Reporting FOTO Outcomes in the WebPT EMR (MIPS Quality Measures)

Because the FOTO outcomes measures (217-222, 478) are proprietary, we can only support limited documentation of these measures. They must be completed by the patient outside of WebPT’s documentation, calculated, uploaded to eDoc, and then manually recorded in the patient’s note. We’ll cover the process below.

For more information on each of these patient-reported measures, click here.

FOTO Measure Reporting Requirements and Calculation Steps

FOTO measures are reported once per treatment period for patients aged 14 or older. While the outcome must be administered twice, only the final score is reported with the appropriate measure code. 

  1. You must administer the appropriate outcome at the time of admission (Initial Evaluation) when an evaluation code is billed. This is the Patient’s Functional Status Score at Admission.
  2. You must administer the outcome again at the time of discharge when the re-evaluation code or FLR discharge code is billed. This is the Patient’s Functional Status Score at Discharge.
  3. Next, you’ll need to calculate the Patient’s Functional Status Change Score (this is calculated by subtracting the Patient’s Functional Status Score at Admission from the Patient’s Functional Status Score at Discharge).
  4. The next step is to take the score calculated in Step 3 (Patient’s Functional Status Change Score), and using the provided independent variables in the coefficient spreadsheets linked below, apply multiple linear regressions to the score to determine the Risk-Adjusted Predicted Functional Status Change Score. In this instance, the Patient’s Functional Status Change Score is the dependent variable.
  5. The last step is to calculate the Risk-Adjusted Functional Status Change Residual Score. This is calculated by the Patient’s Functional Status Change Score minus the Risk-Adjusted Predicted Functional Status Change Score (Step 3’s result minus Step 4’s result).
  6. This number is then used to determine which quality code should be billed. This information is included in the table below.

Click here for detailed calculation instructions.

A Note about Scoring

Remember, the FOTO survey must be administered twice. Patients who self-discharge without a second survey are not eligible for MIPS reporting. If a patient refuses or is unable to complete the survey due to blindness, illiteracy, severe mental incapacity, or language incompatibility, and an adequate proxy is not available, you should report the Not Appropriate Denominator exception code listed for the measure.

Measure Guides

Download the appropriate outcome measurement tool and scoring document to share with your patient. We’ve provided links to two versions of each measure survey; a fillable PDF and an online questionnaire. We’ve also included the Measure Specification Guides and required Coefficient Spreadsheets (needed for the regression calculation variables).

Measure 217: Functional Status Change for Patients With Knee Impairments

PDF | Online Questionnaire | Measure Specification Guide | Coefficient Spreadsheet

Measure 218: Functional Status Change for Patients with Hip Impairments

PDF | Online Questionnaire | Measure Specification Guide | Coefficient Spreadsheet

Measure 219: Functional Status Change for Patients with Lower Leg, Foot or Ankle Impairments

PDF | Online Questionnaire  | Measure Specification Guide | Coefficient Spreadsheet

Measure 220: Functional Status Change for Patients with Low Back Impairments

PDF | Online Questionnaire  | Measure Specification Guide | Coefficient Spreadsheet

Measure 221: Functional Status Change for Patients with Shoulder Impairments

PDF | Online Questionnaire | Measure Specification Guide | Coefficient Spreadsheet

Measure 222: Functional Status Change for Patients With Elbow, Wrist or Hand Impairments

PDF | Online Questionnaire | Measure Specification Guide | Coefficient Spreadsheet

Measure 478: Functional Status Change for Patients With Neck Impairments

Access the Questionnaire, Specification Guide, and Coefficient Spreadsheet

Recording FOTO in the WebPT EMR

Let’s review how to report this measure on an Initial Evaluation and when discharging the patient.

Patient’s Score at Admission

Include the outcome measure name and score in the patient’s documentation on the Objective tab of their Initial Evaluation.

  1. In the Add Tests box search for Custom Outcome Measurement Tool or FOTO Patient Inquiry (OMT-General Function) select and use the play button to add. Either option will allow you to include relevant test details. In this example, we'll use the Custom OMT option because it allows us to more easily access eDoc to upload the patient's results.
  2. In the Outcome Measurement Tools section, select the Yes radio button next to Custom Outcome Measurement.                                
  3. Next, enter the Name of the Outcome, Comments, and the patient’s Score. Note: This is their actual score, not a risk-adjusted value. If using the FOTO Patient Inquiry OMT, you'll simply need to enter in the patient's score. 
  4. Next, click the eDoc link. This opens the patient’s eDoc in a new window (check your pop-up blocker if you do not see it). Upload the patient’s survey results. Click here to learn more about eDoc.

Patient’s Score at Discharge & Risk-Adjusted Functional Status Change Residual Score

When completing the patient’s discharge, re-administer the outcome and record the results in the OMT Custom Measurement or the FOTO Patient Inquiry section.

  1. The Score section will contain the patient’s first outcome score. Simply copy that into the comments section.
  2. Include the patient’s discharge score in the Score box. 
  3. Then, follow the instructions above to calculate the Risk-Adjusted Functional Status Change Residual Score using the appropriate Coefficient Spreadsheet. This number does not have to be included in the documentation.
  4. Remember, upload the completed Outcome survey to the patient’s eDoc. You may also want to include your calculation document as well.

Reporting the Measure Data Code (At/Near Discharge Only)

Because this code is only reported once per treatment episode, you’ll only report this code at the patient’s discharge.

  1. Once you have calculated the Risk-Adjusted Functional Status Change Residual Score, you can select the appropriate measure code from the table below.
  2. In the Billing tab, navigate to the Custom CPT Code field.
  3. Enter the Measure name and your selected quality data code from the Measure Quality Code Table below.                                                                            
  4. Because FOTO measures are required to be included at discharge when re-evaluation codes are not typically used, you must include an FLR discharge code to indicate that this is an eligible visit. 
  5. Include the FLR Discharge code in a Custom CPT Code field in addition to the Measure Quality code.                                                                                            

Measure Quality Codes and FLR Discharge Codes