NQMC Update Service: February 24, 2014 ▲ RAND Corporation

NQMC Update Service: February 24, 2014



RAND Corporation

February 24, 2014

RAND Corporation

• Carpal tunnel syndrome (CTS): percentage of electrodiagnostic tests performed on the median nerve in the study hand and interpreted as positive for CTS that meet the specified criteria.

• Carpal tunnel syndrome (CTS): percentage of electrodiagnostic tests performed on the median nerve in the study hand and interpreted as severe CTS that meet all of the specified criteria.

• Carpal tunnel syndrome (CTS): percentage of electrodiagnostic tests performed on the median nerve in the study hand that included a documentation of skin temperature.

• Carpal tunnel syndrome (CTS): percentage of electrodiagnostic tests performed on the median nerve in the study hand that included all the specified components.

• Carpal tunnel syndrome (CTS): percentage of electrodiagnostic tests performed on the median nerve in the study hand whose first skin temperature recorded for that hand/arm was less than or equal to 32 degrees Celsius that have documentation that a repeat skin temperature was at least 32 degrees Celsius before the nerve conduction studies were performed.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom a suspicion of CTS was explicitly documented in the medical record at or before the visit at which a provider first evaluated the finger symptoms.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom at least two of the following were documented in the medical record for the initial evaluation visit: location, quality, duration, and onset.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom height and weight or a clinical judgment about presence or absence of obesity/overweight are documented in the medical record for the initial evaluation visit.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom no provider documented that they prescribed diuretics as treatment for CTS symptoms.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom no provider documented that they prescribed muscle relaxants as treatment for CTS symptoms.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom no provider documented that they prescribed opiates (opioids) as treatment for CTS symptoms.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom no provider documented that they prescribed or recommended NSAIDs as treatment for CTS symptoms.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom no provider has documented that they prescribed or administered laser therapy as treatment for CTS symptoms.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom one or more of the specified criteria regarding MRI, ultrasound or CT testing is documented in the medical record.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom one or more risks of steroids (or prior receipt of steroids) were documented in the medical record as having been discussed within six weeks before the steroids were administered or prescribed.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom the medical record documents that at least one of the following physical examination maneuvers was performed during the visit: testing for sensory abnormalities in median nerve distribution, testing for thenar muscle weakness, and examination for thenar muscle atrophy.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom the medical record for the visit at which splints were first prescribed, or any subsequent visits occurring within six weeks, documented that the splint was prescribed for at least six weeks.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom the medical record from the visit documented that at least one diagnosis other than CTS was evaluated.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom the physician administering or prescribing steroids documented a follow-up call or visit with the patient within four weeks.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom the presence or absence of at least one of the following risk factors was documented in the medical record at the initial evaluation or two subsequent CTS-related visits: rheumatoid or other arthritis, diabetes mellitus, hypothyroidism, pregnancy, and chronic renal failure.

• Carpal tunnel syndrome (CTS): percentage of eligible patients for whom the progress notes from the visit document the presence or absence of at least one of the following: trauma, deformity, and fever.

• Carpal tunnel syndrome (CTS): percentage of eligible patients having documentation in the six weeks before or at the visit, by the provider who prescribed/administered the steroids, that he or she discussed surgery with the patient.

• Carpal tunnel syndrome (CTS): percentage of eligible patients having documentation of electrodiagnostic testing during the 18 months before surgery.

• Carpal tunnel syndrome (CTS): percentage of eligible patients who have either four or fewer injections in the study hand before the end of the study period or five or more injections in the study hand before the end of the study period and documented refusal of surgery during the six months before the fifth injection.

• Carpal tunnel syndrome (CTS): percentage of eligible patients whose medical record for the visit at which the splint was first prescribed documented that the splint was adjusted so that the wrist was in neutral position.

• Carpal tunnel syndrome (CTS): percentage of eligible visits for which the progress notes documented that the patient was asked about changes in at least one of the following: pain, paresthesias in the first through third digits, or symptoms of hand weakness.