Audiology Quality Consortium

MIPS Measures

Eligible MIPS Measures for Audiologists

For complete measure specifications, visit the Quality Payment Program website. For even more information on successful reporting, check your professional society’s website.

Measure #130: Documentation of Current Medications in the Medical Record [PDF]

Current Measures
Medication must be documented for a minimum of 60% of every eligible Medicare patient visit for hearing, tinnitus, or balance evaluations.

Reporting Criteria
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications’ name, dosage, frequency, and route of administration.

CPT Codes
92537, 92538, 92540, 92541, 92542, 92544, 92545, 92547, 92548, 92557, 92567, 92568, 92570, 92585, 92588, and 92626

ICD-10-CM Codes
No specific ICD-10-CM codes are included for this measure.

Definitions

  • Current Medications – Medications that the patient is presently taking—including all prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements, with each medication’s name, dosage, frequency, and administered route.
  • Route – Documentation of the way in which the medication enters the body (some examples include but are not limited to oral, sublingual, subcutaneous injections, and/or topical application).
  • Not Eligible (Denominator Exception) – A patient is not eligible if the patient is in an urgent or emergent medical situation where time is of the essence and to delay treatment would jeopardize the patient’s health status on the date of the encounter. This reason must be documented.

Numerator Note: The MIPS-eligible clinician must document, in the medical record, the fact that they obtained, updated, or reviewed a medication list on the date of the encounter. MIPS-eligible clinicians submitting this measure may document medication information received from the patient, authorized representative(s), caregiver(s), or other available health care resources. By submitting the action described in this measure, the provider attests to having documented a list of current medications utilizing all immediate resources available at the time of the encounter. G8427 should be submitted if the MIPS-eligible clinician documented that the patient is not currently taking any medications.

Numerator Quality-Data Coding Options

  • G8427 – MIPS-eligible clinician attests to documenting, in the medical record, the fact that they obtained, updated, or reviewed the patient’s current medications.

OR

  • G8430 – MIPS-eligible clinician attests to documenting, in the medical record, the fact that the patient is not eligible for a current list of medications being obtained, updated, or reviewed by the MIPS-eligible clinician.

OR

  • G8428 – Current list of medications was not documented as having been obtained, updated, or reviewed by the MIPS-eligible clinician; reason not given.
Measure #134: Preventative Care and Screening – Screening for Clinical Depression and Follow-Up Plan [PDF]

Current Measures
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen. Screen and follow-up plan must be documented one time per calendar year for CPT Code 92625—Assessment of Tinnitus—for a minimum of 60% of the eligible Medicare patients. This measure should be reported if you routinely utilize a depression screening tool and if this measure is within your state scope of practice. Required for tinnitus evaluations.

Reporting Criteria
Patients 12 years or older with the following procedure codes. This measure should be reported a minimum of once per calendar year, per patient.

CPT Codes
92625

ICD-10-CM Codes
No specific ICD-10-CM codes are included for this measure.

Definitions

  • Screening – Completion of a clinical or diagnostic tool used to identify people at risk of developing or having a certain disease or condition, even in the absence of symptoms.
  • Standardized Depression Screening Tool – A normalized and validated depression screening tool developed for the patient population in which it is being utilized. The name of the age appropriate standardized depression screening tool utilized must be documented in the medical record.
  • Follow-Up Plan – Documented follow-up for a positive depression screening must include one or more of the following:
    • Additional evaluation or assessment for depression
    • Suicide Risk Assessment
    • Referral to a practitioner who is qualified to diagnose and treat depression
    • Pharmacological interventions
    • Other interventions or follow-ups for the diagnosis and/or treatment of depression

Numerator Quality-Data Coding Options

  • G9717 – Documentation stating the patient has an active diagnosis of depression or has a diagnosed bipolar disorder, and, therefore, screening or follow-up is not required

OR

  • G8431 – Screening for depression is documented as being positive, AND a follow-up plan is documented

OR

  • G8510 – Screening for depression is documented as negative; a follow-up plan is not required

OR

  • G8433 – Screening for depression not completed; documented reason

OR

  • G8432 – Depression screening not documented; reason not given

OR

  • G8511 – Screening for depression documented as positive; follow-up plan not documented; reason not given

Depression Screening Tools
Available tools include, but are not limited to, the following:

Measure #154: (Falls) Risk Assessment [PDF]

Current Measures
This screen is paired with the follow-up plan, Measure #155: (Falls) Risk Plan of Care, and must be documented one time per calendar year for a minimum of 60% of the eligible Medicare patients for vestibular evaluations.

Reporting Criteria
Patient is 65 years old or older with a history of falls (indicated when a patient has fallen twice in the previous 12 months or one time resulting in an injury that required medical attention). If a patient has documentation of two or more falls in the past year or any fall with injury in the past year (in which CPT II code 1100F is submitted), then the follow-up plan [Measure #155: (Falls) Risk Plan of Care] should also be submitted.

CPT Codes
This measure should be reported a minimum of once per calendar year per patient if any of the following CPT codes were performed: 92540, 92541, 92542, 92548.

ICD-10-CM Codes
No specific ICD-10-CM codes are included for this measure.

Definitions

  • Fall – A sudden, unintentional change in position causing an individual to land at a lower level, on an object, on the floor, or on the ground, other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force.
  • Risk Assessment – Comprised of balance/gait AND one or more of the following: postural blood pressure, vision, home fall hazards, and documentation on whether or not medications are a contributing factor to falls within the past 12 months.
  • Balance/Gait Assessment – Medical record must include documentation of observed transfer and walking or use of a standardized scale (e.g., Get Up and Go Test, Berg Balance Test, Tinetti Balance Assessment Tool) or documentation of referral for assessment of balance/gait.
  • Postural Blood Pressure – Documentation of blood pressure values in supine and then in standing positions.
  • Vision Assessment – Medical record must include documentation that patient is functioning well with vision or is not functioning well with vision based on discussion with the patient or use of a standardized scale or assessment tool (e.g., Snellen chart) or documentation of referral for assessment of vision.
  • Home Fall Hazards Assessment – Medical record must include documentation of counseling on home fall hazards OR documentation of inquiry of home fall hazards OR referral for evaluation of home fall hazards.
  • Medications Assessment – Medical record must include documentation of whether the patient’s current medications may or may not contribute to falls.

Patient Reports—Exclusion 1 (documentation of no falls in the past 12 months or one fall without injury)

  • Step 1—Code on claim should be CPT II code 1101F.

Patient Reports—Exclusion 2 (two or more falls in the past 12 months or one fall with an injury)

  • Step 1—Risk assessment not performed for medical reasons (patient is not ambulatory, bedridden, immobile, and/or confined to wheelchair).
  • Step 2—Perform CPT 92540, 92541, 92542, and/or 92548.
  • Step 3—Codes on claim should be CPT II code 3288F with 1P modifier and CPT II code 1100F; 1P is to report documented circumstances that appropriately exclude patients (i.e., immobile; confined to bed, chair, or wheelchair).
  • Step 4—Perform and report Measure #155: (Falls) Risk Plan of Care.

Patient Reports—Positive reporting (two or more falls in the past 12 months or one fall with an injury)

  • Step 1—Risk assessment completed by performing a standardized scale and by reviewing and documenting whether current medications may or may not be contributing to falls, dizziness, imbalance, or vertigo.
  • Step 2—Perform CPT II codes 92540, 92541, 92542, and/or 92548.
  • Step 3—When warranted, refer for assessment of supine and standing blood pressure, vision assessment, home falls risk hazards, and/or medication review.
  • Step 4—Codes on claim should be CPT II codes 3288F and 1100F.
  • Step 5—Perform and report Measure #154: (Falls) Risk Plan of Care.

Additional Tools and Resources
Falls risk assessment tools and resources include, but are not limited to, the following:

Measure #155: (Falls) Risk Plan of Care [PDF]

Current Measures
This measure is paired with Measure #154: (Falls) Risk Assessment, and must be reported one time per calendar year for a minimum of 60% of eligible patients for vestibular evaluations. This measure should also be reported if the patient meets the reporting criteria, even if a falls risk assessment was not performed.

Reporting Criteria
Patient is 65 years old or older with a history of falls (indicated when a patient has fallen twice in the previous 12 months or one time resulting in an injury that required medical attention).

This measure should be reported a minimum of once per calendar year per patient if any of the following CPT codes were performed.

CPT Codes
92540, 92541, 92542, 92548

Code 0518F 

ICD-10-CM Codes
No specific ICD-10-CM codes are included for this measure.

Definitions

  • Plan of Care – Must include balance, strength, and gait training.
  • Balance, Strength, and Gait Training – Medical record must include documentation that balance, strength, and gait training/instructions were provided OR referral to an exercise program, which includes at least one of the three components—balance, strength, or gait—OR referral to physical therapy.
  • Fall – A sudden, unintentional change in position causing an individual to land at a lower level, on an object, on the floor, or on the ground, other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force.

Clinical Recommendation Statements

The United States Preventive Services Task Force (USPSTF) recommends exercise or physical therapy to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls.
Grade: B recommendation.

The American Geriatrics Society (AGS) 2010 Clinical Practice Guidelines document recommends the following:

Multifactorial/Multicomponent Interventions to Address Identified Risk(s) and Prevent Falls

  1. A strategy to reduce the risk of falls should include multifactorial assessment of known fall risk factors and management of the risk factors identified.
  2. The components most commonly included in efficacious interventions were:
    • Adaptation or modification of home environment
    • Withdrawal or minimization of psychoactive medications
    • Withdrawal or minimization of other medications
    • Management of postural hypotension
    • Management of foot problems and footwear
    • Exercise, particularly balance, strength, and gait training
  3. All older adults who are at risk of falling should be offered an exercise program incorporating balance, gait, and strength training. Flexibility and endurance training should also be offered, but not as sole components of the program.
  4. Multifactorial/multicomponent intervention should include an education component complementing and addressing issues specific to the intervention being provided, tailored to individual cognitive function and language.
  5. The health professional or team conducting the fall risk assessment should directly implement the interventions or should assure that the interventions are carried out by other qualified healthcare professionals.

Code 0518F With 1P Modifier
Plan of care not documented for medical reasons (patient is not ambulatory, is bedridden, is immobile, or is wheelchair bound) (meets exclusion criteria).

Note: The Audiology Quality Consortium (AQC) recommends referral to the ordering and/or primary care physician for Vitamin D supplement advice.

Measure #181: Elder Maltreatment Screen and Follow-Up Plan [PDF]

Current Measures
Percentage of patients aged 65 years and older with a documented elder maltreatment screen that was done using an elder maltreatment screening tool on the date of encounter AND a follow-up plan documented on the date of the positive screen.

Reporting Criteria
The documented follow-up plan must be related to positive elder maltreatment screening. For example: “Patient referred for protective services due to positive elder maltreatment screening.” Patients with cognitive impairment are included in the denominator of this measure and need to be screened using an elder maltreatment screening tool.

This measure should be submitted a minimum of once per performance period for at least 70% of eligible patients.

Denominator
All patients aged 65 years and older AND who have had the following CPT codes performed:

92540, 92541, 92548, 92550, 92557, 92567, 92570, 92587, 92588, 92625

Numerator
Patients with a documented elder maltreatment screen using an elder maltreatment screening tool on the date of the encounter AND a follow-up plan documented on the date of the positive screen.

Documentation of an elder maltreatment screening must include identification of the specific tool used. Examples of screening tools for elder maltreatment include, but are not limited to, the following: Elder Abuse Suspicion Index (EASI), Vulnerability to Abuse Screening Scale (VASS), and Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST). These tools are psychometrically sound instruments with demonstrated reliability and validity indices. See the links below.

Definitions
Screen for Elder Maltreatment – An elder maltreatment screen should include assessment and documentation of one or more of the following components:

  • Physical Abuse – Infliction of physical injury by punching, beating, kicking, biting, burning, shaking, or other actions that result in harm.
  • Psychological Abuse – Willful infliction of mental or emotional anguish by threat, humiliation, isolation, or other verbal or nonverbal conduct.
  • Neglect – Involves attitudes of others or actions caused by others—such as family members, friends, or institutional caregivers—that have an extremely detrimental effect upon well-being.
    • Active – Behavior that is willful—or, when the caregiver intentionally withholds care or necessities. The neglect may be motivated by financial gain or may reflect interpersonal conflicts.
    • Passive – Situations where the caregiver is unable to fulfill his or her caregiving responsibilities as a result of illness, disability, stress, ignorance, lack of maturity, or lack of resources.
  • Sexual Abuse – Forcing of undesired sexual behavior by one person upon another—against their will—who is either competent or unable to fully comprehend and/or give consent. This may also be called
  • Elder Abandonment – Desertion of an elderly person by (a) an individual who has assumed responsibility for providing care for an elder or (b) a person with physical custody of an elder.
  • Financial or Material Exploitation – Taking advantage of a person for monetary gain or profit.
  • Unwarranted Control – Controlling a person’s ability to make choices about living situations, household finances, and medical care.

Note: Self-neglect is a prevalent form of abuse in the elderly population. Screening for self-neglect is not included in this measure.

Follow-Up Plan
Must include the name of the screening tool used AND a documented report to state or local Adult Protective Services (APS) or the appropriate state agency. For state-specific information describing how to report suspected elder maltreatment, including self-neglect, consult the following resources:

Not Eligible/Denominator Exception
A patient is not eligible if one or more of the following reasons is documented:

  • Patient refuses to participate and has reasonable decisional capacity for self-protection.
  • Patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient’s health status.

Numerator Quality-Data Coding Options

Elder Maltreatment Screen Documented as Positive AND Follow-Up Plan Documented
Performance Met: G8733 – Elder maltreatment screen is documented as positive AND a follow-up plan is documented.

OR

Elder Maltreatment Screen Documented as Negative; Follow-Up Plan Not Required
Performance Met: G8734 – Elder maltreatment screen is documented as negative; a follow-up plan is not required.

OR

Elder Maltreatment Screen Not Documented, Patient Not Eligible
Denominator Exception: G8535 – Elder maltreatment screen is not documented; documentation is presented showing that the patient is not eligible for the elder maltreatment screen at the time of the encounter.

OR

Elder Maltreatment Screen Documented as Positive; Follow-Up Plan Not Documented; Patient Not Eligible for Follow-Up Plan
Denominator Exception: G8941 – Elder maltreatment screen is documented as positive; follow-up plan is not documented;  documentation is presented showing that the patient is not eligible for follow-up plan at the time of the encounter.

OR

Elder Maltreatment Screen Not Documented; Reason Not Given
Performance Not Met: G8536 – There is no documentation of an elder maltreatment screen; a reason is not given.

OR

Elder Maltreatment Screen Documented as Positive; Follow-Up Plan Not Documented; Reason Not Given
Performance Not Met: G8735 – Elder maltreatment screen is documented as positive; a follow-up plan is not documented; a reason is not given.

Measure #182: Functional Outcome Assessment [PDF]

Current Measures
Percentage of visits for patients aged 18 years and older with documentation of a current functional outcome assessment using a standardized functional outcome assessment tool on the date of the encounter AND documentation of a care plan based on identified functional outcome deficiencies on the date of the identified deficiencies. 

This measure should be submitted at each denominator-eligible visit during the 12-month performance period. 

Denominator
All patients aged 18 years and older AND the following CPT codes performed:
92540, 92541, 92542, 92548, 99201, 99202, 99203, 99204, 99205, 99211, 99212 99213, 99214, 99215.

Numerator
Patients with a documented current functional outcome assessment using a standardized tool AND a documented care plan based on the identified functional outcome deficiencies.

Definitions

  • Functional Outcome –Functional outcome assessment including questionnaires designed to measure the patient’s limitations in performing usual tasks of living and to quantify functional and behavioral systems. 
  • Standardized Tool – A tool that has been normed and validated. Examples of tools for functional outcome assessment include, but are not limited to, the Roland Morris Disability/Activity Questionnaire and the Western Ontario and McMaster University Osteoarthritis Index–Physical Function subscale.
  • Care Plan – A care plan is an ordered assembly of expected/planned activities or actionable elements based on identified deficiencies. These may include observations, goals, services, and appointments, all of which have the objective of organizing and managing health care activities for the patient.

Not Eligible/Denominator Exception
A patient is not eligible if one or more of the following reasons is documented:

  • Patient refuses to participate.
  • Patient is unable to complete the questionnaire.
  • Patient is in an urgent or emergent situation where time is of the essence and to delay treatment would jeopardize the patient’s health status.

Numerator Quality-Data Coding Options

Performance Met (G8539): Functional outcome assessment is documented as positive using a standardized tool, AND a care plan—based on deficiencies identified on the date of the functional outcome assessment—is documented.

OR

Performance Met (G8542): Functional outcome assessment using a standardized tool is documented; no functional deficiencies are identified; a care plan is not required.

OR

Performance Met (G8942): Functional outcome assessment using a standardized tool is documented within the previous 30 days AND a care plan—based on deficiencies identified on the date of the functional outcome assessment—is documented.

 

Denominator Exception (G8540): Functional outcome assessment is NOT documented as being performed; there is documentation that the patient is not eligible for a functional outcome assessment using a standardized tool at the time of the encounter.

OR

Denominator Exception (G9227): Functional outcome assessment is documented; care plan is not documented; there is documentation that the patient is not eligible for a care plan at the time of the encounter.

Measure #226: Preventative Care and Screening (Tobacco Use, Screening, and Cessation Intervention) [PDF]

Current Measures
Report once per reporting period for comprehensive hearing, tinnitus, and vestibular evaluations. Patients are to be asked if they use tobacco. If they respond “yes,” then advise them to quit and offer them, at a minimum, the Tobacco Use and Hearing and Balance Disorders resource.

Reporting Criteria
Patient is 18 years of age or older. This measure should be reported a minimum of once per calendar year per patient.

CPT Codes
92540, 92557, 92625

ICD-10-CM Codes
No specific ICD-10-CM codes are included for this measure.

Submission Criteria
There are three submission criteria for this measure:

  1. All patients who were screened for tobacco use
  2. All patients who were identified as a tobacco user and who received tobacco cessation intervention
  3. All patients who were screened for tobacco use and, if identified as a tobacco user received tobacco cessation intervention, or identified as a tobacco non-user

Each criterion is discussed in more detail below.

Criterion #1: All patients who were screened for tobacco use

Definitions

  • Tobacco Use – Includes any type of tobacco.

Numerator Quality-Data Coding Options

  • G9902 – Patient screened for tobacco use AND identified as a tobacco user

OR

  • G9903 – Patient screened for tobacco use AND identified as a tobacco non-user

OR

  • G9904 – Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)

Criterion #2: All patients who were identified as a tobacco user and who received tobacco cessation intervention

Definitions

  • Tobacco Cessation Intervention – Includes brief counseling (3 minutes or less) and/or pharmacotherapy.

Note: For the purpose of this measure, brief counseling (e.g., minimal and intensive advice/counseling interventions conducted both in person and over the phone) qualifies for the numerator. Written self-help materials (e.g., brochures, pamphlets) and complementary/alternative therapies do not qualify for the numerator.

Numerator Quality-Data Coding Options

  • Patient Identified as Tobacco User Received Tobacco Cessation Intervention

(Two G-codes [G9902 and G9906] are required on the claim form to submit when the action described in the numerator is performed.)

G9906 – Patient identified as a tobacco user received tobacco cessation intervention (counseling and/or pharmacotherapy)

OR

(Two G-codes [G9902 and G9907] are required on the claim form to submit documented circumstances when the action described in the numerator is not performed for medical reasons.)

G9907 – Documentation of medical reason(s) for not providing tobacco cessation intervention (e.g., limited life expectancy, other medical reason)

OR

  • Patient Identified as Tobacco User Did Not Receive Tobacco Cessation Intervention; Reason Not Given

(Two G-codes [G9902 and G9908] are required on the claim form to submit documented circumstances when the action described in the numerator is not performed and the reason is not given.)

G9908 – Patient identified as tobacco user did not receive tobacco cessation intervention (counseling and/or pharmacotherapy); reason not given

Criterion #3: All patients who were screened for tobacco use and, if identified as a tobacco user received tobacco cessation intervention, or identified as a tobacco non-user

Patients Who Were Screened for Tobacco Use at Least Once Within 24 Months AND Who Received Tobacco Cessation Intervention If Identified as a Tobacco User

 Definitions

  • Tobacco Use – Includes any type of tobacco.
  • Tobacco Cessation Intervention – Includes brief counseling (3 minutes or less) and/or pharmacotherapy.

Note: For the purpose of this measure, brief counseling (e.g., minimal and intensive advice/counseling interventions conducted both in person and over the phone) qualifies for the numerator. Written self-help materials (e.g., brochures, pamphlets) and complementary/alternative therapies do not qualify for the numerator.

Performance Met: CPT II 4004F – Patient was screened for tobacco use AND received tobacco cessation intervention (counseling and/or pharmacotherapy), if identified as a tobacco user.

OR

Patient Who Were Screened for Tobacco Use AND Who Were Identified as a Tobacco Non-User

Performance Met: CPT II 1036F: Current tobacco non-user

OR

Tobacco Screening Not Performed OR Tobacco Cessation Intervention Not Provided for Medical Reasons

(Append a modifier (1P) to CPT Category II code 4004F OR submit a G-code (G9909) to submit documented circumstances that appropriately exclude patients from the denominator.)

Denominator Exception: 4004F with 1P – Documentation of medical reason(s) for not screening for tobacco use (e.g., limited life expectancy, other medical reason)

OR

Denominator Exception: G9909 – Documentation of medical reason(s) for not providing tobacco cessation intervention if identified as a tobacco user (e.g., limited life expectancy, other medical reason)

OR

Tobacco Screening Not Performed OR Tobacco Cessation Intervention Not Provided; Reason Not Otherwise Specified

(Append a submission modifier (8P) to CPT Category II code 4004F to submit circumstances when the action described in the numerator is not performed and the reason is not otherwise specified.)

Performance Not Met: 4004F with 8P: Tobacco screening not performed OR tobacco cessation intervention not provided; reason not otherwise specified

Additional Tools and Resources

See Tobacco Use and Hearing and Balance Disorders [PDF] for assistance with patient counseling to be used for intervention.

Measure #261: Referral for Otologic Evaluation for Patients with Acute or Chronic Dizziness [PDF]

Current Measures
One referral to a physician per calendar year for a minimum of 60% of the eligible Medicare patients diagnosed with benign paroxysmal benign paroxysmal positional vertigo (BPPV) or dizziness.

Reporting Criteria
Percentage of patients aged birth and older who were referred to a physician (preferably a physician specially trained in disorders of the ear) for an otologic evaluation subsequent to an audiologic evaluation after presenting with acute or chronic dizziness.

CPT Codes
92540, 92541, 92542, 92544, 92545, 92546, 92547, 92548, 92550, 92557, 92567, 92568, 92570, 92575

ICD-10-CM Codes
R42, H81.10, H81.11, H81.12, H81.13

G-Codes

  • G8856 – Referral to a physician for otologic evaluation performed
  • G8857 – Patient is not eligible for the referral for otologic evaluation measures (e.g., patients who are already under the care of a physician for acute or chronic dizziness)

OR

  • G8858 – Referral to a physician for an otologic evaluation not performed, reason not given
Measure #318: Falls: Screening for Future Falls Risk

Note: This quality measure is reported through an electronic health record or registry and is NOT claims-based.

Measure Description
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period.

This measure should be reported a minimum of once per reporting period for patients who were screened for future fall risk at least once within the measurement period.

Denominator
All patients aged 65 years and older who were seen for a visit during the reporting period.

Denominator Exceptions
Documentation of medical reason(s) for not screening for fall risk (e.g., patient is not ambulatory).

Denominator Exclusions
None

Numerator
Patients over 65 years old who were screened for fall risk during the reporting period.

Definitions

  • Future Fall Risk – Patients are considered at risk for future falls if they have had two OR more falls in the past year OR any fall with an injury in the past year.
  • Screening for Future Fall Risk – Assessment of whether an individual has experienced a fall or has problems with gait or balance. A specific screening tool is not required for this measure; however, potential screening tools include the Morse Fall Scale and the Timed Get Up and Go Test.
  • Fall – A sudden, unintentional change in position causing an individual to land at a lower level, on an object, on the floor, or on the ground, other than as a consequence of sudden onset of paralysis, epileptic seizure, or overwhelming external force.
  • Rationale – Identification of older patients at risk for falls is vital for their health and safety. Falling is one of the most frequently occurring health issues for individuals aged 65 years or older and is a leading cause of fatal and non-fatal injuries among older persons (Schneider, Shubert, & Harmon 2010). Falls account for approximately 10% of all Emergency Department (ED) visits for the older population (Owens et al., 2006), and the number of ED visits for falls is increasing (Shankar et al., 2017). As individuals age, the rate of falls also increases (Dykes et al., 2010), with the fall rates for individuals older than age 80 years increasing to 50% (Doherty & Crossen-Sills, 2009). It is estimated that, each year, one in every four adults over the age of 65 will fall (Centers for Disease Control and Prevention, 2019). The financial costs associated with falls in the elderly are staggering. The expenses for fall-related hospitalizations are approximately $30,000 per admission (Woolcott et al., 2012). Each year, approximately $50 billion is spent on the treatment of non-fatal fall injuries, and $754 million is spent on the treatment of fatal falls (Florence et al., 2019). As important members of the health care team for older patients, audiologists can be at the forefront of identifying individuals at risk for future falls.

References

Doherty, M., & Crossen-Sills, J. (2009). Fall risk: Keep your patients in balance. The Nurse Practitioner: The American Journal of Primary Health Care, 34(12), 46–51.

Dykes, P. C., Carroll, D. L., Hurley, A., Lipsitz, S., Benoit, A., Chang, F., Meltzer, S., Tsurikova, R., Zuyov, L., & Middleton, B. (2010). Fall prevention in acute care hospitals: A randomized trial. JAMA, 304(17), 1912–1918.

Florence, C. S., Bergen, G., Atherly, A., Burns, E. R., Stevens, J. A., & Drake, C. (2018). Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society, 66(4), 693–698.

Owens, P. L., Russo, C. A., Spector, W., & Mutter, R. (2006). Emergency department visits for injurious falls among the elderly, 2006 [Healthcare Cost and Utilization Project (HCUP) Statistical Brief #80].

Schneider, E. C., Shubert, T. E., & Harmon, K. J. (2010). Addressing the escalating public health issue of falls among older adults. North Carolina Medical Journal, 71(6), 547–552.

Shankar, K. N, Ganz, D. A, & Liu, S. W. (2017). Trends and Characteristics of Emergency Department Visits for Fall-Related Injuries in Older Adults, 2003-2010. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 18(5), 785-793.  

Woolcott, J. C., Khan, K. M., Mitrovic, S., Anis, A. H., & Marra, C. A. (2012). The cost of fall related presentations to the ED: A prospective, in-person, patient-tracking analysis of health resource utilization. Osteoporosis International, 23(5),1513–1519.