AAO20: Tympanostomy Tubes: Comprehensive Audiometric Evaluation

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High Priority Status: No / N/A

CBE Number: N/A

Measure Description:

Percentage of patients aged 6 months through 12 years with a diagnosis of otitis media with effusion (OME) who received tympanostomy tube insertion and received a comprehensive audiometric evaluation within 6 months prior to tympanostomy tube insertion.

Instructions:

This measure is to be submitted a minimum of once per performance period for patients diagnosed with OME who undergo tympanostomy tube insertion during the measurement period. This measure may be submitted by clinicians based on the services provided and the measure-specific denominator coding.

Denominator:

All patients aged 6 months through 12 years with a diagnosis of OME who received tympanostomy tube insertion.

Denominator Note:

To meet the denominator criteria, a patient must have been diagnosed with OME AND have undergone tympanostomy tube insertion within the performance period.

Denominator Exclusions:

None

Denominator Criteria:

Patients aged 6 months through 12 years

AND

Diagnosis: Otitis Media with Effusion (OME)

AND

Procedure: Tympanostomy Tube Insertion

AND

Patient Visit: Encounter Visit

For a list of all codes that qualify as denominator eligible visits, reference Addendum attached.

Numerator:

Patients who received a comprehensive audiometric evaluation within 6 months prior to tympanostomy tube insertion.

Numerator Note:

To meet the intent of the measure, documentation is required that a comprehensive audiometric evaluation was performed within 6 months before tympanostomy tube insertion. Comprehensive audiometric evaluation is typically performed by an audiologist, but the specific methods will vary with the age of the child.

Denominator Exceptions:

Patient or caregiver(s) refusal of hearing test.

Measure Classifications:

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

Clinical Recommendation Statement:

Clinicians should obtain an age-appropriate hearing test if OME persists for 3 months or longer OR prior to surgery when a child becomes a candidate for tympanostomy tube insertion.

Rosenfeld RM, Schwartz SR, Pynnonen MA, et al. Clinical practice guideline: Tympanostomy tubes in children. Otolaryngology Head Neck Surg. 2013;149(1 Suppl):S1-S35. doi:10.1177/0194599813487302

 Rationale:

Otitis media with effusion is often accompanied by hearing loss which can impair early language acquisition, especially in severe cases which often necessitate tympanostomy tube insertion. Therefore, it is imperative that any patient for whom tympanostomy tube insertion is indicated have their hearing tested.

 Supporting Clinical Practice Guideline (CPG):

For more details, reference the Clinical Practice Guideline: Tympanostomy Tubes in Children (Update) [2022]

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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 specifications.

Addendum