Measure IROMS 17: Functional Status Change for Patients With Low Back Functional Status Deficit

IROMS 17: Functional Status Change for Patients With Low Back Functional Status Deficit is a calculated value derived from the completion of the Modified Oswestry Low Back Pain Questionnaire (ODI), a patient-reported survey. To complete the ODI, patients are asked to select their level of disability on a six-point scale for each of ten categories, including personal care, lifting, walking, and traveling. Answers are scored from “0” (no disability) to “5” (complete disability). There are 50 points possible. To calculate the total score, find the sum of all points, divide by 50 (total points possible), and then multiply by 100. This is the percentage of perceived disability.

To calculate the functional status change for IROMS 17, patients must complete the ODI at least twice during their episode of care.  If the ODI surveys are administered on paper, the surveys must be filled out electronically for the risk-adjusted MCID calculation.

Note: 

  • 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 to document IROMS 17 in SOAP 2.0. 

Clinic Settings

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.

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

IROMS 17 is an outcome quality measure and satisfies the outcome measure reporting requirement for PTs and OTs.

Patient Eligibility

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 17 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 low back functional status. See the Diagnoses that Trigger Reporting (ICD-10) section below.
  • The visit type is Initial Evaluation, Re-Evaluation, and/or Discharge
Note: To report this measure, you must document the ODI on the Initial Evaluation.

Measure Requirements

IROMS 17 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 Minimum Clinically Important Difference (MCID) of 6. This means that the patient’s reported scores must decrease by 6 points to contribute positively to your MIPS score. After you collect two survey scores, the MCID will be calculated. We partnered with Healthmonix to provide these measures, and they will apply the risk adjustment formula to the MCID score. The risk-adjusted score will be available in your MIPSPro account.

Measure Reporting in the WebPT EMR 

  1. 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.
  2. 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.
  3. Then, on the Objective tab, navigate to the Outcome Measurement Tools section and choose the Modified Oswestry Low Back Pain Questionnaire from the ‘Select a questionnaire’ drop-down.
  4. From the Modified Oswestry Low Back Pain Questionnaire 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.

  5. Complete documentation (including all appropriate MIPS measures) and finalize the note.
  6. 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. 
  7. 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)

  • Instability:  M53.2X5, M53.2X6, M53.2X7
  • Spondylosis/spondylolisthesis:  M45*, M43.1*, M47*
  • Non-radiographic axial spondyloarthritis of thoracolumbar region: M54.A5
  • Non-radiographic axial spondyloarthritis of lumbar region: M54.A6
  • Non-radiographic axial spondyloarthritis of lumbosacral region: M54.A7
  • Low back pain, unspecified: M54.50
  • Vertebrogenic low back pain: M54.51
  • Other low back pain: M54.59
  • Anterior Spinal and Vertebral artery compression syndromes: M47.0, M47.015, M47.016
  • Other Spondylosis with myelopathy: M47.1, M47.15, M47.16
  • Other Spondylosis with radiculopathy: M47.2, M47.25, M47.26, M47.27, M47.28
  • Spondylosis, unspecified: M47.9
  • Anterior spinal artery compression syndromes, thoracolumbar region: M47.015
  • Anterior spinal artery compression syndromes, lumbar region: M47.016
  • Disc protrusion/Prolapse:  M51.0*, M51.1*, M51.2*, M51.3*, M51.4*, M51.8*, S33.0*
  • Stenosis:  M48.0*, M99.7*
  • Sprain:  S33.1*, S33.5*, S39.0*
  • Strain:  S39.002, S39.012
  • Treatment Signs and symptoms associated with back:  M54.4*, M54.5*, M54.9*

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