Reduction of Pain for Patients with Polyneuropathy

Measure Purpose: Calculate if patients 18 years and older with neuropathic pain in their feet was improved at 12 months

The numerator: patients whose Visual Analog Scale (VAS) or Numeric Pain Rating Scale (NRS) pain score for patient’s feet at 12 months (+/- 60 days) was improved from the index score.

is divided by

the denominator: patients aged 18 years and older diagnosed with polyneuropathy with associated neuropathic pain in the feet and a VAS greater than or equal to 40 or NRS greater than or equal to 4 at index visit

Improvement is defined as 30% reduction in scale score for the first index score inpatient record. The index score does not reset annually.   

Required exclusions are removed from the denominator:

• Polyneuropathy with associated neuropathic pain with a VAS less than or equal to 39 or NRS less than or equal to 3 at index visit
• Patients who died
• Second VAS or NRS score not collected at twelve months (+/-60 days)
• VAS or NRS pain is not linked to foot pain

Allowable exclusions are removed from the denominator:

• Patient declines or refuses to complete pain assessment on date of encounter
• Unable to complete pain assessment on date of encounter (For example, non-verbal with no care partner present, coma, etc.)
• Patient has contraindications to appropriate pain medications documented in their history
• Patient has an allergy to appropriate pain medications documented in their history

Key Phrases

LOINC codes available to assist in identification of performance in the pain assessment panel (38212-7) are: 

• 38204-4 Pain primary location:Anat:Pt:*:Nom:Reported
• 39111-0 Body site:Anat:Pt:^Patient:Nom:

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

• NRS for foot pain is (0-10)
• VAS for foot pain is (0-100)
• Patient denies foot pain 

Measure Calculation Example

Dr. Stolyarova saw 100 patients aged 18 and older with a diagnosis of polyneuropathy between January 1 and December 31 who had a NRS score greater than 4 or VAS score greater than 41 from the prior year in their medical record. This is the denominator.

Fourteen of these patients denied having pain in their feet and are excluded from the denominator. Of the remaining 86 patients, Dr. Stolyarova documented improved NRS or VRS scores for 32 patients. This is the numerator. 

Quality of patient care = 32/(100-14). Dr. Stolyarova has a score of 37.2% for this measure.