Functional Status Assessment for Hip Replacement
Percentage of patients aged 18 years and older with primary total hip arthroplasty (THA) who completed baseline and follow-up (patient-reported) functional status assessments
National Committee for Quality Assurance
Centers for Medicare & Medicaid Services
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Finalized Date/Time
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CPT(R) contained in the Measure specifications is copyright 2004-2013 American Medical Association. LOINC(R) copyright 2004-2013 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2013 International Health Terminology Standards Development Organisation. ICD-10 copyright 2013 World Health Organization. All Rights Reserved.
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Measuring functional status for patient undergoing total hip 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).
Clinicians should ask patients to report on functional status during at least two points in time while undergoing treatment: before surgery and after a period of post-surgical recovery.
A higher score indicates better quality
NQF ID Number
Disclaimer
These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications.
THE MEASURES AND SPECIFICATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND.
Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].
eMeasure Identifier
56
measureStartDate
measureEndDate
Bachmeier CJ, March LM, Cross MJ, Lapsley HM, Tribe KL, Courtenay BG et al. A comparison of outcomes in osteoarthritis patient undergoing total hip and knee replacement surgery. Osteoarthritis Cartilage 2001; 9:137-146.
Rose M, Bjorner JB, Becker J, Fries JF, Ware JE. Evaluation of a preliminary physical function item bank supported expected advantages of the Patient-Reported Outcomes Measurement Information System (PROMIS). J Clin Epidemiol 2008; 61:17-33.
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.
Selim AJ, Berlowitz D, Kazis LE, Rogers W, Wright SM, Qian SX, Rohendler JA, Spiro A, Miller D, Selim BJ, Fincke BG. Comparison of Health Outcomes for Male Seniors in the Veterans Health Administration and Medicare Advantage Plans. Health Services Research 2010; 45(2): 376-396.
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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 use of patient-reported outcomes data in eMeasures - such as this measure of functional status - demonstrates the need for the Quality Reporting Data Architecture (QRDA) to support a data attribute that indicates that the patient provided the information.
Transmission Format
TBD
Initial Patient Population
Adults aged 18 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
Equals initial patient population
Denominator Exclusions
Patients with multiple trauma at the time of the total hip arthroplasty or patients with severe cognitive impairment
Numerator
Patients with patient reported functional status assessment results (e.g., 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 Population
Not Applicable
Measure Observations
Not Applicable
Supplemental Data Elements
For every patient evaluated by this measure also identify payer, race, ethnicity, and sex.
Not Applicable
Population criteria
-
Initial Patient Population =
- AND: "Patient Characteristic Birthdate: birth date" >= 18 year(s) starts before start of "Measurement Period"
- AND:
- OR: "Occurrence A of Procedure, Performed: Primary THA Procedure" <= 180 day(s) ends before start of "Measurement Period"
- OR: "Occurrence A of Procedure, Performed: Primary THA Procedure" <= 185 day(s) ends after start of "Measurement Period"
- OR: "Occurrence A of Procedure, Performed: Primary THA Procedure" ends concurrent with "Measurement Start Date"
- AND:
- OR:
- AND: "Occurrence A of Encounter, Performed: Outpatient Consultation" <= 180 day(s) ends before start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Encounter, Performed: Outpatient Consultation" >= 60 day(s) ends after end of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Encounter, Performed: Outpatient Consultation" <= 180 day(s) ends after end of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- OR:
- AND: "Occurrence A of Encounter, Performed: Face-to-Face Interaction" <= 180 day(s) ends before start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Encounter, Performed: Face-to-Face Interaction" >= 60 day(s) ends after end of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Encounter, Performed: Face-to-Face Interaction" <= 180 day(s) ends after end of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- OR:
- AND: "Occurrence A of Encounter, Performed: Office Visit" <= 180 day(s) ends before start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Encounter, Performed: Office Visit" >= 60 day(s) ends after end of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Encounter, Performed: Office Visit" <= 180 day(s) ends after end of "Occurrence A of Procedure, Performed: Primary THA Procedure"
-
Denominator =
- AND: "Initial Patient Population"
-
Denominator Exclusions =
- AND:
- OR:
- AND: "Occurrence A of Diagnosis, Active: Fracture - Lower Body" < 1 day(s) starts before start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence A of Diagnosis, Active: Fracture - Lower Body" >= 1 hour(s) ends after start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Diagnosis, Active: Fracture - Lower Body" < 1 day(s) starts before start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Diagnosis, Active: Fracture - Lower Body" >= 1 hour(s) ends after start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- OR:
- AND: "Occurrence A of Diagnosis, Active: Severe Dementia" starts before or during "Measurement Period"
- AND NOT: "Occurrence A of Diagnosis, Active: Severe Dementia" ends before start of "Measurement Period"
-
Numerator =
- AND: "Occurrence A of Functional Status, Result: Functional Status Assessment for Hip Replacement" <= 180 day(s) ends before start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Functional Status, Result: Functional Status Assessment for Hip Replacement" >= 60 day(s) ends after end of "Occurrence A of Procedure, Performed: Primary THA Procedure"
- AND: "Occurrence B of Functional Status, Result: Functional Status Assessment for Hip Replacement" <= 180 day(s) ends after end of "Occurrence A of Procedure, Performed: Primary THA Procedure"
-
Denominator Exceptions =
- None
Patient Characteristic Birthdate: birth date
Measurement Period
Occurrence A of Procedure, Performed: Primary THA Procedure
Measurement Period
Occurrence A of Procedure, Performed: Primary THA Procedure
Measurement Period
Occurrence A of Procedure, Performed: Primary THA Procedure
Measurement Start Date
Occurrence A of Encounter, Performed: Outpatient Consultation
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Encounter, Performed: Outpatient Consultation
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Encounter, Performed: Outpatient Consultation
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence A of Encounter, Performed: Face-to-Face Interaction
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Encounter, Performed: Face-to-Face Interaction
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Encounter, Performed: Face-to-Face Interaction
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence A of Encounter, Performed: Office Visit
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Encounter, Performed: Office Visit
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Encounter, Performed: Office Visit
Occurrence A of Procedure, Performed: Primary THA Procedure
Initial Patient Population
Initial Patient Population
Occurrence A of Diagnosis, Active: Fracture - Lower Body
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence A of Diagnosis, Active: Fracture - Lower Body
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Diagnosis, Active: Fracture - Lower Body
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Diagnosis, Active: Fracture - Lower Body
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence A of Diagnosis, Active: Severe Dementia
Measurement Period
Occurrence A of Diagnosis, Active: Severe Dementia
Measurement Period
Denominator
Occurrence A of Functional Status, Result: Functional Status Assessment for Hip Replacement
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Functional Status, Result: Functional Status Assessment for Hip Replacement
Occurrence A of Procedure, Performed: Primary THA Procedure
Occurrence B of Functional Status, Result: Functional Status Assessment for Hip Replacement
Occurrence A of Procedure, Performed: Primary THA Procedure
Data criteria (QDM Data Elements)
-
"Diagnosis, Active: Fracture - Lower Body" using "Fracture - Lower Body Grouping Value Set (2.16.840.1.113883.3.464.1003.113.12.1037)"
-
"Diagnosis, Active: Severe Dementia" using "Severe Dementia Grouping Value Set (2.16.840.1.113883.3.526.3.1025)"
-
"Encounter, Performed: Face-to-Face Interaction" using "Face-to-Face Interaction Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1048)"
-
"Encounter, Performed: Office Visit" using "Office Visit Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1001)"
-
"Encounter, Performed: Outpatient Consultation" using "Outpatient Consultation Grouping Value Set (2.16.840.1.113883.3.464.1003.101.12.1008)"
-
"Functional Status, Result: Functional Status Assessment for Hip Replacement" using "Functional Status Assessment for Hip Replacement Grouping Value Set (2.16.840.1.113883.3.464.1003.118.12.1029)"
-
"Patient Characteristic Birthdate: birth date" using "birth date LOINC Value Set (2.16.840.1.113883.3.560.100.4)"
-
"Procedure, Performed: Primary THA Procedure" using "Primary THA Procedure Grouping Value Set (2.16.840.1.113883.3.464.1003.198.12.1006)"
Patient Characteristic Birthdate: birth date
Face-to-Face Interaction
Face-to-Face Interaction
Fracture - Lower Body
Fracture - Lower Body
Functional Status Assessment for Hip Replacement
Functional Status Assessment for Hip Replacement
Office Visit
Office Visit
Outpatient Consultation
Outpatient Consultation
Primary THA Procedure
Severe Dementia
Encounter, Performed: Face-to-Face Interaction
Diagnosis, Active: Fracture - Lower Body
Functional Status, Result: Functional Status Assessment for Hip Replacement
Encounter, Performed: Office Visit
Encounter, Performed: Outpatient Consultation
Procedure, Performed: Primary THA Procedure
Diagnosis, Active: Severe Dementia
Reporting Stratification
- None
Supplemental Data Elements
-
"Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity CDCREC Value Set (2.16.840.1.114222.4.11.837)"
-
"Patient Characteristic Payer: Payer" using "Payer SOP Value Set (2.16.840.1.114222.4.11.3591)"
-
"Patient Characteristic Race: Race" using "Race CDCREC Value Set (2.16.840.1.114222.4.11.836)"
-
"Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex AdministrativeSex Value Set (2.16.840.1.113762.1.4.1)"
Patient Characteristic Sex: ONC Administrative Sex
Patient Characteristic Race: Race
Patient Characteristic Ethnicity: Ethnicity
Patient Characteristic Payer: Payer