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Overuse of Neuroimaging for patients with Primary Headache and a Normal Neurological Evaluation

Percentage of patients with a diagnosis of primary headache disorder whom advanced brain imaging was not ordered.

Date Reviewed: November 19, 2017

Measure Info

MIPS 419CMS 419
Measure Type: 
Efficiency
Measure Steward: 
American Academy of Neurology
Clinical Topic Area: 
Headache

Care Setting: 
Outpatient
Data Source: 
Claims
Registry

ACP supports QPP measure 419: "Overuse of Neuroimaging for Patients with Primary Headache and a Normal Neurological Evaluation" because implementation will likely promote appropriate use of neuroimaging in patients with primary headache and the data source attributes the measure outcome to the ordering clinician. While we support this measure, the measure developers cite outdated evidence to form the basis of the measure. Additionally, quality reporting programs should be aware of the potential for clinicians to manipulate the measure to work in their favor by documenting an exception to the rule (e.g., "change in the type of headache”). To avoid potential measure gaming, developers should consider revising the specifications to clearly define appropriate exceptions to eligibility.