Projects: N²QOD
Qualified Clinical Data Registry Reporting

The Quality Outcomes Database (QOD) has been approved as a 2017 CMS-Approved Qualified Clinical Data Registry (QCDR) for the Merit-Based Incentive Program (MIPS) 2017 reporting year.

The QOD Surgical QCDR reporting mechanism provides participating registry eligible professionals (EPs) with a method to satisfy MIPS requirements under the Quality category and avoid associated penalties by reporting on a more meaningful set of non-MIPS measures developed by the profession. The QOD can serve as a tool to assist EPs with meeting the following QCDR reporting requirements:

  1. Report at least six measures for at least 50 percent of the EPs applicable patients seen during the 2017 participation period.
  2. Report on at least one outcome measure.

The QOD Surgical Spine QCDR offers sixteen unique, surgical spine non-MIPS measures that have been approved by the Centers for Medicare & Medicaid Services (CMS) and from which an EP can choose to report for purposes of satisfying the Quality portion of MIPS. These measures, focused on surgical spine care, were the first specialty-specific measures developed by the profession for purposes of satisfying federal quality reporting mandates. The list of Surgical Spine Care measures available through the QOD for 2017 MIPS reporting are listed below:

QOD Surgical Spine Non-PQRS Measures:

Measure ID

Measure Title

NPA 3

Functional Outcome Assessment for Spine Intervention

NPA 4

Quality of Life Assessment for Spine Intervention

NPA 5

Patient Satisfaction with Spine Care

NPA 6

Spine‐related procedure Site Infection

NPA 7

Complication Following Spine‐related Procedure

NPA 9

Referral for post‐acute Care Rehabilitation

NPA 10

Unplanned Reoperation Following Spine Procedure Within the 30-day Post‐Operative Period

NPA 11

Unplanned Readmission Following Spine Procedure Within the 30-day Post‐Operative Period

NPA 14

Medicine Reconciliation Following Spine Related Procedure

NPA 15

Risk–assessment for Elective Spine Procedure

NPA 16

Depression and Anxiety Assessment Prior to Spine‐Related Therapies

NPA 17

Narcotic Pain Medicine Management Following Elective Spine Procedure

NPA 18

Smoking Assessment and Cessation Coincident with Spine-related Therapies

NPA 19

Body Mass Assessment and Follow‐up Coincident with Spine-related Therapies

NPA 20

Unhealthy Alcohol Use Assessment Coincident With Spine Care

NPA 22

Spine/Extremity Pain Assessment


The complete list of surgical spine measures and specifications can be found here: QOD Surgical Spine Non-MIPS Measure Specification.

The QOD QCDR is open to all participating QOD registry physicians. EPs interested in participating in the QOD QCDR who are not currently participating in the QOD registry can enroll by completing the steps for QOD participation at: http://www.neuropoint.org/NPA%20N2QOD%20Participation.html.

The Merit-Based Incentive Payment System (MIPS) is a payment track under the new Quality Payment Program (QPP) under MACRA (Medicare Access and CHIP Re-Authorization Act) that combines requirements that were previously included in the Physician Quality Reporting System (PQRS), the Medicare EHR Incentive Program (Meaningful Use), and Value-Based Payment Modifier (VBM) programs.

In 2017, EPs who do not satisfactorily participate in the QPP will be subject to a 4.0% payment adjustment in their 2019 Medicare payments.  The QOD QCDR will provide EPs with a method for reporting data for MIPS under the Quality Category.  To learn more about the QPP and MIPS reporting options and requirements, visit: https://qpp.cms.gov.

Please contact the NPA at info@neuropoint.org, tel: 847-378-0549, with questions or for more information on the QOD and QOD QCDR.