Functional Status Assessment for Total Hip Replacement CMS56v13

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
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      Thank you for your inquiry about CMS56v13: Functional Status Assessment for Total Hip Replacement. The measure evaluates whether patients complete a patient-reported functional status assessment (FSA) before and after a Total Hip Arthroplasty (THA). To meet the initial population/denominator and numerator, the measure looks for documentation where patient had a primary THA and an outpatient encounter within the specified time frames, and an initial assessment and a follow-up assessment before and after primary THA within the specified timeframes.
       
      To further illustrate, if the measurement period is January 1, 2025 through December 31, 2025, the following would need to be true for a patient to qualify for the denominator regarding the THA procedure and outpatient encounter timing:
       
      • The patient would had to have had a primary THA during the period of November 1, 2023 through October 31st, 2024
      AND
      • The patient would have had to have had an eligible outpatient encounter during the period of August 1, 2024 through December 31, 2025.
       
      In order to meet numerator, a patient would have had to have completed a patient-reported FSA in the 90 days prior to or on the day of the primary THA procedure, and in the 300 - 425 days after the THA procedure.
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      Thank you for your inquiry about CMS56v13: Functional Status Assessment for Total Hip Replacement. The measure evaluates whether patients complete a patient-reported functional status assessment (FSA) before and after a Total Hip Arthroplasty (THA). To meet the initial population/denominator and numerator, the measure looks for documentation where patient had a primary THA and an outpatient encounter within the specified time frames, and an initial assessment and a follow-up assessment before and after primary THA within the specified timeframes.   To further illustrate, if the measurement period is January 1, 2025 through December 31, 2025, the following would need to be true for a patient to qualify for the denominator regarding the THA procedure and outpatient encounter timing:   • The patient would had to have had a primary THA during the period of November 1, 2023 through October 31st, 2024 AND • The patient would have had to have had an eligible outpatient encounter during the period of August 1, 2024 through December 31, 2025.   In order to meet numerator, a patient would have had to have completed a patient-reported FSA in the 90 days prior to or on the day of the primary THA procedure, and in the 300 - 425 days after the THA procedure.
    • CMS0056v14
    • CMS0056v13
    • collecting accurate data for measure

      Can you please provide further explanation on this measure- the how the denominator is determined and how to meet the numerator regarding the dates needed for this measure? Functional Status Assessment for Total Hip Replacement MIPS/MVP 2025: Patients 19 years of age and older who had a primary total hip arthroplasty (THA) between November two years prior to the measurement period and October of the year prior to measurement period; and who had an outpatient encounter between November of the year prior to the measurement period and the end of the measurement period. * Qualifying encounter period falls between 01-Aug-2024 to 31-Dec-2025. * Primary total hip arthroplasty (THA) procedure period falls between 01-Nov-2023 to 31-Oct-2024.

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Stephanie Haley (Inactive)
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