Use of Imaging Studies for Low Back Pain (LBP)

What Is the Measure?

This measure looks at the percentage of enrolled patients 18 to 50 years of age diagnosed with uncomplicated low back pain during the measurement period who did not have an imaging study (X-ray, MRI, or CT scan) within 28 days after the diagnosis.

Eligible Codes

9.1

9.2

9.3

Description Code(s)

Uncomplicated low back pain

Exclusions

Patients with any of the following conditions are excluded from the measure:

• Cancer

• HIV

• Major organ transplant

• Recent trauma within 3 months prior to episode date to 28 days after the episode date

• Previous diagnosis of low back pain within 6 months prior to episode date

• History of Intravenous drug abuse within 12 months prior to episode date

• Neurologic impairment (cauda equina syndrome) within 12 months prior to episode date

• Spinal infection within 12 months prior to the episode date

• Prolonged treatment (>_ 90 consecutive days) with corticosteroids within 12 months prior to the episode date

• Hospice patients

How to Improve Score

• Document all comorbid conditions and relevant medical history in the patients’ medical record.

• Educate patients and their caregivers that imaging studies are not necessary for confirmation of most uncomplicated low back pain diagnoses. In the majority of cases, low back pain resolves within 6 weeks.

• Teach patients about ways to alleviate symptoms at home, and when they should seek additional treatment.

9.4

9.5

Additional Measures: Use of Imaging Studies for Low Back Pain (LBP)