Understanding Quality Measure 485-Improvement in Patient Reported Itch Severity
May 1, 2025
Understanding Quality Measure 485: Psoriasis – Improvement in Patient-Reported Itch Severity
By Kimberly Bailey
When it comes to treating psoriasis, patient comfort and quality of life are just as important as managing visible symptoms. That’s where Quality Measure 485 comes in—an essential performance metric focused on improving itch severity, one of the most disruptive symptoms reported by patients.
For medical assistants, biologic coordinators, and providers, understanding how to document and report this measure correctly is key. Below is a practical breakdown of what you need to know to meet Measure 485 successfully.
What Is Quality Measure 485?
Quality Measure 485 tracks improvement in patient-reported itch severity in individuals diagnosed with psoriasis. It’s designed to reflect the effectiveness of treatment over time based on how much the patient’s itch improves, as reported by them directly. This is one of the patient-reported outcome (PRO) measures that ties quality reporting to meaningful symptom relief.
🔹 Key Points to Remember
1. Triggering the Denominator
To enter the denominator group (the group of patients eligible for reporting under this measure), the following must occur:
The initial Numeric Itch Rating is 4 or greater
The patient must return for a follow-up visit with the same diagnosis of psoriasis within the reporting period
This ensures the patient has a qualifying baseline and a relevant follow-up timeline for monitoring change.
2. Meeting the Numerator
The measure is met when:
The patient reports a 3-point or greater reduction in their Numeric Itch Rating at a follow-up visit
This change must be documented accurately and reflects a clinically significant improvement in the patient’s itch severity.
3. Credit Attribution
Credit for the measure goes to:
The provider who documents the initial itch rating, even if another provider performs the follow-up and documents the improvement
Understanding this ensures providers are recognized for initiating and tracking patient improvement effectively.
✅ Best Practices for Documentation
📝 Document the Numeric Itch Rating at Every Visit
Whenever you note psoriasis as a diagnosis, make it standard practice to also complete the Numeric Itch Rating Scale. This consistency increases the chance of meeting the measure and ensures continuity of care.
🎯 Be Thorough at the Initial Visit
Double-check that the itch severity is documented clearly and correctly—especially if it meets the 4+ threshold. This step is essential to trigger the denominator and begin tracking the patient’s progress.
🤝 Coordinate with the Care Team
Make sure all clinicians and support staff are on the same page regarding this measure. A team-based approach increases documentation accuracy and helps avoid missed opportunities for quality reporting.
📌 Summary
To meet Quality Measure 485, keep these steps in mind:
Initial visit: Document a Numeric Itch Rating of 4 or higher
Follow-up visit: Must occur during the same reporting period with the same psoriasis diagnosis
Outcome goal: Achieve and document a 3-point or more reduction in itch severity
Credit: Goes to the provider who records the initial rating, regardless of who performs the follow-up
By aligning your documentation practices with this measure, your team contributes not only to quality metrics but also to real, tangible improvements in patient care.
For more detailed documentation instructions, consult the official Quality Measure 485 guidelines or reach out to your quality improvement team for support.
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