High Priority Status: Yes / Outcome
CBE Number: N/A
Measure Description:
Percentage of patients aged 1 year and older who underwent a tonsillectomy and had a post-tonsillectomy hemorrhage requiring reevaluation or surgical intervention within the 21-day postoperative period.
Instructions:
This measure is to be submitted each time a patient underwent a tonsillectomy during the performance period. This measure may be submitted by clinicians based on the services provided and the measure-specific denominator coding.
Denominator:
- Patients aged 1-18 years who underwent a tonsillectomy
- Patients aged 19 years and older who underwent a tonsillectomy
- Patients aged 1-18 years old who underwent a tonsillectomy
- Patients aged 19 years and older who underwent a tonsillectomy
Denominator Exclusions:
Patients with known bleeding and/or clotting disorders
Denominator Exceptions:
None.
Numerator:
- Patients who experienced post-tonsillectomy hemorrhage that required reevaluation or surgical intervention within 1 day post-procedure (primary hemorrhage)
- Patients who experienced post-tonsillectomy hemorrhage that required reevaluation or surgical intervention within 1 day post-procedure (primary hemorrhage)
- Patients who experienced post-tonsillectomy hemorrhage that required reevaluation or surgical intervention between 2 and 21 days post-procedure (secondary hemorrhage)
- Patients who experienced post-tonsillectomy hemorrhage that required reevaluation or surgical intervention between 2 and 21 days post-procedure (secondary hemorrhage)
Numerator Note:
Day 0 is the day of surgery; Day 1 is the day after surgery
INVERSE MEASURE – A lower calculated performance rate for this measure indicates better clinical care or control. The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. Submitting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. For inverse measures, a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control.
Measure Classifications:
- Submission Pathway: Traditional MIPS
- Measure Type: Outcome
- High Priority Type: Outcome
- Care Setting(s): Ambulatory Care: Ambulatory Care: Clinician Office/Clinic; Ambulatory; Ambulatory Surgical Center; Ambulatory Care: Hospital; Hospital Outpatient; Outpatient Services; Office Based Surgery Center
- Includes Telehealth: No
- Number of Performance Rates: 1
- Inverse measure: Yes
- Continuous measure: No
- Proportional measure: Yes
- Ratio measure: No
- Risk Adjusted measure: No
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Limited proprietary coding is contained in the measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the measures for commercial gain, or incorporation of the measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial uses of the measures require a license agreement between the user and the American Academy of Otolaryngology – Head and Neck Surgery Foundation.
The measure is not a clinical guideline, does not establish a standard of medical care, and has not been tested for all potential applications. The measure and specifications are provided “as is” without warranty of any kind. Neither the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF), nor its members shall be responsible for any use of the measure. The AAO-HNSF and its members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications.
