Functional Status Assessment for Total Hip Replacement

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Measure Information	2023 Performance Period	2024 Performance Period	2025 Performance Period
Title	Functional Status Assessment for Total Hip Replacement	Functional Status Assessment for Total Hip Replacement	Functional Status Assessment for Total Hip Replacement
CMS eCQM ID	CMS56v11	CMS56v12	CMS56v13
CBE ID*	Not Applicable	Not Applicable	Not Applicable
MIPS Quality ID	376	376	376
Measure Steward	Centers for Medicare & Medicaid Services (CMS)	Centers for Medicare & Medicaid Services (CMS)	Centers for Medicare & Medicaid Services (CMS)
Description	Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 270 - 365 days after the surgery	Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 300 - 425 days after the surgery	Percentage of patients 19 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 300 - 425 days after the surgery
Measure Scoring	Proportion measure	Proportion measure	Proportion measure
Measure Type	Process	Process	Process
Stratification	*See CMS56v11.html	None	None
Risk Adjustment	*See CMS56v11.html	None	None
Rationale	*See CMS56v11.html	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 older adults, 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). Show more > 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 older adults, 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). Show less	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 older adults, 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 et al., 2010). Show more > 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 older adults, 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 et al., 2010). Show less
Clinical Recommendation Statement	*See CMS56v11.html	While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific... questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015). Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick, 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/TKA (Gkiatas, 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard, 2021). Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin, 2021) (Holte, 2021). Show more > While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015). Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick, 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/TKA (Gkiatas, 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard, 2021). Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin, 2021) (Holte, 2021). Show less	While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific... questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015). Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick et al., 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/Total Knee Arthroplasty (TKA) (Gkiatas et al., 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard et al., 2021). Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin et al., 2021) (Holte et al., 2021). Show more > While there is no clinical guideline recommending that clinicians assess patients who are undergoing total hip replacements using patient-reported outcomes of function and pain, several clinical specialty societies support the use of a general health questionnaire and a disease-specific questionnaire for these patients. In particular, they recommend the Veterans RAND 12-item health survey (VR-12) or the Patient-Reported Outcomes Measurement Information System [PROMIS]-10-Global as the general health questionnaire and the Hip Disability and Osteoarthritis Outcome Score [HOOS], Jr. as the disease-specific questionnaire (American Association of Orthopaedic Surgeons, the American Joint Replacement Registry, The Hip Society, The Knee Society, & the American Association of Hip and Knee Surgeons, 2015). Peer-reviewed and grey literature support additional exclusions for patients undergoing total hip replacements. Staged procedures, concurrent procedures, partial procedures, resurfacing procedures, revision procedures, and removal of implant devices or prosthesis were linked to significant morbidity; complications (such as dislocation, infection, and reinfection); and high failure rates (Ludwick et al., 2021). In addition, mechanical complications, such as instability and dislocation, are also linked to complications and are associated with primary and revision THA/Total Knee Arthroplasty (TKA) (Gkiatas et al., 2021). Malignant neoplasms (such as osteonecrosis of the femoral head) are associated with substantial pain and functional disabilities before THA/TKA (Bernhard et al., 2021). Additionally, peer-reviewed and grey literature support various postoperative time frames, including follow-up within 10 to 14 months (Franklin et al., 2021) (Holte et al., 2021). Show less
Improvement Notation	A higher score indicates better quality	A higher score indicates better quality	A higher score indicates better quality
Definition	*See CMS56v11.html	None	None
Guidance	The same functional status assessment (FSA) instrument must be used for the initial and follow-up assessment. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.	The same FSA instrument must be used for the initial and follow-up assessment. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.	The same FSA instrument must be used for the initial and follow-up assessment. This eCQM is a patient-based measure. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
Initial Population	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 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between November of the year prior to the measurement period and the end of the... measurement period Show more > Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between November of the year prior to the measurement period and the end of the measurement period Show less	Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between August of the year prior to the measurement period and the end of the... measurement period Show more > Patients 19 years of age and older who had a primary THA between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between August of the year prior to the measurement period and the end of the measurement period Show less
Denominator	Equals Initial Population	Equals Initial Population	Equals Initial Population
Denominator Exclusions	Exclude patients with two or more fractures indicating trauma in the 24 hours before or at the start of the total hip arthroplasty or patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients who are in hospice care for any... part of the measurement period. Show more > Exclude patients with two or more fractures indicating trauma in the 24 hours before or at the start of the total hip arthroplasty or patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients who are in hospice care for any part of the measurement period. Show less	Exclude patients who are in hospice care for any part of the measurement period. Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients with one or more specific lower body fractures indicating trauma in the 24 hours... before or at the start of the total hip arthroplasty. Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty. Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty. Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty. Exclude patients with a mechanical complication on the day of the total hip arthroplasty. Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure. Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after. Show more > Exclude patients who are in hospice care for any part of the measurement period. Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients with one or more specific lower body fractures indicating trauma in the 24 hours before or at the start of the total hip arthroplasty. Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty. Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty. Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty. Exclude patients with a mechanical complication on the day of the total hip arthroplasty. Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure. Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after. Show less	Exclude patients who are in hospice care for any part of the measurement period. Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients with one or more specific lower body fractures indicating trauma in the 24 hours... before or at the start of the total hip arthroplasty. Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty. Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty. Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty. Exclude patients with a mechanical complication on the day of the total hip arthroplasty. Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure. Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after. Show more > Exclude patients who are in hospice care for any part of the measurement period. Exclude patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients with one or more specific lower body fractures indicating trauma in the 24 hours before or at the start of the total hip arthroplasty. Exclude patients with a partial hip arthroplasty procedure on the day of the total hip arthroplasty. Exclude patients with a revision hip arthroplasty procedure, an implanted device/prosthesis removal procedure or a resurfacing/supplement procedure on the day of the total hip arthroplasty. Exclude patients with a malignant neoplasm of the pelvis, sacrum, coccyx, lower limbs, or bone/bone marrow or a disseminated malignant neoplasm on the day of the total hip arthroplasty. Exclude patients with a mechanical complication on the day of the total hip arthroplasty. Exclude patients with a second total hip arthroplasty procedure 1 year before or after the original total hip arthroplasty procedure. Exclude patients who die on the day of the total hip arthroplasty procedure or in the 300 days after. Show less
Numerator	Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [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 Show more > Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [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 Show less	Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [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 300 - 425 days after the THA procedure Show more > Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [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 300 - 425 days after the THA procedure Show less	Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [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 300 - 425 days after the THA procedure Show more > Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Patient-Reported Outcomes Measurement Information System [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 300 - 425 days after the THA procedure Show less
Numerator Exclusions	Not Applicable	Not Applicable	Not Applicable
Denominator Exceptions	None	None	None
Telehealth Eligible	Yes	Yes	Yes
Next Version	CMS56v12	CMS56v13	No Version Available
Previous Version	No Version Available	CMS56v11	CMS56v12

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Additional Resources for CMS56v13

CMS56v13-TRN.xlsx

Header

Updated the eCQM version number.
Measure Section:
eCQM Version Number
Source of Change:
Annual Update
Changed all references from NQF to CBE to identify the consensus-based entity role.
Measure Section:
CBE Number
Source of Change:
Annual Update
Updated copyright.
Measure Section:
Copyright
Source of Change:
Annual Update
Changed qualifying encounter to expand the timing from 'November of the year prior' to 'August of the year prior' to align with the allowable post-surgery assessment dates.
Measure Section:
Initial Population
Source of Change:
Annual Update
Updated grammar, wording, and/or formatting to improve readability and consistency.
Measure Section:
Multiple Sections
Source of Change:
Annual Update

Logic

Changed qualifying encounter to expand the timing from 'November of the year prior' to 'August of the year prior' to align with the allowable post-surgery assessment dates.
Measure Section:
Definitions
Source of Change:
Annual Update
Renamed value set to 'Payer Type' to more accurately reflect the contents and intent of the value set.
Measure Section:
Definitions
Source of Change:
Standards/Technical Update
Updated the timing comparison precision in the definitions from datetime to date by adding 'day of' operator to align with the measure intent and address time zone issues.
Measure Section:
Definitions
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Measure Lead
Updated the value set name for 'Online Assessments' to 'Virtual Encounter' for a more accurate description.
Measure Section:
Definitions
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Measure Lead
Updated the version number of the Hospice Library to v6.0.000 and the library name from 'Hospice' to 'HospiceQDM.'
Measure Section:
Definitions
Source of Change:
Annual Update
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'
Measure Section:
Definitions
Source of Change:
Annual Update
Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'
Measure Section:
Functions
Source of Change:
Annual Update

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

Value set Hospice Care Ambulatory (2.16.840.1.113883.3.526.3.1584): Added 2 SNOMED CT codes (170935008, 170936009) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 SNOMED CT code (385765002) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set Lower Body Fractures Excluding Ankle and Foot (2.16.840.1.113883.3.464.1003.1178): Added 633 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set Malignant Neoplasms of Lower and Unspecified Limbs (2.16.840.1.113883.3.464.1003.1180): Added 97 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set Mechanical Complications Excluding Upper Body (2.16.840.1.113883.3.464.1003.1182): Added 31 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001): Deleted 2 SNOMED CT codes (30346009, 37894004) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 CPT code (99201) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set Virtual Encounter (2.16.840.1.113883.3.464.1003.101.12.1089): Deleted 2 CPT codes (98969, 99444) based on review by technical experts, SMEs, and/or public feedback. Deleted 3 HCPCS codes (G2061, G2062, G2063) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008): Deleted 1 CPT code (99241) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
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Measure Lead
Value set Partial Arthroplasty of Hip (2.16.840.1.113883.3.464.1003.1184): Added 13 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback. Added 1 CPT code (27125) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set (2.16.840.1.114222.4.11.3591): Renamed to Payer Type based on recommended value set naming conventions.
Measure Section:
Terminology
Source of Change:
Annual Update
Value set Primary THA Procedure (2.16.840.1.113883.3.464.1003.198.12.1006): Added 7 SNOMED CT codes (1230048008, 1231410001, 1231411002, 1231412009, 1231413004, 1231414005, 1231415006) based on review by technical experts, SMEs, and/or public feedback. Deleted 3 SNOMED CT codes (179294005, 179305003, 19954002) based on review by technical experts, SMEs, and/or public feedback. Added 36 ICD-10-PCS codes based on review by technical experts, SMEs, and/or public feedback. Added 1 CPT code (27132) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 HCPCS code (S2118) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set Removal, Revision and Supplement Procedures of the Lower Body and Spine (2.16.840.1.113883.3.464.1003.1189): Added 147 SNOMED CT codes based on review by technical experts, SMEs, and/or public feedback. Added 1 HCPCS code (S2118) based on review by technical experts, SMEs, and/or public feedback. Added 3 CPT codes (27134, 27137, 27138) based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead
Value set (2.16.840.1.113883.3.464.1003.101.12.1089): Renamed to Virtual Encounter based on review by technical experts, SMEs, and/or public feedback.
Measure Section:
Terminology
Source of Change:
Measure Lead