Physician Quality Reporting System (PQRS)

Orthopaedic Specific Measures

There are 190 individual measures (including 5 new measures for claims and registry reporting, 11 new registry-only measures, and 4 new measures for EHR-based reporting only) and 14 measure groups. There are 18 clinical measures, one (1) administrative measure, and (2) measure groups: Perioperative Care and Back Pain that may apply to orthopaedic surgeons:

Clinical Measures

20. Perioperative Care: Timing of Antibiotic Prophylaxis - Ordering Physician

21. Perioperative Care: Selection of Prophylactic Antibiotic - First OR Second Generation Cephalosporin

22. Perioperative Care: Discontinuation of Prophylactic Antibiotics (Non-Cardiac Procedures)

23. Perioperative Care: Venous Thromboembolism (VTE) Prophylaxis (When Indicated in ALL Patients)

Note: Perioperative Care Measures 20-23 can be reported individually or as a measure group

24. Osteoporosis: Communication with the Physician Managing Ongoing Care Post Fracture of Hip, Spine or Distal Radius for Men and Women Aged 50 years and Older

39. Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older

40. Osteoporosis: Management Following Fracture of Hip, Spine or Distal Radius for Men and Women Aged 50 Years and Older

41. Osteoporosis: Pharmacologic Therapy for Men and Women Aged 50 Years and Older

109. Osteoarthritis (OA): Function and Pain Assessment

126. Diabetic Mellitus: Diabetic Foot and Ankle Care, Peripheral Neuropathy - Neurological Evaluation

127. Diabetic Mellitus: Diabetic Foot and Ankle Care, Ulcer Prevention - Evaluation of Footwear

130. Documentation of Current Medications in the Medical Record

131. Pain Assessment Prior to Initiation of Patient Therapy and Follow-up

142. Osteoarthritis (OA): Assessment for Use of Anti-Inflammatory or Analgesic Over-the-Counter (OTC) Medications

147: Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy

154. Falls: Risk Assessment (2-part Measure with 155)

155. Falls: Plan of Care (2-part Measure with 154)

163. Diabetes Mellitus: Foot Exam

Administrative Measure

124. Health Information Technology (HIT): Adoption/Use of Health Information Technology (EHRs)

Back Pain Measure Group – Note that these are reportable only as a measures group – not individually (See How to Participate in 2011 PQRS section)

148. Initial Visit

149. Physical Exam

150. Advice for Normal Activities 

151. Advice Against Bed Rest

A full description of the Back Pain Measures Group is available.

You can access all of the measures, codes, and details in the 2011 Physician Quality Reporting System Measure Specifications Manuals, which are downloadable from the CMS web site.

There are a few other measures that might be applicable to orthopedic surgeons in as well. These include measure number 46, medication reconciliation; measure number 108, disease modifying anti-rheumatic drug therapy in rheumatoid arthritis; measure 145, procedures using fluoroscopy; measures 177-180, assessment and management of rheumatoid arthritis; measure 186, wound care for venous ulcers; and measures 217-223, change in risk adjusted functional status for upper and lower extremity impairments. We have not included these measures in the worksheets, but you may use them if applicable to your practice.