This is a custom measure for podiatrists that is square in the clinical domain of Podiatry. The Hammer Toe Outcome is the percentage of patients who have lesser toe deformity (hammer and claw tows) causing pain that receive any type of treatment and have significant reduction in pain as a result of that intervention.
Denominator – Minimum Number to Report on the Measure
To report on this measure, you need to treat at minimum 20 patients with a painful hammertoe condition (Diagnosis codes: Q66.89, M20.41, M20.42, M20.5x1, M20.5x2, M20.61, M20.62). Most people that have corns on the proximal or distal interphalangeal joint of the dorsal aspect should have a diagnosis of hammertoe or mallet toe. In your documentation, with your diagnosis of L84 for the corn, include the diagnosis code of the hammertoe when the problem of the corn is caused by a hammertoe. That visit can now be included to report on this measure.
Significant Reduction in Pain
There must be at least two visits to measure a change in pain using a pain scale of 1-10. The first visit, when you diagnose the hammer toe, document the pain level. To qualify for the measure, the initial level of pain must be 3 or more. The second (or subsequent visits), document the change in pain level. To meet the measure, the pain level must have decreased significantly. This is defined as equal to or less than 50% of the initial pain level. There may be more than 2 visits for treatment of the hammer toe. To qualify, it is the last or most recent visit where the pain level must have decreased significantly from the initial visit.
Intervention
You have to provide the patient with an intervention to address their pain. Interventions include but are not limited to:
- • Surgical intervention
- • Shoe wear modifications
- • Orthotics
- • Physical Therapy
- • Shaving Corn
- • Injections
Numerator – To Get a Good Score
For the 20 (or more) patients that you treated for hammer, at least 50% need to have a significant reduction in pain. It will count against you if the pain level does not decrease significantly (equal to or less that 50% of the initial value). It will also count against you if you do not document the pain level.
Exclusions – They Will Not Count For or Against Your Metrics
- • If the patient is not eligible candidate for evaluation of less toe pain an exclusion can be claimed
- ○ Patient has been prescribed Opioids
- ○ Patients that do not return for a follow up
- • You must document why the patient was not an eligible candidate for treatment of hammertoe to claim the exclusion
Specs on MEX5: https://registryclearinghouse.com/mex5-2021-measure-specification\
Contact Registry Clearinghouse at info@registryclearinghouse.com or schedule a meeting to learn more about how Registry Clearinghouse can help you.
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