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Use of Imaging Studies for Low Back Pain

The percentage of patients with a primary diagnosis of low back pain who did not have an imaging study (plain X-ray, MRI, CT scan) within 28 days of diagnosis

Date Reviewed: May 11, 2023
Support
    Health Plan

Measure Info

CMIT ID 5813 CBE 0052
Measure Type
Process
Measure Steward
National Committee for Quality Assurance
Clinical Topic Area
Pain Assessment and Management
Care Setting
Outpatient
Data Source
Claims

The clinical impact of this performance measure is high because low back pain affects 75 to 85 percent of adults at some time in their lives. In 2019, 39 percent of adults experienced back pain in the United States. This performance measure assesses the overuse of imaging studies (plain x-ray, magnetic resonance imaging, and computed tomography scans) in adults with acute, uncomplicated low back pain. In 2021, the performance rates varied between 74-78 percent depending on plan type, indicating a performance gap. This performance measure is evidence-based and follows clinical guidance to reduce unnecessary imaging and promote high-value care. The PMC believes implementation will likely reduce unnecessary imaging in patients with uncomplicated low back pain and related harms.