Measure 127: Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of Footwear (SOAP 1.0)

Measure 127 is about preventing amputations for patients diagnosed with diabetes. Mechanical changes in the feet (e.g., bunions, hammertoes, etc.) combined with peripheral neuropathy increase the risk of skin breakdown. Shoes that do not fit properly (i.e., too tight OR too loose) or are worn out can contribute to this problem, a situation that is entirely preventable if addressed regularly by providers (like PTs) in contact with individuals with diabetes.

Note:

Quality measures must be documented in both WebPT and Keet. The data in Keet is collated and sent to CMS during the MIPS submission period, and the data in the WebPT EMR supports what is sent to CMS.
Previously, Members reporting for MIPS with WebPT selected which measures they wanted to collect data for during the setup process. This step has been eliminated. You can now select which MIPS measures to collect data for on a visit by visit basis.

Who can report this measure?

PTs can report this measure.

Patient Qualifications

Patient age (18 or older)
Visit type: Initial Evaluation or Re-Evaluation
A diagnosis code for diabetes is needed. This may seem like an obvious statement, but most measures that therapists are eligible to report on do not have a diagnosis code requirement.

When do I report on this measure?

During each eligible visit within the performance period for patients with a qualifying diagnosis (e.g., Diabetes Mellitus). Evaluation frequency is decided by the Risk Profile determined during the examination, which is included in the Measure Specification Guide.

Measure Requirements

In addition to performing the neurological evaluation described by Measure #126, you also should also:

Measure the feet using a standardized device
Provide counseling on appropriate footwear based on the degree of risk for ulceration
Document all of these actions and findings in your visit note

Measure Specification

For more information on Measure 127, please see the Measure Specification Guide.

Measure Reporting in WebPT

On the Objective tab, add the Footwear Evaluation test to satisfy measure requirements.
In the Observation section, select the Yes radio button next to the Footwear Evaluation. Remember, providing counseling on the best footwear for the patient’s needs is a required part of this measure, so ensure that you select the Counseling provided checkbox.
When finished documenting, validate the selection in Keet.

Keet: Reporting Selections

In Keet, you’ll need to add this activity to the patient’s Care Plan.

Note: The data in Keet is collated and sent to CMS. The data in the WebPT EMR supports what is submitted to CMS in the event of an audit.

Use the MIPS Badge on the patient chart or the MIPS tab in the note to open Keet.
Log in to Keet.

Note: After logging in to Keet, keep the tab open to remain logged in to Keet to streamline this step while documenting on future appointments. Keet may log users out after three hours of inactivity.
In Keet, navigate to the patient’s Episode of Care that corresponds with the case in the WebPT EMR.
Click Add Activity.
Click Measure 127: Diabetes Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention – Evaluation of Footwear to add to the patient’s Care Plan.
In the Care Plan, click the ellipses (...) icon in the Action column.
Click Complete.
Select the option that best describes your supporting documentation.
Click Submit.

Diagnoses that Trigger Reporting (ICD-10)

E10.10, E10.11, E10.21, E10.22, E10.29, E10.311, E10.319, E10.3211, E10.3212, E10.3213, E10.3219, E10.3291, E10.3292, E10.3293, E10.3299, E10.3311, E10.3312, E10.3313, E10.3319, E10.3391, E10.3392, E10.3393, E10.3399, E10.3411, E10.3412, E10.3413, E10.3419, E10.3491, E10.3492, E10.3493, E10.3499, E10.3511, E10.3512, E10.3513, E10.3519, E10.3521, E10.3522, E10.3523, E10.3529, E10.3531, E10.3532, E10.3533, E10.3539, E10.3541, E10.3542, E10.3543, E10.3549, E10.3551, E10.3552, E10.3553, E10.3559, E10.3591, E10.3592, E10.3593, E10.3599, E10.37X1, E10.37X2, E10.37X3, E10.37X9, E10.36, E10.39, E10.40, E10.41, E10.42, E10.43, E10.44, E10.49, E10.51, E10.52, E10.59, E10.610, E10.618, E10.620, E10.621, E10.622, E10.628, E10.630, E10.638, E10.641, E10.649, E10.65, E10.69, E10.8, E10.9, E11.00, E11.01, E11.10, E11.11, E11.21, E11.22, E11.29, E11.311, E11.319, E11.3211, E11.3212, E11.3213, E11.3219, E11.3291, E11.3292, E11.3293, E11.3299, E11.3311, E11.3312, E11.3313, E11.3319, E11.3391, E11.3392, E11.3393, E11.3399, E11.3411, E11.3412, E11.3413, E11.3419, E11.3491, E11.3492, E11.3493, E11.3499, E11.3511, E11.3512, E11.3513, E11.3519, E11.3521, E11.3522, E11.3523, E11.3529, E11.3531, E11.3532, E11.3533, E11.3539, E11.3541, E11.3542, E11.3543, E11.3549, E11.3551, E11.3552, E11.3553, E11.3559, E11.3591, E11.3592, E11.3593, E11.3599, E11.37X1, E11.37X2, E11.37X3, E11.37X9, E11.36, E11.39, E11.40, E11.41, E11.42, E11.43, E11.44, E11.49, E11.51, E11.52, E11.59, E11.610, E11.618, E11.620, E11.621, E11.622, E11.628, E11.630, E11.638, E11.641, E11.649, E11.65, E11.69, E11.8, E11.9, E13.00, E13.01, E13.10, E13.11, E13.21, E13.22, E13.29, E13.311, E13.319, E13.321, E13.3211, E13.3212, E13.3213, E13.3219, E13.3291, E13.3292, E13.3293, E13.3299, E13.3311, E13.3312, E13.3313, E13.3319, E13.3391, E13.3392, E13.3393, E13.3399, E13.3411, E13.3412, E13.3413, E13.3419, E13.3491, E13.3492, E13.3493, E13.3499, E13.3511, E13.3512, E13.3513, E13.3519, E13.3521, E13.3522, E13.3523, E13.3529, E13.3531, E13.3532, E13.3533, E13.3539, E13.3541, E13.3542, E13.3543, E13.3549, E13.3551, E13.3552, E13.3553, E13.3559, E13.3591, E13.3592, E13.3593, E13.3599, E13.37X1, E13.37X2, E13.37X3, E13.37X9, E13.36, E13.39, E13.40, E13.41, E13.42, E13.43, E13.44, E13.49, E13.51, E13.52, E13.59, E13.610, E13.618, E13.620, E13.621, E13.622, E13.628, E13.630, E13.638, E13.641, E13.649, E13.65, E13.69, E13.8, E13.9