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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
261 0000 Process Yes Communication and Care Coordination Claims

Measure Description

Percentage of patients aged birth and older referred to a physician (preferably a physician specially trained in disorders of the ear) for an otologic evaluation subsequent to an audiologic evaluation after presenting with acute or  chronic dizziness


This measure is to be submitted a minimum of once per performance period for all patients seen during the performance period who present with acute or chronic dizziness. This measure is intended to ensure that patients with acute or chronic dizziness receive a referral in order to receive appropriate care. This measure may be submitted by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

NOTE: No notes related

Measure Submission

The listed denominator criteria is used to identify the intended patient population. The numerator quality-data codes included in this specification are used to submit the quality actions allowed by the measure. All measure-specific coding should be submitted on the claim(s) representing the eligible encounter.


Patients referred to a physician for an otologic evaluation subsequent to an audiologic evaluation who present with acute or chronic dizziness


NUMERATOR NOTE: The physician receiving the referral, or providing care currently, should preferably be specially trained in disorders of the ear. Denominator exception will be determined on the date of the denominator eligible encounter.

Numerator Quality-Data Coding Options


Denominator Exception: G8857:
Referral for Otologic Evaluation Not Performed for Documented Reasons

Patient is not eligible for the referral for otologic evaluation measure (e.g., patients who are already under the care of a physician for acute or chronic dizziness)


Performance Met: G8856:
Referral for Otologic Evaluation

Referral to a physician for an otologic evaluation performed


Performance Not Met: G8858:
Referral for Otologic Evaluation Not Performed, Reason not Given:

Referral to a physician for an otologic evaluation not performed, reason not given

Numerator Note: No data


All patients aged birth and older presenting with acute or chronic dizziness

Eligible cases are determined and must be reported, if either of the following conditions

Option 1 – Denominator Criteria (Eligible Cases):

Patients aged birth and older


Diagnosis for Dizziness (ICD-10-CM): H81.10, H81.11, H81.12, H81.13, R42


Patient encounter during the performance period (CPT): 92540, 92541, 92542, 92544, 92545, 92546,
92547, 92548, 92550, 92557, 92567, 92568, 92570, 92575


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