CQM Measure CMS130v5 Colorectal Cancer Screening

CQM Measure CMS130v5 Colorectal Cancer Screening

NQS Domain: Clinical Process/Effectiveness

Description: Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer.

Denominator Logic

Patient was >= 50 years old on or before the start of measurement period.


AND Patient was < 75 years old on or before the start of measurement period.


AND Patient had one or more appointment scheduled during measurement period, with CPT code in [99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397] or HCPCS code in [G0438, G0439] entered.

Denominator Exclusion Logic

OR Patient had Patient Problem Malignant Neoplasm of Colon (CQM ValueSet: 2.16.840.1.113883.3.464.1003.108.12.1001) started before end of measurement period

OR Patient had appointment scheduled before end of measurement period with Procedure Total Colectomy (CQM ValueSet: 2.16.840.1.113883.3.464.1003.198.12.1019) entered.

Numerator Logic

OR Patient had appointment scheduled <= 9 years before or during measurement period, with Procedure Colonoscopy (CQM ValueSet: 2.16.840.1.113883.3.464.1003.108.12.1020) entered.

OR Patient had one or more appointment scheduled <= 4 years before or during measurement period, with Procedure Flexible Sigmoidoscopy (CQM ValueSet: 2.16.840.1.113883.3.464.1003.198.12.1010) entered.

OR Patient had lab result Fecal Occult Blood Test (FOBT) (CQM ValueSet:2.16.840.1.113883.3.464.1003.198.12.1011) recorded during measurement period.

 

For more information, please visit the CMS website here.

How To (Website)

Step 1: Ensure that the patient had one or more appointment scheduled during the measurement period with one of the above CPT or HCPCS codes (indicated in the denominator/numerator fields) entered, or has had a lab ordered as specified in the numerator section above.

Here is a screen shot of the lab order area of the drchrono application:

Step 2: If the results of the order are FecalOccultBloodTest(FOBT) it should be entered in the “Lab result value” field and the “Lab order status” value should be flagged as “Results Received” to report the data for the measure.

 

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