97163, 97165, 97166, 97167, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 98940, 98941, 98942, or 98943), or an Initial Evaluation Status M-code (M1135). A patient presenting with an elbow, wrist, or hand impairment, who has had an interruption of a Treatment Episode for the same functional knee deficit secondary to an appropriate reason like hospitalization or surgical intervention, is an Initial Evaluation.
Discharge– Discharge is accompanied by a treatment finalization and evaluation completion M-Code (M1014) for identifying the close of a Treatment Episode for the same elbow, wrist or hand deficit identified at the Initial Evaluation and documented by a Discharge report by the MIPS eligible clinician. An interruption in clinical care for an appropriate reason like hospitalization or surgical intervention requires a discharge from the current Treatment Episode.
Encounter – A visit between the patient and the provider for the purpose of assessing and/or improving a functional deficit.
Patient Reported –The patient directly provides answers to the FS measure items using a standardized, reliable and valid, computerized adaptive testing or short form (static/paper and pencil) method. If the patient cannot reliably respond independently (e.g. in the presence of cognitive deficits), a suitable proxy may provide answers.

NOTE: Patient encounters for this measure conducted via telehealth (e.g., encounters coded with GQ, GT, 95, or POS 02 modifiers) are allowable.

Measure Submission Type:

Measure data may be submitted by individual MIPS eligible clinicians, groups, or third party intermediaries. The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The quality-data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.

Denominator

All patients 14 years and older with elbow, wrist or hand impairments who have initiated a Treatment Episode.

Denominator Criteria (Eligible Cases):
All patients aged >14 on date of Initial Evaluation
AND
Patient encounter during the performance period identifying evaluation (CPT or M-code): 97161, 97162, 97163, 97165, 97166, 97167, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 98940, 98941, 98942, 98943,* or M1135
AND
With an elbow, wrist, or hand impairment and/or diagnosis pertaining to a functional deficit affecting the elbow, wrist, or hand: M05.121, M05.122, M05.131, M05.132, M05.141, M05.142, M05.221, M05.222, M05.231, M05.232, M05.241, M05.242, M05.321, M05.322, M05.331, M05.332, M05.341, M05.342, M05.421, M05.422, M05.431, M05.432, M05.441, M05.442, M05.521, M05.522, M05.531, M05.532, M05.541, M05.542, M05.621, M05.622, M05.631, M05.632, M05.641, M05.642, M05.721, M05.722, M05.731, M05.732, M05.741, M05.742, M05.821, M05.822, M05.831, M05.832, M05.841, M05.842, M06.021, M06.022, M06.031, M06.032, M06.041, M06.042, M06.221, M06.222, M06.231, M06.232, M06.241, M06.242, M06.321, M06.322, M06.331, M06.332, M06.341, M06.342, M06.821, M06.822, M06.831, M06.832, M06.841, M06.842, M08.021, M08.022, M08.031, M08.032, M08.041, M08.042, M08.221, M08.222, M08.231, M08.232, M08.241, M08.242, M08.421, M08.422, M08.431, M08.432, M08.441, M08.442, M08.821, M08.822, M08.831, M08.832, M08.841, M08.842, M08.921, M08.922, M08.931, M08.932, M08.941, M08.942, M11.021, M11.022, M11.031, M11.032, M11.041, M11.042, M11.121, M11.122, M11.131, M11.132, M11.141, M11.142, M11.221, M11.222, M11.231, M11.232, M11.241, M11.242, M11.821, M11.822, M11.831, M11.832, M11.841, M11.842, M12.521, M12.522, M12.531, M12.532, M12.541, M12.542, M12.821, M12.822, M12.831, M12.832, M12.841, M12.842, M13.121, M13.122, M13.131, M13.132, M13.141, M13.142, M13.821, M13.822, M13.831, M13.832, M13.841, M13.842, M14.621, M14.622, M14.631, M14.632, M14.641, M14.642, M14.821, M14.822, M14.831, M14.832, M14.841, M14.842, M18.0, M18.11, M18.12, M18.2, M18.31, M18.32, M18.4, M18.51, M18.52, M19.021, M19.022, M19.031, M19.032, M19.041, M19.042, M19.121, M19.122, M19.131, M19.132, M19.141, M19.142, M19.221, M19.222, M19.231, M19.232, M19.241, M19.242, M20.001, M20.002, M20.011, M20.012, M20.021, M20.022, M20.031, M20.032, M20.091, M20.092, M21.021, M21.022, M21.221, M21.222, M21.231, M21.232, M21.241, M21.242, M21.331, M21.332, M21.511, M21.512, M21.521, M21.522, M21.831, M21.832, M21.931, M21.932, M21.941, M21.942, M24.021, M24.022, M24.031, M24.032, M24.041, M24.042, M24.121, M24.122, M24.131, M24.132, M24.141, M24.142, M24.221, M24.222, M24.231, M24.232, M24.241, M24.242, M24.421, M24.422, M24.431, M24.432, M24.441, M24.442, M24.444, M24.445, M24.521, M24.522, M24.531, M24.532, M24.541, M24.542, M24.621, M24.622, M24.631, M24.632, M24.641, M24.642, M24.821, M24.822, M24.831, M24.832, M24.841, M24.842, M25.021, M25.022, M25.031, M25.032, M25.041, M25.042, M25.221, M25.222, M25.231, M25.232, M25.241, M25.242, M25.321, M25.322, M25.331, M25.332, M25.341, M25.342, M25.421, M25.422, M25.431, M25.432, M25.441, M25.442, M25.521, M25.522, M25.531, M25.532, M25.541, M25.542, M25.621, M25.622, M25.631, M25.632, M25.641, M25.642, M25.721, M25.722, M25.731, M25.732, M25.741, M25.742, M25.821, M25.822, M25.831, M25.832, M25.841, M25.842, M61.031, M61.032, M61.041, M61.042, M61.131, M61.132, M61.141, M61.142, M61.144, M61.145, M61.231, M61.232, M61.241, M61.242, M61.331, M61.332, M61.341, M61.342, M61.431, M61.432, M61.441, M61.442, M62.031, M62.032, M62.041, M62.042, M62.131, M62.132, M62.141, M62.142, M62.231, M62.232, M62.241, M62.242, M62.431, M62.432, M62.441, M62.442, M62.531, M62.532, M62.541, M62.542, M63.831, M63.832, M63.841, M63.842, M65.231, M65.232, M65.241, M65.242, M65.311, M65.312, M65.321, M65.322, M65.331, M65.332, M65.341, M65.342, M65.351, M65.352, M65.4, M65.831, M65.832, M65.841, M65.842, M66.121, M66.122, M66.131, M66.132, M66.141, M66.142, M66.144, M66.145, M66.231, M66.232, M66.241, M66.242, M66.331, M66.332, M66.341, M66.342, M66.831, M66.832, M66.841, M66.842, M67.231, M67.232, M67.241, M67.242, M67.321, M67.322, M67.331, M67.332, M67.341, M67.342, M67.421, M67.422, M67.431, M67.432, M67.441, M67.442, M67.821, M67.822, M67.823, M67.824, M67.831, M67.832, M67.833, M67.834, M67.841, M67.842, M67.843, M67.844, M67.931, M67.932, M67.941, M67.942, M70.031, M70.032, M70.041, M70.042, M70.11, M70.12, M70.21, M70.22, M70.31, M70.32, M70.831, M70.832, M70.841, M70.842, M70.931, M70.932, M70.941, M70.942, M71.021, M71.321, M71.322, M71.331, M71.332, M71.341, M71.342, M71.421, M71.422, M71.431, M71.432, M71.441, M71.442, M71.521, M71.522, M71.531, M71.532, M71.541, M71.542, M71.821, M71.822, M71.831, M71.832, M71.841, M71.842, M72.0, M77.01, M77.02, M77.11, M77.12, M77.21, M77.22, M79.631, M79.632, M79.641, M79.642, M79.644, M79.645, M84.331D, M84.331G, M84.331K, M84.331P, M84.331S, M84.332D, M84.332G, M84.332K, M84.332P, M84.332S, M84.333D, M84.333G, M84.333K, M84.333P, M84.333S, M84.334D, M84.334G, M84.334K, M84.334P, M84.334S, M84.341D, M84.341G, M84.341K, M84.341P, M84.341S, M84.342D, M84.342G, M84.342K, M84.342P, M84.342S, M84.344D, M84.344G, M84.344K, M84.344P, M84.344S, M84.345D, M84.345G, M84.345K, M84.345P, M84.345S, M92.11, M92.12, M92.201, M92.202, M92.211, M92.212, M92.221, M92.222, M92.291, M92.292, M93.221, M93.222, M93.231, M93.232, M93.241, M93.242, M93.831, M93.832, M93.841, M93.842, M93.931, M93.932, M93.941, M93.942, M94.221, M94.222, M94.231, M94.232, M94.241, M94.242, M94.8X3, M94.8X4, M96.631, M96.632, M97.41XA, M97.41XD, M97.41XS, M97.42XA, M97.42XD, M97.42XS, S42.401D, S42.401G, S42.401K, S42.401P, S42.401S, S42.402D, S42.402G, S42.402K, S42.402P, S42.402S, S42.411D, S42.411G, S42.411K, S42.411P, S42.411S, S42.412D, S42.412G, S42.412K, S42.412P, S42.412S, S42.414D, S42.414G, S42.414K, S42.414P, S42.414S, S42.415D, S42.415G, S42.415K, S42.415P, S42.415S, S42.421D, S42.421G, S42.421K, S42.421P, S42.421S, S42.422D, S42.422G, S42.422K, S42.422P, S42.422S, S42.424D, S42.424G, S42.424K, S42.424P, S42.424S, S42.425D, S42.425G, S42.425K, S42.425P, S42.425S, S42.431D, S42.431G, S42.431K, S42.431P, S42.431S, S42.432D, S42.432G, S42.432K, S42.432P, S42.432S, S42.434D, S42.434G, S42.434K, S42.434P, S42.434S, S42.435D, S42.435G, S42.435K, S42.435P, S42.435S, S42.441D, S42.441G, S42.441K, S42.441P, S42.441S, S42.442D, S42.442G, S42.442K, S42.442P, S42.442S, S42.444D, S42.444G, S42.444K, S42.444P, S42.444S, S42.445D, S42.445G, S42.445K, S42.445P, S42.445S, S42.447D, S42.447G, S42.447K, S42.447P, S42.447S, S42.448D, S42.448G, S42.448K, S42.448P, S42.448S, S42.451D, S42.451G, S42.451K, S42.451P, S42.451S, S42.452D, S42.452G, S42.452K, S42.452P, S42.452S, S42.454D, S42.454G, S42.454K, S42.454P, S42.454S, S42.455D, S42.455G, S42.455K, S42.455P, S42.455S, S42.461D, S42.461G, S42.461K, S42.461P, S42.461S, S42.462D, S42.462G, S42.462K, S42.462P, S42.462S, S42.464D, S42.464G, S42.464K, S42.464P, S42.464S, S42.465D, S42.465G, S42.465K, S42.465P, S42.465S, S42.471D, S42.471G, S42.471K, S42.471P, S42.471S, S42.472D, S42.472G, S42.472K, S42.472P, S42.472S, S42.474D, S42.474G, S42.474K, S42.474P, S42.474S, S42.475D, S42.475G, S42.475K, S42.475P, S42.475S, S42.481G, S42.481K, S42.481P, S42.481S, S42.482G, S42.482K, S42.482P, S42.482S, S42.491D, S42.491G, S42.491K, S42.491P, S42.491S, S42.492D, S42.492G, S42.492K, S42.492P, S42.492S, S42.494D, S42.494G, S42.494K, S42.494P, S42.494S, S42.495D, S42.495G, S42.495K, S42.495P, S42.495S, S49.101D, S49.101G, S49.101K, S49.101P, S49.101S, S49.102D, S49.102G, S49.102K, S49.102P, S49.102S, S49.111D, S49.111G, S49.111K, S49.111P, S49.111S, S49.112D, S49.112G, S49.112K, S49.112P, S49.112S, S49.121D, S49.121G, S49.121K, S49.121P, S49.121S, S49.122D, S49.122G, S49.122K, S49.122P, S49.122S, S49.131G, S49.131K, S49.131P, S49.131S, S49.132D, S49.132G, S49.132K, S49.132P, S49.132S, S49.141G, S49.141K, S49.141P, S49.141S,  S49.142D, S49.142G, S49.142K, S49.142P, S49.142S, S49.191D, S49.191G, S49.191K, S49.191P, S49.191S, S49.192D, S49.192G, S49.192K, S49.192P, S49.192S, S50.01XA, S50.01XD, S50.01XS, S50.02XA, S50.02XD, S50.02XS, S50.11XA, S50.11XD, S50.11XS, S50.12XA, S50.12XD, S50.12XS, S52.001D, S52.001E, S52.001F, S52.001G, S52.001H, S52.001J, S52.001K, S52.001M, S52.001N, S52.001P, S52.001Q, S52.001R, S52.001S, S52.002D, S52.002E, S52.002F, S52.002G, S52.002H, S52.002J, S52.002K, S52.002M, S52.002N, S52.002P, S52.002Q, S52.002R, S52.002S, S52.011D, S52.011G, S52.011K, S52.011P, S52.011S, S52.012D, S52.012G, S52.012K, S52.012P, S52.012S, S52.021D, S52.021E, S52.021F, S52.021G, S52.021H, S52.021J, S52.021K, S52.021M, S52.021N, S52.021P, S52.021Q, S52.021R, S52.021S, S52.022D, S52.022E, S52.022F, S52.022G, S52.022H, S52.022J, S52.022K, S52.022M, S52.022N, S52.022P, S52.022Q, S52.022R, S52.022S, S52.024D, S52.024E, S52.024F, S52.024G, S52.024H, S52.024J, S52.024K, S52.024M, S52.024N, S52.024P, S52.024Q, S52.024R, S52.024S, S52.025D, S52.025E, S52.025F, S52.025G, S52.025H, S52.025J, S52.025K, S52.025M, S52.025N, S52.025P, S52.025Q, S52.025R, S52.025S, S52.031D, S52.031E, S52.031F, S52.031G, S52.031H, S52.031J, S52.031K, S52.031M, S52.031N, S52.031P, S52.031Q, S52.031R, S52.031S, S52.032D, S52.032E, S52.032F, S52.032G, S52.032H, S52.032J, S52.032K, S52.032M, S52.032N, S52.032P, S52.032Q, S52.032R, S52.032S, S52.034D, S52.034E, S52.034F, S52.034G, S52.034H, S52.034J, S52.034K, S52.034M, S52.034N, S52.034P, S52.034Q, S52.034R, S52.034S, S52.035D, S52.035E, S52.035F, S52.035G, S52.035H, S52.035J, S52.035K, S52.035M, S52.035N, S52.035P, S52.035Q, S52.035R, S52.035S, S52.041D, S52.041E, S52.041F, S52.041G, S52.041H, S52.041J, S52.041K, S52.041M, S52.041N, S52.041P, S52.041Q, S52.041R, S52.041S, S52.042D, S52.042E, S52.042F, S52.042G, S52.042H, S52.042J, S52.042K, S52.042M, S52.042N, S52.042P, S52.042Q, S52.042R, S52.042S, S52.044D, S52.044E, S52.044F, S52.044G, S52.044H, S52.044J, S52.044K, S52.044M, S52.044N, S52.044P, S52.044Q, S52.044R, S52.044S, S52.045D, S52.045E, S52.045F, S52.045G, S52.045H, S52.045J, S52.045K, S52.045M, S52.045N, S52.045P, S52.045Q, S52.045R, S52.045S, S52.091D, S52.091E, S52.091F, S52.091G, S52.091H, S52.091J, S52.091K, S52.091M, S52.091N, S52.091P, S52.091Q, S52.091R, S52.091S, S52.092D, S52.092E, S52.092F, S52.092G, S52.092H, S52.092J, S52.092K, S52.092M, S52.092N, S52.092P, S52.092Q, S52.092R, S52.092S, S52.101D, S52.101E, S52.101F, S52.101G, S52.101H, S52.101J, S52.101K, S52.101M, S52.101N, S52.101P, S52.101Q, S52.101R, S52.101S, S52.102D, S52.102E, S52.102F, S52.102G, S52.102H, S52.102J, S52.102K, S52.102M, S52.102N, S52.102P, S52.102Q, S52.102R, S52.102S, S52.111D, S52.111G, S52.111K, S52.111P, S52.111S, S52.112D, S52.112G, S52.112K, S52.112P, S52.112S, S52.121D, S52.121E, S52.121F, S52.121G, S52.121H, S52.121J, S52.121K, S52.121M, S52.121N, S52.121P, S52.121Q, S52.121R, S52.121S, S52.122D, S52.122E, S52.122F, S52.122G, S52.122H, S52.122J, S52.122K, S52.122M, S52.122N, S52.122P, S52.122Q, S52.122R, S52.122S, S52.124D, S52.124E, S52.124F, S52.124G, S52.124H, S52.124J, S52.124K, S52.124M, S52.124N, S52.124P, S52.124Q, S52.124R, S52.124S, S52.125D, S52.125E, S52.125F, S52.125G, S52.125H, S52.125J, S52.125K, S52.125M, S52.125N, S52.125P, S52.125Q, S52.125R, S52.125S, S52.131D, S52.131E, S52.131F, S52.131G, S52.131H, S52.131J, S52.131K, S52.131M, S52.131N, S52.131P, S52.131Q, S52.131R, S52.131S, S52.132D, S52.132E, S52.132F, S52.132G, S52.132H, S52.132J, S52.132K, S52.132M, S52.132N, S52.132P, S52.132Q, S52.132R, S52.132S, S52.134D, S52.134E, S52.134F, S52.134G, S52.134H, S52.134J, S52.134K, S52.134M, S52.134N, S52.134P, S52.134Q, S52.134R, S52.134S, S52.135D, S52.135E, S52.135F, S52.135G, S52.135H, S52.135J, S52.135K, S52.135M, S52.135N, S52.135P, S52.135Q, S52.135R, S52.135S, S52.181D, S52.181E, S52.181F, S52.181G, S52.181H, S52.181J, S52.181K, S52.181M, S52.181N, S52.181P, S52.181Q, S52.181R, S52.181S, S52.182D, S52.182E, S52.182F, S52.182G, S52.182H, S52.182J, S52.182K, S52.182M, S52.182N, S52.182P, S52.182Q, S52.182R, S52.182S, S52.201D, S52.201E, S52.201F, S52.201G, S52.201H, S52.201J, S52.201K, S52.201M, S52.201N, S52.201P, S52.201Q, S52.201R, S52.201S, S52.202D, S52.202E, S52.202F, S52.202G, S52.202H, S52.202J, S52.202K, S52.202M, S52.202N, S52.202P, S52.202Q, S52.202R, S52.202S, S52.211D, S52.211G, S52.211K, S52.211P, S52.211S, S52.212D, S52.212G, S52.212K, 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