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Hospital Outpatient Quality Reporting Specifications Manual, v12.0a

For use in submitting data for encounters from 01/01/19 through 12/31/19.

View and/or download individual sections of the Specifications Manual, (PDF documents, unless noted), listed below.

Release Notes, Version 12.0 (06/26/18)
Release Notes, Version 12.0a (12/20/18)

Table of Contents

Acknowledgement

Program Background
Using the Manual
Outpatient Delivery Settings

Measure Information Form Format Overview

1.1 - Acute Myocardial Infarction (AMI)

AMI Measure Set

AMI General Data Element List
AMI Specific Data Element List
AMI Population Algorithm
Measurement Information Forms and Algorithms
(OP-2, OP-3, OP-5)

Note: Measurement Information Form OP-5 is used for both AMI and Chest Pain.

1.2 - Chest Pain (CP)

CP Measure Set

CP General Data Element List
CP Specific Data Element List
CP Population Algorithm
Measurement Information Forms and Algorithms
(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 Forms and Algorithms
(OP-18, OP-22)

1.4 - Stroke

Stroke Measure Set

Stroke General Data Element List
Stroke Specific Data Element List
Stroke Population Algorithm
Measurement Information Form and Algorithm
(OP-23)

1.5 - Imaging Efficiency

OP-8: MRI Lumbar Spine for Low Back Pain

OP-10: Abdomen CT - Use of Contrast Material

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

1.6 - Measures Submitted via a Web-Based Tool

OP-29: Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients

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

OP-33: External Beam Radiotherapy for Bone Metastases

1.7 - Outcome Measures

OP-32: Facility 7-Day Risk-Standardized Hospital Visit Rate after Outpatient Colonoscopy

OP-35: Admissions and Emergency Department (ED) Visits for Patients Receiving Outpatient Chemotherapy

OP-36: Hospital Visits after Hospital Outpatient Surgery

Data Dictionary and General Abstraction Guidelines

Introduction
Interpretation of Data Dictionary Terms
Data Dictionary Terms
General Abstraction Guidelines

Alphabetical Data Element List and Data Dictionary

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

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

Population, Sampling and Transmission

Introduction
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

Hospital Outpatient Population Data XML File Layout

Tools and Resources
Tools and Resources Table of Contents
Arrival Time Guidelines
Departure Time Guidelines

Reason for Delay in Fibrinolytic Therapy Guidelines

OP-29 Tool

OP-29 Algorithm

OP-29 Denominator Codes

OP-29 Fact Sheet

OP-31 Cataracts Improvement Following Surgery

OP-33 Algorithm

OP-33 Fact Sheet

A - ICD-10-CM Diagnosis and CPT Code Tables, XLSX or PDF
B - Glossary of Terms, PDF

C - Medication Tables, PDF

D - Preview Section, PDF

Download Entire Manual, PDF or ZIP (12/20/18)

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