Functional Status Assessment for Total Hip Replacement

Last updated: June 9, 2017

CMS Measure ID: CMS56v5
Version: 5
NQF Number: None
Measure Description:

Percentage of patients 18 years of age and older with primary total hip arthroplasty (THA) who completed baseline and follow-up patient-reported functional status assessments

Initial Patient Population:

Patients 18 years of age and older who had a primary total hip arthroplasty (THA) within the 12 month period that begins 180 days before the start of the measurement period and ends 185 days after the start of the measurement period and who had an outpatient encounter not more than 180 days prior to procedure, and at least 60 days and not more than 180 days after THA procedure

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients with multiple fractures indicating trauma at the time of the total hip arthroplasty or patients with severe cognitive impairment

Numerator Statement:

Patients with patient-reported functional status assessment results (eg, VR-12, VR-36,PROMIS-10-Global Health, PROMIS-29, HOOS) not more than 180 days prior to the primary THA procedure, and at least 60 days and not more than 180 days after THA procedure

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: Centers for Medicare & Medicaid Services (CMS)
Domain: Person and Caregiver-Centered Experience and Outcomes
Next Version: Functional Status Assessment for Total Hip Replacement
Previous Version: Functional Status Assessment for Hip Replacement
Improvement Notation:

A higher score indicates better quality

Guidance:

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

Addendum Notes: ICD-10 Value Set addition
Quality ID: 376
High Priority Measure: Yes
Data Submission Method: EHR
Specialty Measure Set: Orthopedic Surgery

Specifications

Release Notes

Header

  • Updated Clinical Recommendation Statement.

    Section: Clinical Recommendation Statement

    Source: Measure Lead

  • ​Updated Copyright.

    Section: Copyright

    Source: Annual Update

  • Updated Denominator Exclusion language to reference fractures as an indication of trauma.

    Section: Denominator Exclusions

    Source: Measure Lead

  • Updated the description to 'years of age' instead of 'aged' to align language with other measures.

    Section: Description

    Source: Measure Lead

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • Removed guidance about QRDA as it is not pertinent to the measure calculation.

    Section: Guidance

    Source: Measure Lead

  • Updated Initial Population description to reference patients of a certain age instead of adults to align language with other measures.

    Section: Initial Population

    Source: Measure Lead

  • Updated Rationale.

    Section: Rationale

    Source: Measure Lead

  • Updated References.

    Section: Reference

    Source: Measure Lead

  • Added the word 'Total' to the title to indicate the type of replacement surgery.

    Section: Title

    Source: Measure Lead

Logic

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Denominator Exclusions

    Source: QDM Standards

  • Moved the attribute to the right hand side of the numerator statement to align with QDM requirements.

    Section: Numerator

    Source: QDM Standards

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

Value Set

  • Value set Fracture - Lower Body (2.16.840.1.113883.3.464.1003.113.12.1037): Added 40 SNOMEDCT codes.

    Section: None

    Source: None

  • Value set Primary THA Procedure (2.16.840.1.113883.3.464.1003.198.12.1006): Added 2 SNOMEDCT codes (265158005, 450813004).

    Section: None

    Source: None

  • Value set Fracture - Lower Body (2.16.840.1.113883.3.464.1003.113.12.1037): Added 282 ICD10CM codes.

    Section: None

    Source: ICD-10 Addendum

External Resources