eCQM Title

Functional Status Assessment for Total Knee Replacement

eCQM Identifier (Measure Authoring Tool) 66 eCQM Version number 7.5.000
NQF Number Not Applicable GUID be8d9655-1194-46ef-b43e-4b1d0c36ab71
Measurement Period January 1, 20XX through December 31, 20XX
Measure Steward Centers for Medicare & Medicaid Services (CMS)
Measure Developer National Committee for Quality Assurance
Endorsed By None
Percentage of patients 18 years of age and older who received an elective primary total knee arthroplasty (TKA) and completed a functional status assessment within 90 days prior to the surgery and in the 270-365 days after the surgery
This Physician Performance Measure (Measure) and related data specifications are owned and stewarded by the Centers for Medicare & Medicaid Services (CMS). CMS contracted (Contract HHSP23320095627WC; HHSP23337008T) with the National Committee for Quality Assurance (NCQA) to develop this electronic measure. NCQA is not responsible for any use of the Measure. NCQA makes no representations, warranties, or endorsement about the quality of any organization or physician that uses or reports performance measures and NCQA has no liability to anyone who relies on such measures or specifications.

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CPT(R) contained in the Measure specifications is copyright 2004-2017 American Medical Association. LOINC(R) copyright 2004-2017 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2017 International Health Terminology Standards Development Organisation. ICD-10 copyright 2017 World Health Organization. All Rights Reserved.
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Measure Scoring Proportion
Measure Type Process
Risk Adjustment
Rate Aggregation
Measuring functional status for patients undergoing total knee replacement 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).
Clinical Recommendation Statement
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 VR-12 or PROMIS Global 10 in addition to condition-specific tools (AAHKS 2015).
Improvement Notation
A higher score indicates better quality
The American Association of Hip and Knee Surgeons (2015). Patient Reported Outcomes Summit for Total Joint Arthroplasty Report. Retrieved from the American Association of Hip and Knee Surgeons Website:
Rothrock NE, Hays RD, Spritzer K, Yount SE, Riley W, Cella D. Relative to the general US population, chronic diseases are associated with poorer health-related quality of life as measured by the Patient-Reported Outcomes Measurement Information System (PROMIS). J Clin Epidemiol 2010; 63(11):1195-204.
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.

The same FSA instrument must be used for the initial and follow-up assessment.
Transmission Format
Initial Population
Patients 19 years of age and older who had a primary total knee arthroplasty (TKA) in the year prior to the measurement period and who had an outpatient encounter during the measurement period
Equals initial population
Denominator Exclusions
Patients with two or more fractures indicating trauma at the time of the total knee arthroplasty or patients with severe cognitive impairment that overlaps the measurement period.

Exclude patients whose hospice care overlaps the measurement period.
Patients with patient-reported functional status assessment results (i.e., VR-12, PROMIS-10 Global Health, KOOS, KOOS Jr.) in the 90 days prior to or on the day of the primary TKA procedure, and in the 270 - 365 days after the TKA procedure
Numerator Exclusions
Not applicable
Denominator Exceptions
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity, and sex

Table of Contents

Population Criteria




Data Criteria (QDM Data Elements)

Supplemental Data Elements

Risk Adjustment Variables

Measure Set