Source: https://ecqi.healthit.gov/sites/default/files/ecqm/measures/CMS56v8.html
Timestamp: 2020-08-07 16:25:32
Document Index: 149780000

Matched Legal Cases: ['arts 90', 'arts 90', 'arts 90', 'arts 90', 'arts 90', 'arts 12']

eCQM Identifier (Measure Authoring Tool) 56 eCQM Version number 8.1.000
NQF Number Not Applicable GUID 2f291003-3f2f-48af-bef9-e5aacb95ac3e
Total hip arthroplasties (THAs) are common surgical procedures that address hip pain and functional impairment, primarily caused by osteoarthritis. Although THA is an effective procedure for addressing osteoarthritis for many patients, some people, particularly those with more severe preoperative pain and impairment, do not experience the improvements in pain, function, and quality of life expected from the procedure (Beswick et al., 2012; Fortin et al., 1999; Tilbury et al., 2016). In 2010, providers performed 326,100 THAs, with 95 percent of them in patients age 45 and older (Wolford, Palso, & Bercovitz, 2015). Although THAs were introduced as a procedure for the elderly, the percentage of patients age 55 to 64 (29 percent) who had a THA in 2010 exceeded the percentage of patients age 75 and older (26 percent) who had a THA (Wolford, Palso, & Bercovitz, 2015). Kurtz et al. (2009) projected that patients younger than 65 would account for 52 percent of THAs by 2030. This growth in hip surgeries for patients younger than 65 is significant because these patients often require more expensive joint arthroplasties that will better withstand the wear caused by physical activity (Bozic et al., 2006).
This measure evaluates whether patients complete a patient-reported functional status assessment (FSA) before and after a THA. Measuring functional status for patients undergoing THA permits longitudinal assessment - from the patient's perspective - of the impact of surgical intervention on pain, physical function, as well as health-related quality of life (Rothrock, 2010).
The American Association of Hip and Knee Surgeons (AAHKS) states that it is important to ensure that the general/mental health survey be completed prior to surgery during the preoperative visit, as well as the post-operative visit. AAHKS recommends using a general health instrument, such as the Veterans RAND 12-item health survey (VR-12) or PROMIS Global  10 in addition to condition-specific tools (AAHKS, 2015).
Beswick, A. D., Wylde, V., Gooberman-Hill, R., et al. (2012). What proportion of patients report long-term pain after total  hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. British Medical Journal Open, 2(1), 1-12.
Fortin, P. R., Clarke, A. E., Joseph, L., et al. (1999). Outcomes of total hip and knee replacement preoperative functional status predicts outcomes at six months after surgery. American College of Rheumatology, 42(8), 1722-1728.
Tilbury, C., Haanstra, T. M., Leichtenberg, C. S., et al. (2016). Unfulfilled expectations after total hip and knee arthroplasty surgery: There is a need for better preoperative patient information and education. Journal of Arthroplasty, 31(10), 2136-2145.
Wolford, M. L., Palso, K., & Bercovitz, A. (2015, February). Hospitalization for total hip replacement among inpatients aged 45 and over: United States, 2000-2010. NCHS Data Brief No. 186. Hyattsville, MD: National Center for Health Statistics.
A functional status assessment (FSA) is based on administration of a validated  instrument to eligible patients that asks patients to answer questions related to various domains including: pain, physical function, emotional well-being, health-related quality of life, symptom acuity.
Patients 19 years of age and older who had a primary total hip arthroplasty (THA) in the year prior to the measurement period and who had an outpatient encounter during the measurement period
Patients with two or more fractures indicating trauma at the time of the total hip arthroplasty or patients with severe cognitive impairment that overlaps the measurement period.
Patients with patient-reported functional status assessment  results (i.e., VR-12, PROMIS-10-Global Health, Hip Disability and Osteoarthritis Outcome Score [HOOS], HOOS Jr.) in the 90 days prior to or on the day of the primary THA procedure, and in the 270 - 365 days after the THA procedure
exists ( "Total Hip Arthroplasty Procedure" )
or exists ( "Total Hip Arthroplasty with 2 or More Lower Body Fractures" )
or exists ( "Dementia Diagnosis" )
exists ( "Assessed Initial and Followup HOOS with THA" )
or exists ( "Assessed Initial and Followup HOOSJr with THA" )
or exists ( "Assessed Initial and Followup PROMIS10 with THA" )
or exists ( "Assessed Initial and Followup VR12 Oblique with THA" )
or exists ( "Assessed Initial and Followup VR12 Orthogonal with THA" )
Assessed Initial and Followup HOOS with THA
"Total Hip Arthroplasty Procedure" TotalHip
with "HOOS Total Assessment Scores" InitialHipAssessmentHOOS
such that TotalHip.relevantPeriod starts 90 days or less on or after day of InitialHipAssessmentHOOS.authorDatetime
with "HOOS Total Assessment Scores" FollowupHipAssessmentHOOS
such that FollowupHipAssessmentHOOS.authorDatetime 270 days or more after day of
end of TotalHip.relevantPeriod
and FollowupHipAssessmentHOOS.authorDatetime 365 days or less after day of
Assessed Initial and Followup HOOSJr with THA
with "HOOSJr Total Assessment Scores" InitialHipAssessment
such that TotalHip.relevantPeriod starts 90 days or less on or after day of InitialHipAssessment.authorDatetime
with "HOOSJr Total Assessment Scores" FollowupHipAssessment
such that FollowupHipAssessment.authorDatetime 270 days or more after day of
and FollowupHipAssessment.authorDatetime 365 days or less after day of
Assessed Initial and Followup PROMIS10 with THA
with "PROMIS10 Total Assessment Scores" InitialHipAssessmentPROMIS10
such that TotalHip.relevantPeriod starts 90 days or less on or after day of InitialHipAssessmentPROMIS10.authorDatetime
with "PROMIS10 Total Assessment Scores" FollowupHipAssessmentPROMIS10
such that FollowupHipAssessmentPROMIS10.authorDatetime 270 days or more after day of
and FollowupHipAssessmentPROMIS10.authorDatetime 365 days or less after day of
Assessed Initial and Followup VR12 Oblique with THA
with "VR12 Oblique Total Assessment Scores" InitialHipAssessmentOblique
such that TotalHip.relevantPeriod starts 90 days or less on or after day of InitialHipAssessmentOblique.authorDatetime
with "VR12 Oblique Total Assessment Scores" FollowupHipAssessmentOblique
such that FollowupHipAssessmentOblique.authorDatetime 270 days or more after day of
and FollowupHipAssessmentOblique.authorDatetime 365 days or less after day of
Assessed Initial and Followup VR12 Orthogonal with THA
with "VR12 Orthogonal Total Assessment Scores" InitialHipAssessmentOrthogonal
such that TotalHip.relevantPeriod starts 90 days or less on or after day of InitialHipAssessmentOrthogonal.authorDatetime
with "VR12 Orthogonal Total Assessment Scores" FollowupHipAssessmentOrthogonal
such that FollowupHipAssessmentOrthogonal.authorDatetime 270 days or more after day of
and FollowupHipAssessmentOrthogonal.authorDatetime 365 days or less after day of
HOOS Total Assessment Scores
["Assessment, Performed": "Quality of life score [HOOS]"] HOOSLifeQuality
with ["Assessment, Performed": "Sport-recreation score [HOOS]"] HOOSSport
such that HOOSLifeQuality.authorDatetime same day as HOOSSport.authorDatetime
and HOOSSport.result is not null
with ["Assessment, Performed": "Activities of daily living score [HOOS]"] HOOSActivityScore
such that HOOSLifeQuality.authorDatetime same day as HOOSActivityScore.authorDatetime
and HOOSActivityScore.result is not null
with ["Assessment, Performed": "Symptoms score [HOOS]"] HOOSSymptoms
such that HOOSLifeQuality.authorDatetime same day as HOOSSymptoms.authorDatetime
and HOOSSymptoms.result is not null
with ["Assessment, Performed": "Pain score [HOOS]"] HOOSPain
such that HOOSLifeQuality.authorDatetime same day as HOOSPain.authorDatetime
and HOOSPain.result is not null
where HOOSLifeQuality.result is not null
HOOSJr Total Assessment Scores
( ["Assessment, Performed": "Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement [HOOSJR]"] HOOSJr
where HOOSJr.result is not null
Total Hip Arthroplasty Procedure
( ["Procedure, Performed": "Primary THA Procedure"] THAProcedure
where THAProcedure.relevantPeriod starts 12 months or less before start of "Measurement Period"
Total Hip Arthroplasty with 2 or More Lower Body Fractures
"Total Hip Arthroplasty Procedure" THAProcedure
where LowerBodyFracture.prevalencePeriod starts less than 1 day on or before THAProcedure.relevantPeriod
( ["Assessment, Performed": "VR-12 Mental component summary (MCS) score - oblique method T-score"] VR12MentalAssessment
( ["Assessment, Performed": "VR-12 Mental component summary (MCS) score - orthogonal method T-score"] VR12MentalOrthogonal
where VR12MentalOrthogonal.result is not null ) VR12MentalScore
with ( ["Assessment, Performed": "VR-12 Physical component summary (PCS) score - orthogonal method T-score"] VR12PhysicalOrthogonal
where VR12PhysicalOrthogonal.result is not null ) VR12PhysicalScore
code "Activities of daily living score [HOOS]" ("LOINC Code (72095-3)")
code "Pain score [HOOS]" ("LOINC Code (72097-9)")
code "Quality of life score [HOOS]" ("LOINC Code (72093-8)")
code "Sport-recreation score [HOOS]" ("LOINC Code (72094-6)")
code "Symptoms score [HOOS]" ("LOINC Code (72096-1)")
valueset "Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement [HOOSJR]" (2.16.840.1.113883.3.464.1003.118.12.1210)
valueset "Primary THA Procedure" (2.16.840.1.113883.3.464.1003.198.12.1006)
"Assessment, Performed: Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement [HOOSJR]" using "Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement [HOOSJR] (2.16.840.1.113883.3.464.1003.118.12.1210)"
"Procedure, Performed: Primary THA Procedure" using "Primary THA Procedure (2.16.840.1.113883.3.464.1003.198.12.1006)"
"Assessment, Performed: Activities of daily living score [HOOS]" using "Activities of daily living score [HOOS] (LOINC Code 72095-3)"
"Assessment, Performed: Pain score [HOOS]" using "Pain score [HOOS] (LOINC Code 72097-9)"
"Assessment, Performed: Quality of life score [HOOS]" using "Quality of life score [HOOS] (LOINC Code 72093-8)"
"Assessment, Performed: Sport-recreation score [HOOS]" using "Sport-recreation score [HOOS] (LOINC Code 72094-6)"
"Assessment, Performed: Symptoms score [HOOS]" using "Symptoms score [HOOS] (LOINC Code 72096-1)"