MBHR03 Pain Interference Response utilizing PROMIS

Measure Title  

Pain Interference Response utilizing PROMIS

 

Measure Description

The percentage of adult patients (18 years of age or older) who report chronic pain issues and demonstrated a response to treatment at one month from the index score.

 

 Denominator

Adult patients (18 years of age or older) who report chronic pain issues (i.e., persistent pain for at least 90 days) as significantly impacting their life

Denominator Criteria (Eligible cases):
Patients ages >= 18
AND
Patients report chronic pain (i.e., persistent pain for at least 90 days)

AND

Patient Encounter CPT codes: 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
Patient self-reported pain impacting their life identified by a PROMIS Pain Interference short form of at least 4 items or computer adaptive test score > 60 (using T-score metric)

 

Numerator

The number of patients in the denominator who demonstrated a response to treatment via a PROMIS Pain Interference score that is reduced by 2 or more points from the index score, one month (+/- 21 days) after the index visit.

 

Denominator Exclusions

• Patients who die OR
  • Are enrolled in hospice in the measurement year (PRO2003.1Y1) OR
  • Are unable to complete the PROMIS Pain Interference measure at follow-up due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, AND a suitable recorder (e.g., advocate) is not available (PRO2003.1Y2)

 

Denominator Exceptions (PRO2003.6Y)

• Patient refused to complete a PROMIS Pain Interference measure at follow-up OR
• Ongoing care not indicated (e.g., referred to another provider or facility, consultation only) OR
• Patient self-discharged early (e.g., financial or insurance reasons, transportation problems, or reason unknown) OR
• Medical reasons (e.g., scheduled for surgery or hospitalized)

NQF Number

N/A

 

NQS Domain

Effective Clinical Care

 

High Priority

Yes

 

High Priority Type

Outcome

 

Measure Type

Patient Reported Outcome (PRO)

 

Meaningful Measure Area

Functional Outcomes

 

 Inverse Measure

No

 

Proportional Measure  

Yes

 

Continuous Variable Measure

No

               

Ratio Measure

No

 

 Number of performance rates to be submitted

1

 

Overall Performance Rate

1st Performance Rate

 

Measure Risk-Adjusted?

No

               

Care Setting

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