Measure Title: Functional Status Change for Patients with Vestibular Dysfunction
Measure Description: Percentage of patients aged 14 years and older diagnosed with vestibular dysfunction who achieve a Minimal Clinically Important Difference (MCID) as measured via the validated Dizziness Handicap Inventory or equivalent instrument to indicate functional, emotional, and physical improvement
· Submission Age Criteria 1: Patients aged 14-17 years of age
· Submission Age Criteria 2: Patients aged 18-64 years of age
· Submission Age Criteria 3: Patients aged 65 years and older
· Submission Criteria 4: Overall total rate of patients aged 14 years and older
The measure is adjusted to patient characteristics known to be associated with functional status and quality of life outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician, and at the clinic level to assess quality.
Denominator: Denominator Criteria (Eligible Cases):
SUBMISSION CRITERIA 1: Patients aged 14-17 years of age on date of encounter
SUBMISSION CRITERIA 2: Patients aged 18-64 years and older on date of encounter
SUBMISSION CRITERIA 3: Patients aged 65 years of age and older on date of encounter
SUBMISSION CRITERIA 4: Patients aged 14 years of age and older on date of encounter
AND
A diagnosis of vestibular dysfunction diagnosis (ICD-10-CM): BPPV: H81.10, H81.11, H81.12, H81.13
OR
Dizziness: R42, H81.10, H81.11, H81.12, H81.13,
OR
Disorders of vestibular function: H81*
OR
Vertiginous syndromes: H82*
OR
Other diseases of inner ear: H83*
OR
Abnormalities of gait and mobility: R26*
OR
Other lack of coordination: R27*
OR
Repeated falls: R29.6
OR
Concussion: S06.0*, F07.81
OR
History of falling: Z91.81
OR
Epidemic vertigo: A88.1
OR
Benign neoplasm of cranial nerves: D33.3
OR
Migraine: B43.109, G43.819
AND
An Index Patient Visit Indicator:
Physical Therapy CPT: 97161, 97162, 97163
OR
Occupational Therapy CPT: 97165, 97166, 97167
AND
Two face to face patient encounters for a treatment episode that began or ended during the performance period: GXXXX[DB1]
Numerator: Patients who achieved a MCID in vestibular dysfunction, as measured via the validated Dizziness Handicap Inventory or equivalent instrument, to indicate functional improvement greater than zero and a Risk Adjusted Functional Status Change Residual Score for the dizziness handicap successfully calculated with an MCID score that is greater than zero from their initial visits and just prior to or at their discharge visits from the PT/OT practice
Denominator Exclusions: Hospice services received by patient at any time during the performance period: GXXXX
OR
Patient unable to complete a DHI or equivalent instrument at admission and discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility without the availability of an adequate proxy available: GXXXX
Denominator Exceptions: None
NQF ID Number: N/A
NQS Domain: Effective Clinical Care
High Priority Measure: Yes
Measure Type: Outcome
Includes Teleheatlh: Yes
Inverse Measure: No
Proportional Measure: Yes
Continuous Variable Measure: No
Ratio Measure: No
Number of performance rates to be calculated and submitted: 4
Risk-Adjusted Status: Yes
Care Setting: Ambulatory Care: Clinical Office/Clinic
Submission Pathway: Traditional MIPS