Measure #353: Total Knee Replacement: Identification of Implanted Prosthesis in Operative Report National Quality Strategy Domain: Patient Safety
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1 Measure #353: Total Knee Replacement: Identification of Implanted Prosthesis in Operative Report National Quality Strategy Domain: Patient Safety 2017 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Process DESCRIPTION: Percentage of patients regardless of age undergoing a total knee replacement whose operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant INSTRUCTIONS: This measure is to be reported each time a procedure for total knee replacement is performed during the performance period. There is no diagnosis associated with this measure. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. Measure Reporting: The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data. DENOMINATOR: All patients regardless of age undergoing a total knee replacement Denominator Criteria (Eligible Cases): All patients regardless of age AND Patient procedure during the performance period (CPT): 27438, 27442, 27445, 27446, NUMERATOR: Patients whose operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant OR Numerator Options: Performance Met: Performance Not Met: Operative report identifies the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant (G9304) Operative report does not identify the prosthetic implant specifications including the prosthetic implant manufacturer, the brand name of the prosthetic implant and the size of each prosthetic implant, reason not given (G9303) 1 of 5
2 RATIONALE: It is important to capture the type of prosthesis used. The rates of prosthesis failure which will require a revision increases from 10 percent at 10 years to approximately 20 percent at 20 years following surgery. (National Institutes of Health, 2003) The FDA requires appropriate tracking of the device but this information may not be readily available to the surgeon performing the revision. The surgeon performing a future revision needs to be able to identify the prosthesis and size of the prosthesis that were used in the initial surgery, to determine if a complete revision is required or if a partial revision could be performed. The initial operative report should contain the necessary information which will ultimately help the future treating physician who performs the revision surgery. This measure is designed for use by physicians and eligible health care professionals managing ongoing care for all patients undergoing a total knee replacement. This measure addresses the immediate postoperative period. CLINICAL RECOMMENDATION STATEMENT: Medical Device Tracking Requirements 2008 (Federal Register, 2008) Effective tracking of devices from the manufacturing facility, through the distributor network (including distributors, retailers, rental firms and other commercial enterprises, device user facilities, and licensed practitioners) and ultimately, to the patient is necessary for the effectiveness of remedies prescribed by the act, such as patient notification (section 518 (a) of the act) or device recall (section 518 (e) of the act). 21 CFR (b) Effective tracking of devices from the manufacturing facility, through the distributor network (including distributors, retailers, rental firms and other commercial enterprises, device user facilities, and licensed practitioners) and ultimately, to the patient is necessary for the effectiveness of remedies prescribed by the act, such as patient notification (section 518 (a) of the act) or device recall (section 518 (e) of the act). 21 CFR (b) COPYRIGHT: 2012 American Association of Hip and Knee Surgeons. All rights reserved. These performance measures are not clinical guidelines. They do not establish a standard of medical care and have not been tested for all potential applications. These Measures and specifications are provided as is without warranty of any kind. AAHKS shall not be responsible for any use of these performance measures. 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. AAHKS disclaims all liability for use or accuracy of any Current Procedural Terminology (CPT ) or other coding contained in the specifications. The Measures are subject to review and may be revised at any time by AAHKS. The Measures may not be altered without the prior written approval of AAHKS. Users of the Measures shall not have the right to alter, enhance, or otherwise modify the Measures. CPT contained in the Measures specifications is copyright American Medical Association. 2 of 5
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4 2017 Registry Individual Measure Flow #353: Total Knee Replacement: Identification of Implanted Prosthesis in Operative Report Please refer to the specific section of the Measure Specification to identify the Denominator and numerator information for use in reporting this Individual Measure. 1. Start with Denominator 2. Check Encounter: a. If Encounter as Listed in the Denominator equals No, do not include in Eligible Population or Denominator. Stop Processing. b. If Encounter as Listed in the Denominator equals Yes, include in denominator population. 3. Denominator Population: a. Eligible population or Denominator is all Eligible Patients in the Denominator. Denominator is represented as Denominator in the Sample Calculation listed at the end of this document. Letter d equals 8 procedures in the sample calculation. 4. Start Numerator 5. Check Operative Report Identifies the Prosthetic Implant Specifications Including the Prosthetic Implant Manufacturer, the Brand Name of the Prosthetic Implant and the Size of Each Prosthetic Implant: a. If Operative Report Identifies the Prosthetic Implant Specifications Including the Prosthetic Implant Manufacturer, the Brand Name of the Prosthetic Implant and the Size of Each Prosthetic Implant equals Yes, include in Data Completeness Met and Performance Met. b. Data Completeness Met and Performance Met is represented in the Data Completeness and Performance Rate in the Sample Calculation listed at the end of this document. Letter a equals 6 procedures in Sample Calculation. c. If Operative Report Identifies the Prosthetic Implant Specifications Including the Prosthetic Implant Manufacturer, the Brand Name of the Prosthetic Implant and the Size of Each Prosthetic Implant equals No, proceed to check Operative Report Does Not Identify the Prosthetic Implant Specifications Including the Prosthetic Implant Manufacturer, the Brand Name of the Prosthetic Implant and the Size of Each Prosthetic Implant, Reason Not Given. 6. Check Operative Report Does Not Identify the Prosthetic Implant Specifications Including the Prosthetic Implant Manufacturer, the Brand Name of the Prosthetic Implant and the Size of Each Prosthetic Implant, Reason Not Given: a. If Operative Report Does Not Identify the Prosthetic Implant Specifications Including the Prosthetic Implant Manufacturer, the Brand Name of the Prosthetic Implant and the Size of Each Prosthetic Implant, Reason Not Given equals Yes, include in Data Completeness Met and Performance Not Met. b. Data Completeness Met and Performance Not Met is represented in the Data Completeness in the Sample Calculation listed at the end of this document. Letter c equals 1 procedure in the Sample Calculation. 4 of 5
5 c. If Operative Report Does Not Identify the Prosthetic Implant Specifications Including the Prosthetic Implant Manufacturer, the Brand Name of the Prosthetic Implant and the Size Of Each Prosthetic Implant, Reason Not Given equals No, proceed to Data Completeness Not Met. 7. Check Data Completeness Not Met: a. If Data Completeness Not Met, the Quality Data Code or equivalent was not reported. 1 procedure has been subtracted from the data completeness numerator in sample calculation. 5 of 5
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