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Musculoskeletal Endorsement Maintenance

Back Pain: Advice Against Bed Rest

Percentage of patients at least 18 years of age and younger than 80 with a back pain episode of 28 days or more with medical record documentation that a physician advised them against bed rest lasting four days or longer.

CBE ID
0313

Back Pain: Advice for Normal Activities

Percentage of patients at least 18 years of age and younger than 80 with a back pain episode of 28 days or more with medical record documentation that a physician advised them to maintain or resume normal activities.

CBE ID
0314

Back Pain: Appropriate Imaging for Acute Back Pain

Percentage of patients at least 18 years of age and younger than 80 with a diagnosis of back pain for whom the physician ordered imaging studies during the six weeks after pain onset, in the absence of “red flags” (overuse measure, lower performance is better).

CBE ID
0315

Back Pain: Appropriate Use of Epidural Steroid Injections

Percentage of patients at least 18 years of age and younger than 80 with back pain who have received an epidural steroid injection in the absence of radicular pain AND those patients with radicular pain who received an epidural steroid injection without image guidance (i.e. overuse measure, lower performance is better).

CBE ID
0309

Back Pain: Initial Visit

Percentage of patients at least 18 years of age and younger than 80 with a diagnosis of back pain who have medical record documentation of all of the following on the date of the initial visit to the physician:
1. Pain assessment
2. Functional status
3. Patient history, including notation of presence or absence of “red flags”
4. Assessment of prior treatment and response, and
5. Employment status

CBE ID
0322

Back Pain: Mental Health Assessment

The percentage of patients at least 18 years of age and younger than 80 with a diagnosis of back pain for whom documentation of a mental health assessment is present in the medical record prior to intervention or when pain lasts more than 6 weeks.

CBE ID
0316

Back Pain: Patient Reassessment

Percentage of patients at least 18 years of age and younger than 80 with back pain with documentation that the physician conducted reassessment of both of the following within four to six weeks of their initial back pain visit or of a surgical procedure date:
1) Pain AND
2) Functional status

CBE ID
0306

Back Pain: Physical Exam

Percentage of patients at least 18 years of age and younger than 80 with a back pain episode of 28 days or more with documentation of a physical examination on the date of the initial visit with the physician.

CBE ID
0319

Back Pain: Recommendation for Exercise

Percentage of patients at least 18 years of age and younger than 80 with back pain lasting more than 12 weeks, with documentation of physician advice for supervised exercise.

CBE ID
0317

Back Pain: Repeat Imaging Studies

Percentage of patients at least 18 years of age and younger than 80 with a back pain episode of 28 days or more who received inappropriate repeat imaging studies in the absence of red flags or progressive symptoms (overuse measure, lower performance is better).

CBE ID
0312