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