Brief Description of Measure:

​CMS139: Falls: Screening for Future Fall Risk:
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period

Description of Issue:

​The measure developer received a JIRA ticket inquiring about therapy codes for this measure. The current measure does not include occupational and physical therapy codes which may be used by orthopedic providers to implement this measure.

Proposed Solution:

Since it is appropriate for orthopedic providers to screen for falls risk, it is appropriate to add occupational and physical therapy evaluation codes. We will add the following value sets (grouping OIDs) to the measure to the Qualifying Encounters definition:

valueset "Occupational Therapy Evaluation": 'urn:oid:2.16.840.1.113883.3.526.3.1011'
valueset "Physical Therapy Evaluation": 'urn:oid:2.16.840.1.113883.3.526.3.1022'

Before

//Logic
define "Qualifying Encounter":
  ( ["Encounter, Performed": "Office Visit"]
    union ["Encounter, Performed": "Annual Wellness Visit"]
    union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"]
    union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"]
    union ["Encounter, Performed": "Home Healthcare Services"]
    union ["Encounter, Performed": "Ophthalmological Services"]
    union ["Encounter, Performed": "Preventive Care Services-Individual Counseling"]
    union ["Encounter, Performed": "Discharge Services - Nursing Facility"]
    union ["Encounter, Performed": "Nursing Facility Visit"]
    union ["Encounter, Performed": "Care Services in Long-Term Residential Facility"]
    union ["Encounter, Performed": "Audiology Visit"]
    union ["Encounter, Performed": "Telephone Visits"]
    union ["Encounter, Performed": "Online Assessments"] ) ValidEncounter
    where ValidEncounter.relevantPeriod during "Measurement Period"

After

//Terminology
valueset "Occupational Therapy Evaluation": 'urn:oid:2.16.840.1.113883.3.526.3.1011'
valueset "Physical Therapy Evaluation": 'urn:oid:2.16.840.1.113883.3.526.3.1022'

//Logic
define "Qualifying Encounter":
  ( ["Encounter, Performed": "Office Visit"]
    union ["Encounter, Performed": "Annual Wellness Visit"]
    union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"]
    union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"]
    union ["Encounter, Performed": "Home Healthcare Services"]
    union ["Encounter, Performed": "Ophthalmological Services"]
    union ["Encounter, Performed": "Preventive Care Services-Individual Counseling"]
    union ["Encounter, Performed": "Discharge Services - Nursing Facility"]
    union ["Encounter, Performed": "Nursing Facility Visit"]
    union ["Encounter, Performed": "Care Services in Long-Term Residential Facility"]
    union ["Encounter, Performed": "Audiology Visit"]
    union ["Encounter, Performed": "Telephone Visits"]
    union ["Encounter, Performed": "Online Assessments"]
    union ["Encounter, Performed": "Occupational Therapy Evaluation"]
    union ["Encounter, Performed": "Physical Therapy Evaluation"]
    ) ValidEncounter
    where ValidEncounter.relevantPeriod during day of "Measurement Period"

Rationale for Change:

The goal of this change is to facilitate measure implementation for orthopedic providers.