Overview
CMS66v8
(2020)
CMS66v9
(2021)
CMS66v10
(2022)
Identifiers
| CMS eCQM ID | NQF eCQM ID | NQF | MIPS Quality ID |
| CMS66v10 | – | – | 375 |
*MIE only supports data collection and reporting using eCQM specifications
Definitions
| Description | Percentage of patients 18 years of age and older who received an elective primary total knee arthroplasty (TKA) and completed a functional status assessment within 90 days prior to the surgery and in the 270-365 days after the surgery |
| Initial Patient Population | Patients 19 years of age and older who had a primary total knee arthroplasty (TKA) in the year prior to the measurement period and who had an outpatient encounter during the measurement period |
| Denominator | Equals Initial Population |
| Denominator Exclusions | Exclude patients with two or more fractures indicating trauma at the time of the total knee arthroplasty or patients with severe cognitive impairment that starts before or in any part of the measurement period. Exclude patients who are in hospice care for any part of the measurement period.
|
| Numerator | Patients with patient-reported functional status assessment results (i.e., Veterans RAND 12-item health survey [VR-12], Measurement Information System [PROMIS]-10 Global Health, Knee Injury and Osteoarthritis Outcome Score [KOOS], KOOS Jr.) in the 90 days prior to or on the day of the primary TKA procedure, and in the 270 - 365 days after the TKA procedure |
| Numerator Exclusions | – |
| Denominator Exceptions | – |
| Measure Type | Process measure |
| Measure Scoring | Proportion measure |
| Granularity | Patient |
| Improvement Notation | Higher score indicates better quality |
| Domain | Person and Caregiver-Centered Experience and Outcomes |
Clinical Instructions
Ensure all 18+ year-old patients with a total knee replacement in the year prior to the measurement period have a functional status assessment during the measurement period.
Workflow
Coming soon.
Evidence
Initial Patient Population
| Name | Value Set |
| Encounter, Performed: Office Visit | 2.16.840.1.113883.3.464.1003.101.12.1001 |
| Encounter, Performed: Online Assessments | 2.16.840.1.113883.3.464.1003.101.12.1089 |
| Encounter, Performed: Outpatient Consultation | 2.16.840.1.113883.3.464.1003.101.12.1008 |
| Encounter, Performed: Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure | CPT Code 99024 |
| Encounter, Performed: Telephone Visits | 2.16.840.1.113883.3.464.1003.101.12.1080 |
| Procedure, Performed: Primary TKA Procedure | 2.16.840.1.113883.3.464.1003.198.12.1007 |
Denominator Exclusions
| Name | Value Set |
| Diagnosis: Fracture - Lower Body | 2.16.840.1.113883.3.464.1003.113.12.1037 |
| Diagnosis: Severe dementia (disorder) | SNOMEDCT Code 428351000124105 |
| Encounter, Performed: Encounter Inpatient | 2.16.840.1.113883.3.666.5.307 |
| Intervention, Order: Hospice care ambulatory | 2.16.840.1.113762.1.4.1108.15 |
| Intervention, Performed: Hospice care ambulatory | 2.16.840.1.113762.1.4.1108.15 |
Numerator
| Name | Value Set |
| Assessment, Performed: Activities of daily living score [KOOS} | LOINC Code 72100-1 |
| Assessment, Performed: Knee injury and osteoarthritis outcome score for joint replacement [KOOSJR] | LOINC Code 82324-5 |
| Assessment, Performed: Pain score [KOOS] | LOINC Code 72102-7 |
| Assessment, Performed: PROMIS-10 Global Mental Health (GMH) score T-score | LOINC Code 71969-0 |
| Assessment, Performed: PROMIS-10 Global Physical Health (GPH) score T-score | LOINC Code 71971-6 |
| Assessment, Performed: Quality of life score [KOOS] | LOINC Code 72098-7 |
| Assessment, Performed: Sport-recreation score [KOOS] | LOINC Code 72099-5 |
| Assessment, Performed: Symptoms score [KOOS] | LOINC Code 72101-9 |
| Assessment, Performed: VR-12 Mental component summary (MCS) score - oblique method T-score | LOINC Code 72026-8 |
| Assessment, Performed: VR-12 Mental component summary (MCS) score - orthogonal method T-score | LOINC Code 72028-4 |
| Assessment, Performed: VR-12 Physical component summary (PCS) score - oblique method T-score | LOINC Code 72025-0 |
| Assessment, Performed: VR-12 Physical component summary (PCS) score - orthogonal method T-score | LOINC Code 72027-6 |
Source(s)
eCQI CMS66