Use of Imaging Studies for Low Back Pain (LBP)
HEDIS Measure
Use of Imaging Studies for Low Back Pain (LBP)
Line of business: Commercial Medicaid Medicare
Data Collection Method: Administrative (Claims)
Measure Description
The percentage of members 18–75 years of age with a principal diagnosis of low back pain who did not have an imaging study (plain X- ray, MRI, CT scan) within 28 days of the diagnosis.
*Inverted Measure
Numerator Compliance
An imaging study with a diagnosis of uncomplicated low back pain on the IESD or in the 28 days following the IESD.
Intake period - January 1–December 3 of the measurement year. The intake period is used to identify the first eligible encounter with a principal diagnosis of low back pain.
Index Episode Start Date = The earliest date of service for an eligible encounter during the Intake Period with a principal diagnosis of low back pain.
Quality Value Set Directory Coding Tips
Imaging Study
CPT
- 72020
- 72052
- 72100
- 72110
- 72114
- 72120
- 72131
- 72132
- 72133
- 72141
- 72142
- 72146
- 72147
- 72148
- 72149
- 72156
- 72158
- 72200
- 72202
- 72220
SNOMED CT US Edition
- 2847006
- 6238009
- 6728003
- 7812007
- 21613005
- 22791004
- 24856003
- 26537001
- 35443000
- 41333006
- 45554006
- 46700000
- 47987001
- 48816001
- 57235004
- 60443006
- 61368000
- 66769009
- 68862002
- 72508000
- 79760008
- 86392000
- 90523008
- 90805008
- 91333005
- 91583001
- 168573004
- 168588009
- 241092006
- 241093001
- 241094007
- 241580002
- 241592002
- 241596004
- 241646009
- 241647000
- 241648005
- 276478001
- 303935004
- 419942003
- 429860003
- 429868005
- 429871002
- 430021001
- 430507007
- 431250008
- 431496002
- 431557005
- 431613003
- 431871005
- 431892005
- 432078003
- 432244001
- 432770001
- 433140006
- 433141005
- 440450002
- 443580006
- 444634007
- 448641007
- 700319007
- 700320001
- 700321002
- 702487007
- 702488002
- 702513003
- 702514009
- 702515005
- 702516006
- 702521009
- 702522002
- 702523007
- 702607002
- 702608007
- 709652000
- 709653005
- 709698004
- 711104001
- 711184004
- 711186002
- 711224009
- 711271003
- 712970008
- 713016000
- 715290001
- 715458009
- 716830000
- 717912001
- 718542005
- 718545007
- 723646000
- 726546000
- 772220000
- 783627007
- 840361000
- 868279006
- 3721000087104
- 3731000087102
- 14871000087107
- 17141000087101
- 394451000119106
- 396171000119100
- 411571000119106
- 411611000119102
- 413001000119107
- 495741000119105
- 571891000119109
- 572091000119106
- 16328021000119109
- 16384831000119100
- 16554061000119109
Uncomplicated Low Back Pain
ICD10CM
- M47.26
- M47.27
- M47.28
- M47.816
- M47.817
- M47.818
- M47.896
- M47.897
- M47.898
- M48.061
- M48.07
- M48.08
- M51.16
- M51.17
- M51.26
- M51.27
- M51.36
- M51.37
- M51.86
- M51.87
- M53.2X6
- M53.2X7
- M53.2X8
- M53.3
- M53.86
- M53.87
- M53.88
- M54.16
- M54.17
- M54.18
- M54.30
- M54.31
- M54.32
- M54.40
- M54.41
- M54.42
- M54.50
- M54.51
- M54.59
- M54.89
- M54.9
- M99.03
- M99.04
- M99.23
- M99.33
- M99.43
- M99.53
- M99.63
- M99.73
- M99.83
- M99.84
- S33.100A
- S33.100D
- S33.100S
- S33.110A
- S33.110D
- S33.110S
- S33.120A
- S33.120D
- S33.120S
- S33.130A
- S33.130D
- S33.130S
- S33.140A
- S33.140D
- S33.140S
- S33.5XXA
- S33.6XXA
- S33.8XXA
- S33.9XXA
- S39.002A
- S39.002D
- S39.002S
- S39.012A
- S39.012D
- S39.012S
- S39.092A
- S39.092D
- S39.092S
- S39.82XA
- S39.82XD
- S39.82XS
- S39.92XA
- S39.92XD
- S39.92XS
SNOMED CT US Edition
- 2415007
- 3200003
- 8663007
- 12454008
- 12519004
- 18347007
- 20021007
- 23056005
- 26538006
- 29885006
- 38253002
- 39058009
- 41455002
- 46578006
- 46960006
- 48210000
- 54314008
- 60937000
- 61486003
- 79244005
- 86345004
- 86814006
- 90631008
- 91240008
- 92047003
- 93743001
- 94242004
- 94782007
- 111633007
- 111653006
- 123534001
- 123535000
- 123798002
- 126963001
- 128196005
- 128197001
- 129179000
- 161894002
- 163241009
- 163243007
- 192970008
- 192971007
- 202487003
- 202674000
- 202675004
- 202676003
- 202677007
- 202678002
- 202679005
- 202680008
- 202693003
- 202694009
- 202695005
- 202696006
- 202708005
- 202731005
- 202735001
- 202736000
- 202755000
- 202787002
- 202788007
- 202789004
- 202794004
- 202824000
- 208060001
- 208067003
- 208071000
- 208078006
- 209086000
- 209102002
- 209169008
- 209178002
- 209179005
- 209180008
- 209181007
- 209182000
- 209185003
- 209193003
- 209194009
- 209195005
- 209196006
- 209197002
- 209547009
- 209548004
- 209549007
- 209550007
- 209551006
- 209552004
- 209553009
- 209561004
- 209565008
- 209566009
- 209812006
- 212192004
- 212193009
- 212457004
- 230614002
- 239880009
- 247368002
- 262726002
- 262727006
- 262731000
- 262732007
- 262995003
- 263044008
- 267067009
- 267590006
- 267982002
- 274162005
- 275316003
- 278860009
- 278862001
- 279039007
- 279040009
- 279042001
- 279063004
- 281598004
- 298251000
- 298604007
- 298605008
- 298674008
- 300956001
- 300957005
- 301407002
- 301408007
- 301416003
- 301417007
- 307138004
- 307176005
- 307177001
- 309710005
- 311804006
- 312788000
- 312792007
- 363477002
- 370471003
- 405753002
- 416513001
- 416546007
- 416929004
- 417056009
- 417068000
- 417098007
- 417262009
- 417414000
- 417459008
- 417614006
- 417646006
- 417685004
- 417725008
- 417731006
- 417744001
- 427027005
- 427571000
- 427923007
- 703619001
- 713911007
- 718929000
- 718936004
- 722410009
- 724899004
- 735609006
- 735610001
- 735611002
- 737254001
- 764272007
- 782388003
- 782661001
- 830292003
- 830293008
- 838412000
- 860614004
- 871492003
- 1119215001
- 1119216000
- 1156105001
- 1156802000
- 471000119102
- 9121000119106
- 13291000119100
- 36241000119108
- 100491000119103
- 113611000119100
- 129501000119107
- 291941000119106
- 291951000119108
- 311211000119105
- 313501000119105
- 322141000119100
- 448701000124105
- 12242551000119102
- 12242591000119107
- 15633361000119103
- 15634631000119104
- 15636531000119108
- 15636571000119106
- 15636611000119102
- 15749221000119107
- 15749261000119102
- 15749301000119105
- 15968741000119100
- 15972821000119108
- 16206741000119104
- 16839401000119104
- 16846261000119106
- 29930001000004103