#091: Acute Otitis Externa (AOE): Topical Therapy

Quality ID

091

NQF

0653

High Priority Measure

Yes

Specifications

Registry

Measure Type

Process

Specialty

Emergency Medicine Family Medicine Internal Medicine Otolaryngology Pediatrics Urgent Care

Measure Description

Percentage of patients aged 2 years and older with a diagnosis of AOE who were prescribed topical preparations

 

Instructions

This measure may be submitted based on the actions of the submitting Merit-based Incentive Payment System (MIPS) eligible clinician who performs the quality action, described in the measure, based on services provided within measure-specific denominator coding. This measure is to be submitted once for each occurrence of AOE during the performance period. For the purpose of submitting this measure, only unique occurrences with an onset of AOE diagnosing within the current performance period will be submitted. A unique occurrence of AOE is defined as the period of time that begins with the onset of AOE diagnosing and ends 30 days after the onset of diagnosing.

Merit-based Incentive Payment System (MIPS) eligible clinicians who submit this measure may also find Quality ID #93: Acute Otitis Externa: Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use to be clinically relevant. The measure developer intended for Quality ID #91: Acute Otitis Externa (AOE): Topical Therapy and Quality ID #93: Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy- Avoidance of Inappropriate Use to be paired measures, as they can both be implemented to measure care provided to patients diagnosed with diffuse, uncomplicated AOE.

Measure Submission Type:

Measure data may be submitted by individual MIPS eligible clinicians, groups, or third party intermediaries. The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The quality-data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.

 

Denominator

All patients aged 2 years and older with a diagnosis of AOE

DENOMINATOR NOTE: A new diagnosis code indicates a new occurrence of AOE. If a patient presents with right ear AOE then returns with new onset of left ear AOE symptoms, then the left ear AOE would be considered a new unique occurrence, separate from the right ear AOE.

Denominator Criteria (Eligible Cases):

Patients aged ≥ 2 years on date of encounter

AND

Diagnosis for AOE (ICD-10-CM): H60.311, H60.312, H60.313, H60.319, H60.321, H60.322, H60.323, H60.329, H60.331, H60.332, H60.333, H60.339, H60.391, H60.392, H60.393, H60.399, H60.501, H60.502, H60.503, H60.509, H60.511, H60.512, H60.513, H60.519, H60.521, H60.522, H60.523, H60.529, H60.531, H60.532, H60.533, H60.539, H60.541, H60.542, H60.543, H60.549, H60.551, H60.552, H60.553, H60.559, H60.591, H60.592, H60.593, H60.599, H62.40, H62.41, H62.42, H62.43

AND

Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99281, 99282, 99283, 99284, 99285, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350

WITHOUT

Telehealth Modifier: GQ, GT, 95, POS 02

 

Numerator

Patients who were prescribed topical preparations

Definition:

Prescribed – May include prescription given to the patient for topical preparations at one or more visits during the episode of AOE OR patient already receiving topical preparations as documented in the current medication list.

NUMERATOR NOTE: Denominator Exception(s) are determined on the date of the denominator eligible episode.

Numerator Options:

Performance Met: Topical preparations (including OTC) prescribed for acute otitis externa (4130F)

OR

Denominator Exception: Documentation of medical reason(s) for not prescribing topical preparations (including OTC) for acute otitis externa (4130F with 1P)

OR

Denominator Exception: Documentation of patient reason(s) for not prescribing topical preparations (including OTC) for acute otitis externa (4130F with 2P)

OR

Performance Not Met: Topical preparations (including OTC) for acute otitis externa (AOE) not prescribed, reason not otherwise specified (4130F with 8P)

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