2022 MIPS Measure #472: Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

Description

Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period

Initial Population

Female patients ages 50 to 64 years with an encounter during the measurement period

Denominator

Equals Initial Population

Denominator Exclusions

Exclude patients with a combination of risk factors (as determined by age) or one of the independent risk factors

Ages: 50-54 (>=4 combination risk factors) or 1 independent risk factor

Ages: 55-59 (>=3 combination risk factors) or 1 independent risk factor

Ages: 60-64 (>=2 combination risk factors) or 1 independent risk factor

COMBINATION RISK FACTORS [The following risk factors are all combination risk factors; they are grouped by when they occur in relation to the measurement period]:

The following risk factors may occur any time in the patient’s history but must be active during the measurement period:

  • White (race)
  • BMI <= 20 kg/m2 (must be the first BMI of the measurement period)
  • Smoker (current during the measurement period)
  • Alcohol consumption (> two units per day (one unit is 12 oz. of beer, 4 oz. of wine, or 1 oz. of liquor))

The following risk factor may occur any time in the patient’s history and must not start during the measurement period:

  • Osteopenia

The following risk factors may occur at any time in the patient’s history or during the measurement period:

  • Rheumatoid arthritis
  • Hyperthyroidism
  • Malabsorption Syndromes: celiac disease, inflammatory bowel disease, ulcerative colitis, Crohn’s disease, cystic fibrosis, malabsorption Chronic liver disease Chronic malnutrition Osteoporotic fracture

The following risk factors may occur any time in the patient’s history prior to the start of the measurement period but do not need to be active at the start of the measurement period:

  • Documentation of history of hip fracture in parent
  • Glucocorticoids [cumulative medication duration >= 90 days]

INDEPENDENT RISK FACTORS (The following risk factors are all independent risk factors; they are grouped by when they occur in relation to the measurement period):

The following risk factors may occur at any time in the patient’s history and must not start during the measurement period:

  • Osteoporosis

The following risk factors may occur at any time in the patient’s history prior to the start of the measurement period, but do not need to be active during the measurement period:

  • Gastric bypass
  • FRAX[R] ten-year probability of all major osteoporosis related fracture >= 8.4 percent
  • Aromatase inhibitors

The following risk factors may occur at any time in the patient’s history or during the measurement period:

  • Type I Diabetes
  • End stage renal disease
  • Osteogenesis imperfecta
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Ehlers-Danlos syndrome
  • Cushing’s syndrome
  • Hyperparathyroidism
  • Marfan syndrome
  • Lupus

Numerator

Female patients who received an order for at least one DXA scan in the measurement period

Numerator Exclusions

Not Applicable

Denominator Exceptions

None


Tags

CMS-Family-Medicine-2022, CMS-Internal-Medicine-2022, CMS-Obstetrics-Gynecology-2022, ecqm-2022, Internal Medicine, Obstetrics/Gynecology, Quality-2022