Features Navigation

(800) 825-0224 Live Demo
 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
126 0417 Process No Effective Clinical Care Registry

Measure Description

Percentage of patients aged 18 years and older with a diagnosis of diabetes mellitus who had a neurological examination of their lower extremities within 12 months

Instructions

This measure is to be submitted a minimum of once per performance period for patients with diabetes mellitus seen during the performance period. Evaluation of neurological status in patients with diabetes to assign risk category and therefore have appropriate foot and ankle care to prevent ulcerations and infections ultimately reduces the number and severity of amputations that occur. Risk categorization and follow up treatment plan should be done according to the following table:

Category Risk Profile Evaluation Frequency
0 Normal Annual
1 Peripheral Neuropathy (LOPS) Semi-annual
2 Neuropathy, deformity, and/or PAD Quarterly
3 Previous ulcer or amputation Monthly to quarterly

This measure may be submitted by non-medical doctor/doctor of osteopathic medicine (MD/DO) Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

Measure Submission

Measure data may be submitted by individual MIPS eligible clinicians, groups, or third party intermediaries. The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The quality-data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.

Numerator

Patients who had a lower extremity neurological exam performed at least once within 12 months

Definition

Lower Extremity Neurological Exam – Consists of a documented evaluation of motor and sensory abilities and should include: 10-g monofilament plus testing any one of the following: vibration using 128-Hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, however the clinician should perform all necessary tests to make the proper evaluation.

Numerator Quality-Data Coding Options

Performance Met:

Lower extremity neurological exam performed and documented (G8404)

Performance Not Met:

Lower extremity neurological exam not performed (G8405)

NUMERATOR NOTE:  To determine performance met the lower extremity neurological exam could be performed and documented on the date of the denominator eligible encounter or within the 12-month lookback period from the date of the denominator eligible encounter.

Denominator

Patients aged 18 and older with infrarenal non-ruptured endovascular AAA repairs

Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter

AND

Diagnosis for diabetes (ICD-10-CM): E10.10, E10.11, E10.21, E10.22, E10.29, E10.311, E10.319, E10.3211, E10.3212, E10.3213, E10.3219, E10.3291, E10.3292, E10.3293, E10.3299, E10.3311, E10.3312, E10.3313, E10.3319, E10.3391, E10.3392, E10.3393, E10.3399, E10.3411, E10.3412, E10.3413, E10.3419, E10.3491, E10.3492, E10.3493, E10.3499, E10.3511, E10.3512, E10.3513, E10.3519, E10.3521, E10.3522, E10.3523, E10.3529, E10.3531, E10.3532, E10.3533, E10.3539, E10.3541, E10.3542, E10.3543, E10.3549, E10.3551, E10.3552, E10.3553, E10.3559, E10.3591, E10.3592, E10.3593, E10.3599, E10.37X1, E10.37X2, E10.37X3, E10.37X9, E10.36, E10.39, E10.40, E10.41, E10.42, E10.43, E10.44, E10.49, E10.51, E10.52, E10.59, E10.610, E10.618, E10.620, E10.621, E10.622, E10.628, E10.630, E10.638, E10.641, E10.649, E10.65, E10.69, E10.8, E10.9, E11.00, E11.01, E11.10, E11.11, E11.21, E11.22, E11.29, E11.311, E11.319, E11.3211, E11.3212, E11.3213, E11.3219, E11.3291, E11.3292, E11.3293, E11.3299, E11.3311, E11.3312, E11.3313, E11.3319, E11.3391, E11.3392, E11.3393, E11.3399, E11.3411, E11.3412, E11.3413, E11.3419, E11.3491, E11.3492, E11.3493, E11.3499, E11.3511, E11.3512, E11.3513, E11.3519, E11.3521, E11.3522, E11.3523, E11.3529, E11.3531, E11.3532, E11.3533, E11.3539, E11.3541, E11.3542, E11.3543, E11.3549, E11.3551, E11.3552, E11.3553, E11.3559, E11.3591, E11.3592, E11.3593, E11.3599, E11.37X1, E11.37X2, E11.37X3, E11.37X9, E11.36, E11.39, E11.40, E11.41, E11.42, E11.43, E11.44, E11.49, E11.51, E11.52, E11.59, E11.610, E11.618, E11.620, E11.621, E11.622, E11.628, E11.630, E11.638, E11.641, E11.649, E11.65, E11.69, E11.8, E11.9, E13.00, E13.01, E13.10, E13.11, E13.21, E13.22, E13.29, E13.311, E13.319, E13.3211, E13.3212, E13.3213, E13.3219, E13.3291, E13.3292, E13.3293, E13.3299, E13.3311, E13.3312, E13.3313, E13.3319, E13.3391, E13.3392, E13.3393, E13.3399, E13.3411, E13.3412, E13.3413, E13.3419, E13.3491, E13.3492, E13.3493, E13.3499, E13.3511, E13.3512, E13.3513, E13.3519, E13.3521, E13.3522, E13.3523, E13.3529, E13.3531, E13.3532, E13.3533, E13.3539, E13.3541, E13.3542, E13.3543, E13.3549, E13.3551, E13.3552, E13.3553, E13.3559, E13.3591, E13.3592, E13.3593, E13.3599, E13.37X1, E13.37X2, E13.37X3, E13.37X9, E13.36, E13.39, E13.40, E13.41, E13.42, E13.43, E13.44, E13.49, E13.51, E13.52, E13.59, E13.610, E13.618, E13.620, E13.621, E13.622, E13.628, E13.630, E13.638, E13.641, E13.649, E13.65, E13.69, E13.8, E13.9

AND

Patient encounter during the performance period (CPT): 11042, 11043, 11044, 11055, 11056, 11057, 11719, 11720, 11721, 11730, 11740, 97161, 97162, 97163, 97164, 97597, 97598, 97802, 97803, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350

WITHOUT
Telehealth Modifier: GQ, GT, 95, POS 02

AND NOT
DENOMINATOR EXCLUSIONS:
Clinician documented that patient was not an eligible candidate for lower extremity neurological exam measure, for example patient bilateral amputee, patient has condition that would not allow them to accurately respond to a neurological exam (dementia, Alzheimer’s, etc.), patient has previously documented diabetic peripheral neuropathy with loss of protective sensation

Experience AdvancedMD Software in a Live Demo.

Schedule a short and personalized overview, guided by a live expert.

“The nice thing about AdvancedMD is claims are cleared before they are forwarded to various insurance companies. We know very, very quickly if we have some defective portion on our claim.”

Dwight Romriell, DMD

Read the story  ›

“If we are waiting for a delivery or in between surgeries, we can log in, check messages or patient information and send electronic prescriptions as needed. Mobility is a good thing, and certainly being able to coordinate care with our patients from multiple locations is definitely a plus.”

Lisbeth Chang, MD
Sunrise Women’s Medical Group

Read the story  ›

“[Our] patients are very well-educated and well-informed, and they want to see results quickly. The practice has to run extremely efficiently and be accessible to them. The nice thing about [AdvancedMD] is it has allowed me to be more efficient both in and out of the office. Now I don’t have to come back into the office, which is great for my family and everything else. It saves me a lot of time – probably an hour a day on the three days I work in the second office.”

Keith Berkowitz, MD
Center for Balanced Health

Read the story  ›

“The best thing I ever did in private practice was getting AdvancedMD—it has liberated me.”

Estaban Lavato, MD
La Loma Medical Center