Measure IROMS 13: Functional Status Change for Patients With Lower Extremity Functional Status Deficit
IROMS 13: 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)
To calculate the functional status change for IROMS 13, 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.
Currently, this measure does not have a benchmark and is capped at 3 points. CMS has indicated that they intend to use 2021 performance data to establish a performance benchmark for this measure, so we anticipate that this measure will be worth up to 10 points for the 2022 reporting period.
This is a guide for SOAP 1.0 measure reporting. Click here to learn how IROMS 13 is documented in SOAP 2.0.
We recommend enabling 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.
Who can report this measure?
PTs and OTs can report on this measure.
IROMS 13 is an outcome quality measure and satisfies the outcome measure reporting requirement for PTs and OTs.
Patients who meet any of the criteria below are not eligible to complete IROMS OMTs:
- Patient has a life expectancy of less than 6 months
- Patient is non-English speaking and translation services are unavailable
- Patient has a mental or cognitive impairment that compromises their ability to complete the OMT
- Patient meets Medicare requirements for maintenance therapy
- Ongoing care not indicated
- Patient is extremely medically complex and likely to make poor clinical progress
When do I report on this measure?
IROMS 13 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 18 years of age or older,
- The patient has a diagnosis related to their foot, ankle, knee, hip, or pelvis function. See the Diagnoses that Trigger Reporting (ICD-10) section below.
- The visit type is Initial Evaluation, Re-Evaluation, and/or Discharge
Measure Reporting in the WebPT EMR
- On the Subjective tab, select Yes for Surgery Performed if the patient has recently had surgery directly related to the episode of care. This field is required for accurate measure calculations.
- In the Medical History section of the Subjective Tab, use the radio buttons to indicate if your patient is eligible to complete IROMS OMTs. Click here to view patient exclusions and exceptions.
Then, 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.
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.
Note: 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.
During the patient’s next evaluation (Progress Note/Discharge), go 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 (See image in step 4). The previous score will remain until it’s replaced.
WebPT will automatically calculate the patient’s MCID and apply the risk adjustment formula. The appropriate option for this measure will be automatically selected on the MIPS tab, and the patient’s score will be visible in your MIPSPro account.
Important: The measure will only appear on the MIPS tab after the patient has completed the OMT twice.
MIPS Tab Reporting Selections
On the MIPS tab, the system will automatically select the option that best fits your documentation.
A) You have documented both of the OMTs necessary to calculate the patient’s MCID. The MCID has been calculated, the risk adjustment applied, and is available in your MIPSPro account.
B) Your patient is Excluded from the measure for one of the reasons listed.
C) Your patient is Excepted from this measure for one of the reasons listed.
Diagnoses that Trigger Reporting (ICD-10)
|Ankle Diagnosis||Ankle ICD-10||Hip Diagnosis||Hip ICD-10|
|Achilles tendinopathy|| M76.6*, M76.89*
|Posterior tibialis dysfunction||M76.82*, M76.89*||Hamstring tendinopathies||M67.85*, M70.85*, M76.89*, S76*|
|Ligament sprain||S86.0*, S93.4*||Greater trochanteric pain syndrome||M70.6*, M70.7*, M76.1*, M76.2*, M25.55*|
|Fractures of ankle|| S82.5*, S82.6*, S82.84*, S82.85*, S82.9*
|Fractures of fibula||S82.4*||Hip Arthroplasty||Z47.1*, Z96.64*|
|Repetitive stress injury to musculoskeletal system (ankle-related)||M70.87*, M25.37*, M25.47*, M25.57*, M25.67*, M79.67*||Fracture of femur||S72*|
|Hip Arthroscopy AfterCare||Z47.1 AND appropriate code to indicate HIP|
|Foot Diagnosis||Foot ICD-10||Hip Arthroscopy||Z96.64|
|Plantar fasciitis||M72.2||Osteoarthritis of hip||M16.*|
|Hallus valgus||M20.1*||Repetitive stress injury to musculoskeletal system (hip-related)||M70.6*, M70.7*, M70.85*, M25.35*, M25.45, M25.55*, M25.65*, M79.65*|
|Bunion||M21.61*||Knee Diagnosis||Knee ICD-10|
|In-toeing||Q66.6||Ligamentous injury||S83*, M23*|
|Club foot||M21.54*, Q66.0, Q66.89||Meniscal||S83.2*, M23.3*|
|Pes Planus||Q66.5*, M21.4||Patellofemoral dysfunction||M22.2X1, M22.2X2|
|Fractures of foot and toes||S92*||Tendon disorders||M76.3*, M76.5*|
|Knee Arthroplasty||Z47.1*, Z96.65*|
|Pelvis Diagnosis||Pelvis ICD-10||Fractures of knee||S82.1*, S82.2*, S82.3*|
|Sacroiliac dysfunction||M53.2X8, M53.88||Knee Arthroscopy AfterCare||Z47.1 AND appropriate code to indicate KNEE|
|Piriformis syndrome||G57.0*||Knee Arthroscopy||Z96.65|
|Fracture of pelvis||S32.3*, S32.4*, S32.5*, S32.6*||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*|