Measure Description
Percentage of patients aged 13 years or older with a functional deficit related to the upper-limb who achieve a Minimal Clinically Important Difference (MCID) in QuickDASH or equivalent score that indicates a functional improvement greater than zero. One rate will be reported:
• The Risk-Adjusted MCID proportional difference where the difference between the risk adjusted predicted MCID and the observed MCID (measured via QuickDASH or equivalent tool) proportion is greater than zero.
The measure contains two goals: 1) for patients to achieve an unadjusted MCID greater than zero and, 2) for patients to achieve a risk adjusted MCID where the difference between the risk adjusted predicted MCID and the observed MCID proportion will be greater than zero. The measure is adjusted to patient characteristics known to be associated with functional status and quality of life outcomes (risk adjusted) and used as a performance measure at the patient level, at the individual clinician level, and at the clinic level to assess quality.
Denominator
Denominator Criteria (Eligible cases):
All patients aged 13 years or older with a functional deficit related to the upper-limb functional status on an index visit:ELBOWTendinopathies: M77.0*, M77.1*ORHumeroulnar dislocation: S53*ORCubital tunnel syndrome: G56.2*, S54*ORFracture of lower end of humerus: S42.4*ORFracture of ulna: S52.0*, S52.2*, S52.6*ORFracture of radius: S52.3*, S52.5*OR+J2Olecranon bursitis: M70.2*OROther bursitis: M70.3*OROther instability, elbow: M25.32*OROther soft tissue disorders related to use, overuse, and pressure of forearm: M70.83*, M70.84*OREffusion, elbow: M25.42*ORPain in elbow: M25.52*ORStiffness of elbow: M25.62*ORPain in forearm: M79.63*
HANDCarpal tunnel syndrome: G56.0*ORDislocations: S63.0*, S63.1*, S63.2*ORTendon disorders: S63.3*, S63.4*, S63.5*, S63.6*, S63.8*, S63.9*ORFractures: S62*ORCrepitant synovitis: M70.0*ORBursitis of hand: M70.1*OROther soft tissue disorders related to use, overuse and pressure: M70.84*OROther instability, hand: M25.34*OREffusion, hand: M25.44*ORPain in joints of hand: M25.54*ORStiffness of hand: M25.64*ORPain in hand and fingers: M79.64*
WRISTOther instability, wrist: M25.33*OREffusion, wrist: M25.43ORPain in wrist: M25.53*ORStillness of wrist: M25.63*
SHOULDERAdhesive capsulitis of the shoulder: M75.0*ORDisorder of glenohumeral joint: M94.21*, S43*ORInstability: M24.21*, M24.41*, M24.81*, M25.3ORLabral pathology: S43.43*ORRotator cuff syndromes: M75.1*ORFracture of clavicle: S42.0*ORFracture of humerus: S42.2*, S42.3*OROther soft tissue disorders related to use, overuse, and pressure of shoulder: M70.81*OROther instability, shoulder: M25.31OREffusion, shoulder: M25.41*ORPain in shoulder: M25.51*OR Pain in upper arm: M79.62*ORPain in arm: M79.601, M79.602, M79.603ORStiffness of Shoulder: M25.61*
AND
Denominator Criteria (Eligible Cases):
Submission Criteria 1: Shoulder operative (surgical) patientsSubmission Criteria 2: Shoulder (non-surgical) patientsSubmission Criteria 3: Elbow operative (surgical) patientsSubmission Criteria 4: Elbow (non-surgical) patientsSubmission Criteria 5: Wrist and Hand operative (surgical) patientsSubmission Criteria 6: Wrist and Hand (non-surgical) patientsSubmission Criteria 7: All patients Upper-limb (surgical)Submission Criteria 8: All patients Upper-limb (non-surgical)Submission Criteria 9: All patients Upper-limb (surgical and non-surgical)
AND
Two face to face patient encounters for a treatment episode that began or ended during the performance period
Numerator
Percentage of patients aged 13 years or older with a functional deficit related to the upper-limb functional status who achieve a Functional Status Change Residual Score with a Minimal Clinically Important Difference (MCID) to indicate functional improvement greater than zero and a Risk Adjusted Functional Status Change Residual Score for the upper-limb impairment successfully calculated with an MCID score that is greater than zero
Denominator Exclusions
Hospice services received by patient at any time during the performance periodORPatient unable to complete a DASH or equivalent assessment tool due to blindness, illiteracy, severe mental incapacity or language incompatibility without the availability of an adequate proxy available
Denominator Exceptions
N/A
Numerator Exclusions
N/A
NQF ID Number
N/A
NQS Domain
Effective Clinical Care
High Priority Measure
Yes
Includes Telehealth?
Yes
Inverse Measure
No
Proportional Measure
Yes
Continuous Variable Measure
No
Ratio Measure
No
Number of performance rates to be calculated and submitted
1
Risk-Adjusted Status?
No
Meaningful Measure
Functional Outcomes
Measure Type
Outcome
Care Settings
Ambulatory Care: Clinician Office/Clinic