Measure HM7: Functional Status Change for Patients with Vestibular Dysfunction

HM7: Functional Status Change for Patients with Vestibular Dysfunction is a calculated value derived from the completion of the Dizziness Handicap Inventory (DHI), a patient-reported survey. To complete the DHI, patients are asked to assess their level of perceived handicap as a result of their symptoms. The survey contains 25 items and will take about five to ten minutes to complete. All questions are subgrouped based on whether they address physical, emotional, or functional effects.

In order to calculate the functional status change for HM7, patients must complete the DHI at least twice during their episode of care.  If the DHI surveys are administered on paper, the surveys must be filled out electronically for the risk-adjusted MCID calculation.

  • This measure does not have a benchmark and is capped at 3 points. 
  • This is a guide for SOAP 1.0 Measure Reporting. For 2.0 measure reporting, click here.

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.

Measure Type

HM7 is an outcome quality measure and satisfies the outcome measure reporting requirement for PTs and OTs.

When do I report on this measure?

HM7 is tied to note types, not procedure codes (unlike measures in the QPP set). You’ll report this measure when the following is true:

  • The patient is 14 years of age or older
  • The patient has a diagnosis related to their vestibular function. See the Diagnoses that Trigger Reporting (ICD-10) section below.
  • The visit type is Initial Evaluation, Re-Evaluation, and/or Discharge
Important: To report the measure, you must document the DHI on the Initial Evaluation.

Measure Requirements

HM7 is measured through the completion of at least two ODI surveys by the patient. The first outcome measurement must occur during the Initial Evaluation. The next must occur on a Discharge.

Note: 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 18. This means that the patient’s reported scores must decrease by 18 points 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) x (risk factors)] - [Score at Initial Evaluation x (risk factors)]
  • Risk-adjustment factors: Pain Level (reported on the IE). To learn more about risk-adjustments for complicating factors, click here.
Measure Calculation and Risk-Adjustment Factors
HM7 is risk-adjusted for complicating factors that impact the patient's recovery. This allows providers to accurately compare outcomes across patients. Once the Progress Note and/or Discharge Note survey is completed and the MCID has been determined, the risk-adjustment formula is applied to the patient's MCID score.

HM7 is risk-adjusted by the level of pain reported on the Initial Evaluation.

2022 Risk-Evaluation Update

MIPS measure stewards are required to review the performance of their measures each year and adjust them as needed to ensure their accuracy. As a result, an update to the risk adjustment calculation has been made for HM 7.

All MIPS outcomes measures must be risk-adjusted to ensure an apples-to-apples comparison among patients who have different characteristics that may influence their ability to improve. Risk adjustment may produce a different change score than what is calculated when you simply subtract the discharge score from the intake score.

That said, a reminder that risk adjustment for quality reporting purposes does not change how a therapist should use the information with each individual patient. For example, HM 7 is based on the scores obtained from the Dizziness Handicap Inventory or DHI (a patient reported outcome instrument). The MCID for the DHI is 18 points. A patient that only improves 16 points on the risk-adjusted calculation for the DHII will not meet the MCID; however, they still may have made meaningful progress that can be acknowledged during the episode of care.

Measure Reporting in WebPT

  1. On the Subjective tab, use the radio buttons to indicate whether the episode of care is directly related to a recent surgery. This field is required for accurate measure calculations.
  2. On the Objective tab, navigate to the Outcome Measurement Tools section and choose the Dizziness Handicap Inventory from the ‘Select a questionnaire’ drop-down.
  3. From the Dizziness Handicap Inventory 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.   
    Note: If the survey is completed on paper, the survey must also be completed electronically.
  4. Complete documentation (including all appropriate MIPS measures) and finalize the note.
  5. On the patient’s next evaluation (Progress Note/Discharge), navigate to the Objective tab, select Show Test, and complete the OMT.  The previous score will remain until it’s replaced. If you have staged the survey using one of our intake methods, select the correct survey date and click Get Score.                                   
  6. 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. 
  7. 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 18 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)

  • Vestibular dysfunction diagnosis (ICD-10-CM): BPPV:  H81.10, H81.11, H81.12, H81.13
  • Dizziness: R42, H81.10, H81.11, H81.12, H81.13,
  • Disorders of vestibular function:   H81*
  • Vertiginous syndromes:   H82*
  • Other diseases of inner ear:  H83*
  • Abnormalities of gait and mobility:  R26*
  • Other lack of coordination:  R27*
  • Repeated falls:  R29.6
  • Concussion:  S06.0*, F07.81
  • History of falling:   Z91.81
  • Epidemic vertigo:  A88.1
  • Benign neoplasm of cranial nerves:  D33.3
  • Migraine:  B43.109, G43.819
Did this answer your question? Thanks for the feedback There was a problem submitting your feedback. Please try again later.