Measure Title: Social Role Functioning Assessment utilizing PROMIS Adult Ability to Participate in Social Roles and Activities
Description: The percentage of adult patients (18 years of age or older) who report concerns related to their psychosocial function and who have completed a standardized assessment utilizing the PROMIS Adult Ability to Participate in Social Roles and Activities during measurement period.
Denominator:
Patients aged ≥ 18 years
AND
Diagnosis for mood disorders (ICD-10-CM): F31.0, F31.1, F31.2, F31.3, F31.4, F31.5, F31.6, F31.7, F31.8, F31.9, F32.0, F32.1, F32.2, F32.3, F32.4, F32.5, F32.8, F32.9, F33.0, F33.1, F33.2, F33.3, F33.40, F33.41, F33.42, F33.8, F33.9, F34.0, F34.1, F34.8, F34.9
OR
Diagnosis for anxiety and/or trauma disorders: F40.1 Social phobias; F40.10 Social phobia, unspecified; F40.11 Social phobia, generalized; F41.0 Panic disorder without agoraphobia; F41.1 Generalized anxiety disorder; F41.3 other mixed anxiety disorders; F41.8 other specified anxiety disorders; F41.9 anxiety disorder unspecified; F43.1 Post-traumatic stress disorder (PTSD); F43.10 Post-traumatic stress disorder, unspecified; F43.11 Post-traumatic stress disorder, acute; F43.12 Post-traumatic stress disorder, chronic
OR
Diagnosis for psychosis disorders: F20.0 – Paranoid schizophrenia
F20.1 – Disorganized schizophrenia
F20.2 – Catatonic schizophrenia
F20.3 – Undifferentiated schizophrenia
F20.5 – Residual schizophrenia
F20.81 – Schizophreniform disorder
F20.89 – Other schizophrenia
F20.9 – Schizophrenia, unspecified
F23 – Brief psychotic disorder
F25.0 – Schizoaffective disorder, bipolar type
F25.1 – Schizoaffective disorder, depressive type
F25.8 – Other schizoaffective disorders
F25.9 – Schizoaffective disorder, unspecified
F28 – Other psychotic disorder not due to a substance or known physiological condition
AND
Patient encounter during the denominator identification period (CPT or HCPCS):
0362T, 0373T, 90785, 90791, 90792, 90832,90833, 90834, 90836, 90837, 90838, 90839, 90840, 90845, 90846, 90847, 90849, 90853, 90863, 90875, 90876, 96110, 96112, 96113, 96116, 96121, 96127, 96130, 96131, 96132, 96133, 96136, 96137, 96138, 96139, 96146, 96156, 96158, 96159, 96164, 96165, 96167, 96170, 96171, 96178, 97129, 97130, 97151, 97152, 97153, 97154, 97155, 97156, 97157, 97158, 98966, 98967, 98968, 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215,99354, 99355, 99406, 99407, 99408, 99409, 99446, 99447, 99448, 99449, 99484, 99492, 99493, 99494, G2011, G2061, G2062, G2063, G0396, G0397, G0402, G0438, G0439
Numerator: Adult patients (18 years of age or older) included in the denominator who have at least one completed administration of the PROMIS Adult Ability to Participate in Social Roles and Activities short form or computer adaptive test during a four month measurement period. If the T-score is equal to or less than 40, this suggests a probable difficulty with social role function and ability to effectively participate in one’s usual role, which requires documentation of an appropriate follow-up plan such as further evaluation or referral to treatment.
Denominator Exclusions:
- Patients who die OR
• Are enrolled in hospice in the measurement year OR
• Are unable to complete the PROMIS adult Ability to Participate in Social Roles and Activities measure due to cognitive deficit, visual deficit, motor deficit, language barrier, or low reading level, AND a suitable recorder (e.g., advocate) is not available
Denominator Exceptions: None
National Quality Forum (NQF) number, if applicable
N/A
Care setting(s)
Ambulatory; Ambulatory Care: Clinician Office/Clinic; Ambulatory Care: Hospital; Home Care; Hospital; Hospital Inpatient; Hospital Outpatient; Long Term Care; Nursing Home; Outpatient Services; Rehabilitation Facility; Rehabilitation Facility: Inpatient
Telehealth, if applicable
Yes
Number of performance rates required for measures
1
Traditional vs. inverse measure
Traditional
Proportional, continuous variable, and/or ratio measure indicator
Proportional
Risk adjustment, if applicable
No
Submission pathway
Traditional MIPS