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Claims Data

Valid for Measure Submission

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

Back Pain: Shared Decision Making

  • Percentage of patients at least 18 years of age and younger than 80 with back pain with whom a physician or other clinician reviewed the range of treatment options, including alternatives to surgery prior to surgery. To demonstrate shared decision making, there must be documentation in the patient record of a discussion between the physician and the patient that includes all of the following.
    1) Treatment choices, including alternatives to surgery;
    2) Risks and benefits;
    3) Evidence of effectiveness

    CBE ID
    0310

Back Pain: Surgical Timing

  • Percentage of patients at least 18 years of age and younger than 80 with a back pain episode of 28 days or more without documentation of red flags who had surgery within the first six weeks of back pain onset (overuse measure, lower performance is better).

    Note: This measure is applicable only for physicians who perform surgery.

    CBE ID
    0305

Barrett´s Esophagus

  • Percentage of patients with esophageal biopsy reports for Barrett’s esophagus that contain a statement about dysplasia and if present the grade of dysplasia.

    CBE ID
    1854