CMS166v6 – Use of Imaging Studies for Low Back Pain
Use of Imaging Studies for Low Back Pain
CMS166v6
Percentage of patients 18-50 years of age with a diagnosis
of low back pain who did not have an imaging study
(plain X-ray, MRI, CT scan) within 28 days of the diagnosis.
– DENOMINATOR:
Patients 18-50 years of age with a diagnosis of low back pain during an outpatient or emergency department visit.
– DENOMINATOR EXCLUSION:
Exclude patients with a diagnosis of cancer any time in their history or patients with a diagnosis of recent trauma, IV drug abuse, or neurologic impairment during the 12-month period prior to through the 28 days after the outpatient or emergency department visit.
Exclude patients with a diagnosis of low back pain within the 180 days prior to the outpatient or emergency department visit.
– NUMERATOR
Patients without an imaging study conducted on the date of the outpatient or emergency department visit or in the 28 days following the outpatient or emergency department visit.
– APPLICATION WORKFLOW
For Denominator:
Patients 18-50 years of age with a diagnosis of low back pain during an outpatient or emergency department visit are included in the denominator of this measure. To record diagnosis, go to Patient > Provider Note > Diagnosis
Diagnosis and Procedures
For Numerator:
Patients without an imaging study conducted on the date of the outpatient or emergency department visit or in the 28 days following the outpatient or emergency department visit are included in the numerator. Any one of the following should NOT be documented.
X-Ray of Lower Spine
MRI of Lower Spine
CT Scan of Lower Spine
Denominator Exclusions:
Exclude patients with a diagnosis of cancer any time in their history or patients with a diagnosis of recent trauma, IV drug abuse, or neurologic impairment during the 12-month period prior to through the 28 days after the outpatient or emergency department visit.
Exclude patients with a diagnosis of low back pain within the 180 days prior to the outpatient or emergency department visit. To document this, navigate to Patients > Provider Note > eSuperbill.
