PTE Specialty Quality Reporting - Orthopedics
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1. PTE Specialty Quality Reporting - Orthopedic

 

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1. General Information: Practice (Please complete for each unique practice site)

2. Please indicate whether this the first time information is entered for this practice site, or whether you are updating information for this site:

3. Practice Provider Profile
(Please list all physicians at this practice site)

4. Provider Profile - Please map your selections below to the individual physicians you have listed above.

 Orthopedic Board Certification (please indicate Board certified/Board eligible/neither)
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5. Does this practice participate in the Centers for Medicare and Medicaid's (CMS) "Physician Quality Reporting Initiative" (PQRI) program, with reporting at least 3 CMS PQRI orthopedic measures in the past year?

6. Does this practice use a survey to assess patient experience of care (satisfaction) to improve care?

7. Does this practice use a validated patient functional outcome tool for the majority of patients undergoing one or more of the following targeted conditions?
(The following procedures were selected to represent various surgeries that would be representative of services provided by most orthopaedic practices in Maine. Practices that do not perform these procedures and wish to participate may select "other" and list a procedure representative of their practice for which there is an appropriate, validated outcomes tool)

 Knee/Limb procedures: Lower Limb ToolShoulder procedures: Quick DASH ToolWrist/Carpal tunnel procedures: Boston Carpal Tunnel Tool
Arthroscopy, knee, surgical; with meniscectomy (CPT 29881
Arthroplasty, knee, condyle and plateau; medial and lateral (CPT 27447)
Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty)(CPT 27130)
Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty (CPT 29826)
Neuroplasty and/or transposition; median nerve at carpal tunnel(CPT 64721)

8. Attestation
I have reviewed the data submitted in this survey and agree that it is a correct assessment of this practice. I understand that this practice will participate in an on-site validation of the data, upon request.