Percentage of patients who undergo shoulder arthroscopy or shoulder arthroplasty who have an upper extremity nerve blockade performed before or immediately after the procedure.
Effective Clinical Care
HIGH PRIORITY STATUS:
This measure is to be reported each time a patient undergoes shoulder arthroscopy or shoulder arthroplasty. Eligible patients should have an upper extremity nerve block placed either before or immediately after the surgical procedure. It is anticipated that qualified anesthesia providers and eligible clinicians who provide denominator-eligible services will submit this measure.
Measure Reporting via the Qualified Clinical Data Registry
Patient demographics and CPT codes are used to identify patients who are included in the measure denominator. G-codes and Registry Codes are used to capture the numerator.
Patients who have elective shoulder arthroscopy or shoulder arthroplasty.
Denominator Criteria (Eligible Cases):
Patient encounter during the reporting period (CPT):
23470, 23472, 23473, 23474, 29805, 29806, 29807, 29819, 29820, 29821, 29822, 29823, 29824, 29825, 29826, 29827, 29828
01630, 01634, 01636, 01638
ASA Physical Status = E
Contraindication to upper extremity nerve blockade (ABG Measure Response Code 1086)
Patient or surgeon refusal (ABG Measure Response Code 1086)
Surgeon administered nerve block (ABG Measure Response Code 1087)
Patients who have an upper extremity nerve block placed before or immediately after the procedure.
Numerator Note: Upper extremity block may include any one or combination of the following:
Performance Met: Upper extremity nerve block performed (ABG Measure Response Code 1084)
Performance Not Met: Upper extremity block not performed (ABG Measure Response Code 1085)
ASA Physical Status
Date of Birth
Surgical and ASA CPT Codes
UE Block Performed
Nerve blocks have several advantages in shoulder surgery. First, nerve blocks provide better pain relief after surgery than the combination of general anesthesia and systemic pain-relieving medications such as opioids that are given after surgery. This is because pain relief provided by nerve blocks is much more specific to the location of the pain. You will also need lower doses of opioids after surgery to control your pain. Opioids have a number of side effects, which are discussed below, so minimizing their use is important. Regional anesthesia provides greater muscle relaxation than general anesthesia. You will also need less anesthesia for the surgery because your shoulder is totally numb during and after the procedure. That means that you will have less pain, your recovery will be quicker, and your rehabilitation will be easier.
If you happen to receive a block and sedation for surgery instead of receiving general anesthesia, you may avoid many of the side effects and complications associated with general anesthesia, including feeling sick to your stomach or throwing up after anesthesia, commonly known as postoperative nausea and vomiting (PONV).”