Calculation of Outpatient Imaging Efficiency Measures (OP-8 through OP-11)









The four outpatient imaging efficiency measures (OP-8 through OP-11) are produced from Medicare administrative claims for the fee-for-service population and no additional data submission is required by hospitals. The OIE measures are not risk adjusted; they are calculated as raw/observed rates after the exclusion and inclusion criteria are applied.

The purpose of these measures is to promote high-quality efficient care. Specifically, each of the following measures was created to reduce unnecessary exposure to contrast materials and /or radiation, ensure adherence to evidence-based medicine and practice guidelines, and promote efficiency defined as "absence of waste".



OP-8: MRI Lumbar Spine for Low Back Pain (NQF Endorsed, October 2008) This measure calculates the percentage of patients who had an MRI of the Lumbar Spine with a diagnosis of low back pain without Medicare claims-based evidence of antecedent conservative therapy.



OP-9: Mammography Follow-up Rates (Not NQF Endorsed at this time) This measure calculates the percentage of patients with mammography screening studies done in the outpatient hospital setting that are followed within 45 days by a diagnostic mammography or ultrasound of the breast study in an outpatient or office setting.



OP-10: Abdomen CT –Use of Contrast Material (Not NQF Endorsed at this time) This measure calculates the ratio of CT abdomen studies that are performed both with/without contrast out of all CT abdomen studies performed (those with contrast, those without contrast, and those with both).



OP-11: Thorax CT –Use of Contrast Material (NQF Endorsed, October 2008) This measure calculates the ratio of CT thorax studies that are performed with and without contrast out of all CT thorax studies performed (those with contrast, those without contrast, and those with both).



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