Appropriate Neurological Exam

Measure purpose: Support diagnosis of concussion

The numerator: Patients who had a neurological exam that included all components:

1. Cervical assessment
2. Cognitive function
3. Vestibular function
4. Extraocular movements
5. Gait
6. Balance
7. Coordination

is divided by

The denominator: Patients > 5 years of age diagnosed with concussion seen for an initial visit

Exclusions are removed from the denominator for:

• Patient and/or caregiver refusal
• Patient unable to participate in a neurological exam

Key Phrases

Examples of key phrases you could use to meet the measure include:

• Neurological exam performed for concussion evaluation at initial visit
• Neurological exam performed and included 7 components

Measure Calculation Example

Dr. Harrington has 50 patients between January 1 and December 31 with a diagnosis of concussion over the age of 5. This is the denominator. 

Two patients refused a neurological exam and two patients were unable to participate in the neurological exam. These four patients are excluded from the denominator (50-4). 

16 patients had a neurological exam that included all seven components. This is the numerator. 

Quality of patient care - 16/(50-4). Dr. Harrington has a score of 34% for this measure.