SOAP 2.0 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.
- 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.
- 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.
- 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).
- 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.
- 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).
- This number is then used to determine which quality code should be billed. This information is included in the table below.
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.
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
Measure 218: Functional Status Change for Patients with Hip Impairments
Measure 219: Functional Status Change for Patients with Lower Leg, Foot or Ankle Impairments
Measure 220: Functional Status Change for Patients with Low Back Impairments
Measure 221: Functional Status Change for Patients with Shoulder Impairments
Measure 222: Functional Status Change for Patients With Elbow, Wrist or Hand Impairments
Measure 478: Functional Status Change for Patients With Neck Impairments
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.
- On the Objective tab, expand the Standardized Tests section and click the Add Standardized Test+ link.
- Use the drop-down menu to search and select an Outcome Measurement Tool. In this example, we’ll select Other, because it allows us to more easily access eDoc to upload the patient’s results.
- In the Standardized Test field, enter the name of the OMT. Then click Apply.
- In the Summary of Performance field, enter 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.
- Be sure to upload the patient’s OMT survey results in eDocs. 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.
- The Score section will contain the patient’s first outcome score.
- Re-administer the OMT. Use the FOTO Measure Reporting Requirements and Calculation Steps 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.
- In the Summary of Performance, enter the patient’s Discharge Score.
- Remember, upload the completed Outcome survey to the patient’s eDoc. You may also want to include your calculation document as well. Click here to learn more about eDoc.
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.
- Once you have calculated the Risk-Adjusted Functional Status Change Residual Score, you can select the appropriate measure code from the table below.
- On the Charge Summary Tab, click the CPT+ Code link.
- Use the drop-down menu to select Use Custom Code.
- Enter your selected quality data code from the Measure Quality Code Table below and the Measure name. Then click Apply.
- 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.
- Click the CPT Code+ link, then use the drop-down to select Use Custom Code.
- Enter your FLR discharge code from the Measure Quality Code Table below and the Measure name. Then click Apply.
Measure Quality Codes and FLR Discharge Codes