Measure HM8: Functional Status Change for Patients With Lower Extremity Functional Status Deficit

HM8: Functional Status Change for Patients With Lower Extremity Functional Status Deficit is a calculated value derived from the completion of the Lower Extremity Functional Scale (LEFS), a patient-reported survey. To complete the LEFS, patients use a five-point scale to rate the level of difficulty that they associate with 20 activities, including performing usual work, housework, and school activities; putting on shoes and socks; and walking two blocks. To each question, patients respond with either: 

  • Extreme difficulty or unable to perform activity (zero points)
  • Quite a bit of difficulty (one point)
  • Moderate difficulty (two points)
  • A little bit of difficulty (three points)
  • No difficulty (four points)

In order to calculate the functional status change for HM8, patients must complete the LEFS at least twice during their episode of care. If the LEFS surveys are administered on paper, the surveys must be filled out electronically for the risk adjusted MCID calculation.

Note: This measure does not have a benchmark and is capped at 3 points.  

Clinic Settings

We recommend enabling the Show entire OMT questionnaire when clicking on OMT scorebox in Clinic Settings. Enabling this feature displays the full OMT when the score field is selected and requires each question on the OMT to be answered. To learn more about Clinic Settings, click here.

Who can report this measure?

PTs and OTs can report on this measure. 

Important: This is a QCDR Measure. QCDR Measures are not included in the annual QPP measure set and are specific to the submitting QCDR. WebPT has partnered with Healthmonix to make these outcome measures available to you. Learn more about QCDR measures here. 

Measure Type

HM8 is an outcome quality measure and satisfies the outcome measure reporting requirement for PTs and OTs.

Patient Qualifications

  • Patient age (18 or older)
  • Visit Type: Initial Evaluation AND Re-Evaluation and/or Discharge Summary
  • A diagnosis related to the patient’s foot, ankle, knee, hip, or pelvis function. See the Diagnoses that Trigger Reporting (ICD-10) section below.

When do I report on this measure?

HM8 is tied to note types, not procedure codes (unlike measures in the QPP set). You’ll report this measure on the MIPS tab during a Progress Note/Re-cert/Re-eval if that type of visit occurs, and/or on the Discharge Summary). 

Important: In order to report the measure, you must have completed a survey on the Initial Evaluation.

Measure Requirements

HM8 is measured through the completion of at least two LEFS surveys by the patient.

  • The first outcome measurement must occur during the Initial Evaluation.
  • Scores captured on Progress Notes (PN) will be used to calculate the MCID where no Discharge (DS) score exists (This ensures that patients who self-discharge can still be reported).

Successful reporting of the measure requires a minimal clinically important difference (MCID) of 9. This means that the patient’s reported scores must increase by 9 points in order for the Performance Met code to be automatically selected in the reporting tab.

  • You’ll need at least two survey scores to calculate the MCID. 
  • MCID = [Most recent survey score (PN/DS)] - [Score at Initial Evaluation]

Measure Reporting in WebPT

  1. On the Objective tab, navigate to the Outcome Measurement Tools section and choose the Lower Extremity Functional Scale from the ‘Select a questionnaire’ drop-down.
  2. From the Lower Extremity Functional Scale section, click Show Test and complete the survey. If you have staged the survey using one of our intake methods, select the correct survey date and click Get Score
  3. If the survey is completed on paper, the survey must also be completed electronically. Complete documentation (including all appropriate MIPS measures) and finalize the note.
  4. On the patient’s next evaluation (Progress Note/Discharge), navigate to the Objective tab, select Show Test, and complete the OMT. If you have staged the survey using one of our intake methods, select the correct survey date and click Get Score.  The previous score will remain until it’s replaced.
  5. WebPT will automatically calculate the patient’s MCID and select the appropriate reporting option in the MIPS tab. Important: the measure will only appear on the MIPS tab after the patient has completed the OMT twice.
  6. You’ll be able to see the MIPS reporting option selected when opening the outcome PDF from the patient’s chart. 

MIPS Tab: Reporting Selections

In the MIPS tab, the system will automatically select the measure that best fits your documentation. Remember, if the patient has not seen an improvement of at least 9 points between the Initial Evaluation survey and the Discharge Survey, you will not be able to select the Performance Met code on the MIPS tab. Important: The selection in the MIPS tab will automatically update based on the difference between the Initial Evaluation and the most recently administered survey’s score (whether this is on a Progress Note or Discharge Note).

Below, we’ve indicated which selections meet the performance expectations.

Diagnoses that Trigger Reporting (ICD-10)

Ankle

  • Achilles tendinopathy:  M76.6*, M76.89*
  • Posterior tibialis dysfunction:  M76.82*, M76.89*
  • Ligament sprain:  S86.0*, S93.4*
  • Fractures of ankle:  S82.5*, S82.6*, S82.84*, S82.85*, S82.9*
  • Fractures of fibula:  S82.4*
  • Repetitive stress injury to musculoskeletal system (ankle-related):  M70.87*, M25.37*, M25.47*, M25.57*, M25.67*, M79.67*

Foot

  • Plantar fasciitis:  M72.2
  • Hallus valgus:  M20.1*
  • Bunion: M21.61*
  • In-toeing:  Q66.6
  • Club foot:  M21.54*, Q66.0, Q66.89
  • Pes Planus:  Q66.5*, M21.4
  • Fractures of foot and toes:  S92*

Hip

  • Femoroacetabular impingement:  M25.85*
  • Hamstring tendinopathies:  M67.85*, M70.85*, M76.89*, S76*
  • Greater trochanteric pain syndrome:  M70.6*, M70.7*, M76.1*, M76.2*, M25.55*
  • Hip osteoarthritis:  M16.*
  • Hip Arthroplasty:  Z47.1*, Z96.64*
  • Fracture of femur:  S72*
  • Hip Arthroscopy AfterCare:  Z47.1 AND appropriate code to indicate HIP
  • Hip Arthroscopy:  Z96.64
  • Osteoarthritis of hip:  M16.*
  • Repetitive stress injury to musculoskeletal system (hip-related):  M70.6*, M70.7*, M70.85*, M25.35*, M25.45, M25.55*, M25.65*, M79.65*

Knee

  • Ligamentous injury:  S83*, M23*
  • Meniscal:  S83.2*, M23.3*
  • Patellofemoral dysfunction:  M22.2X1, M22.2X2
  • Tendon disorders:  M76.3*, M76.5*
  • Knee Arthroplasty:  Z47.1*, Z96.65*
  • Fractures of knee:  S82.1*, S82.2*, S82.3*
  • Knee Arthroscopy AfterCare:  Z47.1 AND appropriate code to indicate KNEE
  • Knee Arthroscopy:  Z96.65
  • Osteoarthritis of knee:  M17.*
  • Repetitive stress injury to musculoskeletal system (knee-related):  M70.4*, M70.5*, M70.86*, M25.36*, M25.46*, M25.56*, M25.66*, M79.66*

Pelvis

  • Sacroiliac dysfunction:  M53.2X8, M53.88
  • Piriformis syndrome:  G57.0*
  • Fracture of pelvis:  S32.3*, S32.4*, S32.5*, S32.6*,