CMS 56/MIPS 376 – Functional Status Assessment for Total Hip Replacement

What is this Measure?

This measure evaluates whether healthcare providers assess the functional status of patients who have undergone a total hip replacement.

Populating the Denominator:

Underwent a primary total hip arthroplasty (THA) between November two years prior to the measurement period and up to October of the year prior to the measurement period.

Populating visit and procedure code

Step 1: Open a Chart

Step 2: Open a Progress Note for the Patient for a billable office visit

Step 3: Populate prior encounter date -November two years prior to the measurement period and up to October of the year prior to the measurement period  

Step 4: Enter procedure code representing qualified encounter in the procedure section

Applicable Codes:

SNOMEDCT:

185463005, 185464004, 185465003, 30346009, 3391000175108, 37894004, 439740005        
CPT:

99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215

Step 5: Enter arthroplasty of hip SNOMED

SNOMEDCT:  

15163009

Populating the Numerator:

The numerator includes patients from the denominator who have documented patient-reported functional status assessment results using the same standardized tool.

Populating follow-up Encounter and Lab Order/Result

Step 1: Open a Chart

Step 2: Open a Progress Note for the Patient for a billable office visit

Step 3: Populate current Encounter date  

Step 4: Enter procedure code representing qualified encounter in the procedure section

Applicable Codes:

SNOMEDCT:

185463005, 185464004, 185465003, 30346009, 3391000175108, 37894004, 439740005        
CPT:

99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215

Step 5: Add PROMIS-10 Global Physical and Mental Health score

LOINC: 71971-6 and 71969-0

AND       
SNOMEDCT: example – 370143000

Important Note:

Patient will be excluded from the denominator if they scored in this measure for a prior year.

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