Skip to main content

Pain Assessment and Follow-Up

CBE ID
0420
1.4 Project
Geriatric and Palliative Care
Endorsed
Endorsement Status
Endorsement Removed
1.1 New or Maintenance
Maintenance
E&M Cycle
Fall 2020
Is Under Review
No
1.3 Measure Description

Percentage of visits for patients aged 18 years and older with documentation of a pain assessment using a standardized tool(s) on each visit AND documentation of a follow-up plan when pain is present

    • 1.14 Numerator

      Patient visits with a documented pain assessment using a standardized tool(s) AND documentation of a follow-up plan when pain is present

    • 1.15 Denominator

      All visits for patients aged 18 years and older

    • Exclusions

      Pain Assessment not Documented Patient not Eligible 
      Denominator Exception: G8442: Pain assessment NOT documented as being performed, documentation the patient is not eligible for a pain assessment using a standardized tool
      Not Eligible – A patient is not eligible if one or more of the following reason(s) is documented: 

      Severe mental and/or physical incapacity where the person is unable to express himself/herself in a manner understood by others. For example, cases where pain cannot be accurately assessed through use of nationally recognized standardized pain assessment tools
      Patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient’s health status

    • Most Recent Endorsement Activity
      Measure Retired and Endorsement Removed Geriatrics and Palliative Care Fall Cycle 2020
      Initial Endorsement
      Last Updated
      Removal Date
    • Steward
      Centers for Medicare & Medicaid Services
      Steward Organization Email
      [email protected]
      Steward Organization Copyright

      These measures were developed by Quality Insights of Pennsylvania as a special project under the Quality Insights´ Medicare Quality Improvement Organization (QIO) contract HHSM-500-2005-PA001C with the Centers for Medicare & Medicaid Services. These measures are in the public domain. 

      Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. Quality Insights of Pennsylvania disclaims all liability for use or accuracy of any Current Procedural Terminology (CPT [R]) or other coding contained in the specifications. CPT® contained in the Measures specifications is copyright 2004- 2015 American Medical Association. All Rights Reserved. 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.