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As part of their initiative to publically report and eventually pair reimbursement with specific quality and efficiency measures, the Centers for Medicare and Medicaid Services (CMS) developed an efficiency measure to evaluate use of brain computed tomography (CT) for emergency department (ED) patients who present with atraumatic headache. The measure (CMS OP-15) uses administrative billing data for patients with a final diagnosis of nonspecific headache. A CT scan is not included in the calculation (i.e., considered appropriate) if the patient has any of the following exclusions, which were derived based on guideline review and expert opinion: headache associated with lumbar puncture, dizziness, paresthesia, lack of coordination, subarachn…