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AAO13: Bell’s Palsy: Inappropriate Use of Magnetic Resonance Imaging or Computed Tomography Scan

AAO13: Bell’s Palsy: Inappropriate Use of Magnetic Resonance Imaging or Computed Tomography Scan

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High Priority Status: Yes / Appropriate Use

CBE Number: N/A

Measure Description:

Percentage of patients aged 16 years and older with a new onset diagnosis of Bell’s palsy who had a magnetic resonance imaging (MRI), or a computed tomography (CT) scan of the internal auditory canal, head, neck, or brain ordered within 3 months after diagnosis.

Instructions:

This measure is to be submitted a minimum of once per performance period for patients with a new onset of Bell’s Palsy during the performance period. This measure may be submitted by clinicians based on the measure-specific denominator coding.

Denominator:

All patients aged 16 years and older with a new onset diagnosis of Bell’s palsy.

Denominator Note:

To meet the denominator criteria, a patient must have a visit with a documented diagnosis of new onset Bell’s Palsy (G51.0). Due to the wide variation in the use of ICD-10 code, G51.0, the code description will be evaluated to confirm Bell’s Palsy.

Denominator Exclusions:

None

Numerator:

Patients who had an MRI or CT scan of the internal auditory canal, head, neck, or brain ordered within 3 months after diagnosis.

Numerator Note:

To meet the intent of the measure, the patient with a diagnosis of Bell’s Palsy should not receive routine diagnostic imaging within the expected 3-month recovery time frame unless a denominator exception is met signifying that a patient has features atypical of Bell’s palsy.

INVERSE MEASURE – A lower calculated performance rate for this measure indicates better clinical care or control. The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. Submitting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. For inverse measures, a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control.

Denominator Exceptions:

Medical reason(s) for ordering an MRI or CT scan of the internal auditory canal, head, neck, or brain for the primary diagnosis of Bell’s palsy including:

  • Patients with a diagnosis of Bell’s palsy more than 3 months prior to the date of the referral or performance of imaging with no signs of recovery.
  • Patients with recurrent diagnosis of Bell’s palsy.
  • Patients with paralysis limited to a specific branch, or branches, of the facial nerve.
  • Patients with paralysis associated with other cranial nerve abnormalities, including olfactory nerve, glossopharyngeal nerve, vagus nerve, and hypoglossal nerve.
  • Patients with other diagnosed neurological abnormalities, including simultaneous sudden hearing loss, tinnitus, and/or dizziness; stroke; tumor; seizures; extremity weakness; and/or extremity hypoesthesia.

Measure Classifications

  • Submission Pathway: Traditional MIPS
  • Measure Type: Process
  • High Priority Type: Appropriate Use
  • Meaningful Measures Area: Appropriate Use of Healthcare
  • Care Setting(s): Ambulatory Care: Clinician Office/Clinic
  • Includes Telehealth: Yes
  • Number of Performance Rates: 1
    • Inverse measure: Yes
    • Continuous measure: No
    • Proportional measure: Yes
    • Ratio measure: No
    • Risk Adjusted measure: No

 

© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation. All rights reserved.

 

Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the measures for commercial gain, or incorporation of the measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and the American Academy of Otolaryngology – Head and Neck Surgery Foundation.

 

The measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. The measure and specifications are provided “as is” without warranty of any kind. Neither the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF), nor its members shall be responsible for any use of the measure. The AAO-HNSF and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specification.

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