High Priority Status: Yes / Outcome
CBE Number: N/A
Measure Description:
Percentage of patients aged 18 years and older who have a diagnosis of obstructive sleep apnea and received a corrective procedure for the obstructive sleep apnea and had an improvement in their post-operative sleep study results (i.e., Apnea-Hypopnea Index [AHI], Respiratory Disturbance Index [RDI]) compared to their pre-operative results)
Instructions:
This measure is to be submitted each time a patient underwent a tonsillectomy during the performance period. This measure may be submitted by clinicians based on the services provided and the measure-specific denominator coding.
Denominator:
- Hypoglossal Nerve Stimulation Procedure: All patients aged 18 years and older who have a diagnosis of obstructive sleep apnea and received a corrective procedure for the obstructive sleep apnea.
- Turbinate Procedure: All patients aged 18 years and older who have a diagnosis of obstructive sleep apnea and received a corrective procedure for the obstructive sleep apnea.
Denominator Exclusions:
Patients without a documented post-operative sleep study.
Denominator Exceptions:
None.
Numerator:
- Patients who had an improvement* in their AHI post-operative results compared to their pre-operative results.
- Patients who had an improvement* in their AHI post-operative results compared to their pre-operative results.
*To meet this outcome measure, there must be documentation of an AHI that shows a post-operative score below 20 or half of the pre-operative score (or equivalent value and test supported by evidence and/or guidelines)
Measure Classifications:
- Submission Pathway: Traditional MIPS
- Measure Type: Outcome
- High Priority Type: Outcome
- Care Setting(s): Ambulatory Care: Ambulatory Care: Clinician Office/Clinic; Ambulatory; Ambulatory Surgical Center; Ambulatory Care: Hospital; Hospital Outpatient; Outpatient Services; Office Based Surgery Center
- Includes Telehealth: No
- Number of Performance Rates: 1
- Inverse measure: No
- Continuous measure: No
- Proportional measure: Yes
- Ratio measure: No
- Risk Adjusted measure: No
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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.
