Hospital Outpatient Quality Reporting Specifications Manual, v9.1

For use in submitting data for encounters from 07/01/16 through 12/31/16.

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below. NOTE: For encounters from 10/01/16 through 12/31/16, refer to updates provided in the sections designated with an asterisk (*).

Release Notes, Version 9.1 - Supplement 4* (12/09/16)
Release Notes, Version 9.1 - Supplement 3* (09/30/16)
Release Notes, Version 9.1 - Supplement 2 (05/27/16)
Release Notes, Version 9.1 - Supplement 1 (05/27/16)
Release Notes, Version 9.1 (12/29/15)

Table of Contents


Program Background
Using the Manual
Delivery Settings


1.1 - Outpatient Acute Myocardial Infarction (AMI)

AMI Measure Set

AMI General Data Element List
AMI Specific Data Element List
AMI Population Algorithms
Measurement Information Form (MIF) and Flowchart (Algorithms)
(OP-1, OP-2, OP-3, OP-4, OP-5)

Note: Measurement Information Forms (MIFs) OP-4 and OP-5 are used for both AMI and Chest Pain.

1.2 - Chest Pain (CP)

CP Measure Set

CP General Data Element List
CP Data Element List
CP Population Algorithm
Measurement Information Form (MIF) and Flowchart (Algorithms)
(OP-4, OP-5)

1.3 - Emergency Department (ED)-Throughput

ED-Throughput Measure Set

ED-Throughput General Data Element List
ED-Throughput Specific Data Element List
ED-Throughput Population Algorithm
Measurement Information Form (MIF) and Flowchart (Algorithms)
(OP-18, OP-20, OP-22)

1.4 - Pain Management

Pain Management Measure Set

Pain Management General Data Element List
Pain Management Specific Data Element List
Pain Management Population Algorithm
Measurement Information Form (MIF) and Flowchart (Algorithms)

1.5 - Stroke

Stroke Measure Set

Stroke General Data Element List
Stroke Specific Data Element List
Stroke Population Algorithm
Measurement Information Form (MIF) and Flowchart (Algorithms)

1.6 - Imaging Efficiency

OP-8 MRI Lumbar Spine for Low Back Pain

OP-9 Mammography Follow-up Rates

OP-10 Abdomen CT Use of Contrast Material

OP-11 Thorax CT Use of Contrast Material

OP-13 Cardiac Imaging for Preoperative Risk Assessment for Non Cardiac Low Risk Surgery

OP-14 Simultaneous Use of Brain Computed Tomography (CT) and Sinus Computed Tomography (CT)

1.7 - Web-based Measures

OP-12 The Ability for Providers with HIT to Receive Laboratory Data Electronically Directly into their Office of the National Coordinator for Health Information Technology (ONC) Certified Electronic Health Record (EHR) System as Discrete Searchable Data

OP-17 Tracking Clinical Results Between Visits

OP-25 Safe Surgery Checklist Use

OP-26 Hospital Outpatient Department Volume for Selected Outpatient Surgical Procedures (Updated 12/09/16)

OP-27 Influenza Vaccination Coverage Among Healthcare Personnel

OP-29 Endoscopy/Polyp Surveillance: Appropriate Follow-up Interval for Normal Colonoscopy in Average Risk Patients

OP-30 Endoscopy/Polyp Surveillance: Colonoscopy Interval for Patients with a History of Adenomatous Polyps - Avoidance of Inappropriate Use

OP-31 Cataracts: Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery

OP-33 External Beam Radiotherapy for Bone Metastases (Updated 02/09/16)

1.8 - Outcome Measures

OP-32 Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy (Updated 05/27/16)

Data Dictionary and General Abstraction Guidelines

Interpretation of Data Dictionary Terms
Data Dictionary Terms
General Abstraction Guidelines

Alphabetical Data Dictionary (Updated 07/19/16)

Unable to be Determined (UTD) and Missing/Invalid Values

Data Collection and the UTD Allowable Value
Missing and Invalid Data
Abstraction Software Skip Logic and Missing Data

Population, Sampling and Transmission

Order of Data Flow
Sample Size Requirements
Sampling Approaches
Transmission of Outpatient Population and Sample Data Elements
Introduction and Guidelines for Submission of Data
Transmission Data Element List and Transmission Data Element Pages
Transmission Data Processing Flow

Hospital Outpatient Clinical Data XML File Layout (Updated 07/19/16)

Hospital Outpatient Population Data XML File Layout

A - ICD-10-CM Diagnosis and CPT Code Tables, for:

Third Quarter (07/01/16–09/30/16) encounters, XLSX or PDF (Updated 05/27/16)

Fourth Quarter (10/01/16–12/31/16) encounters , XLSX* or PDF* (09/30/16)

B - Glossary of Terms, PDF

C - Medication Tables, XLSX or PDF

Download entire manual for:

Third Quarter (07/01/16 - 09/30/16) encounters, PDF or ZIP (Updated 12/09/16)
Fourth Quarter (10/01/16 - 12/31/16) encounters, PDF* or ZIP* (Updated 12/09/16)

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