(2024) Electronic Clinical Quality Measures
Description:
Percentage of adults 45-75 years of age who had appropriate screening for colorectal cancer.
Guidance:
Do not count digital rectal exams (DRE), fecal occult blood tests (FOBTs) performed in an office setting or performed on a sample collected via DRE. Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria.
This eCQM is a patient-based measure.
Initial Population:
Patients 45-75 years of age by the end of the measurement period with a visit during the measurement period.
Date of birth information can be entered in DrChrono in the patient chart under the Demographics tab with the Patient's Date of Birth.
With A Visit During the Measurement Period
CPT Codes:
99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99429, 99455, 99456, 99483,
HCPCS Codes:
G0162, G0299, G0300, G0402, G0438, G0439, G0463, G0493, G0494, S0271, S0311, S9123, S9124, T1000, T1001, T1002, T1003, T1004, T1005, T1015, T1019, T1020, T1021, T1022, T1030, T1031
CPT and HCPCS codes can be entered into the billing section for the encounter. Below is an example from the appointment window.
Denominator
Equals initial population.
Denominator Exclusions
Exclude patients who are in hospice care for any part of the measurement period.
Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer.
Exclude patients 66 and older by the end of the measurement period who are living long-term in a nursing home any time on or before the end of during the measurement period.
Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
- Advanced illness with two outpatient encounters during the measurement period or the year prior
- OR advanced illness with one inpatient encounter during the measurement period or the year prior
- OR taking dementia medications during the measurement period or the year prior
Exclude patients receiving palliative care for any part of the measurement period.
Denominator Exceptions
None
Numerator
Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria:
- Fecal occult blood test (FOBT) during the measurement period
- Stool DNA (sDNA) with during the measurement period or the two years prior to the measurement period- Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period
- CT Colonography during the measurement period or the four years prior to the measurement period
- Colonoscopy during the measurement period or the nine years prior to the measurement period
Codes for the screenings can be entered in the billing areas (CPT/HCPCS).
LOINC codes can be entered in the lab orders section of the patient's chart.
Fecal occult blood test (FOBT) during the measurement period LOINC Codes
12503-9 - Hemoglobin.gastrointestinal [Presence] in Stool --4th specimen
12504-7 - Hemoglobin.gastrointestinal [Presence] in Stool --5th specimen
14563-1 - Hemoglobin.gastrointestinal [Presence] in Stool --1st specimen
14564-9 - Hemoglobin.gastrointestinal [Presence] in Stool --2nd specimen
14565-6 - Hemoglobin.gastrointestinal [Presence] in Stool --3rd specimen
2335-8 - Hemoglobin.gastrointestinal [Presence] in Stool
27396-1 - Hemoglobin.gastrointestinal [Mass/mass] in Stool
27401-9 - Hemoglobin.gastrointestinal [Presence] in Stool --6th specimen
27925-7 - Hemoglobin.gastrointestinal [Presence] in Stool --7th specimen
27926-5 - Hemoglobin.gastrointestinal [Presence] in Stool --8th specimen
29771-3 - Hemoglobin.gastrointestinal.lower [Presence] in Stool by Immunoassay
56490-6 - Hemoglobin.gastrointestinal.lower [Presence] in Stool by Immunoassay --2nd specimen
56491-4 - Hemoglobin.gastrointestinal.lower [Presence] in Stool by Immunoassay --3rd specimen
57905-2 - Hemoglobin.gastrointestinal.lower [Presence] in Stool by Immunoassay --1st specimen
58453-2 - Hemoglobin.gastrointestinal.lower [Mass/volume] in Stool by Immunoassay
80372-6 - Hemoglobin.gastrointestinal [Presence] in Stool by Rapid immunoassay
FIT-DNA during the measurement period or the two years prior to the measurement period LOINC Codes
77353-1 - Noninvasive colorectal cancer DNA and occult blood screening [Interpretation] in Stool Narrative
77354-9 - Noninvasive colorectal cancer DNA and occult blood screening [Presence] in Stool
Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period CPT and HCPCS Codes:
44397 - Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)
45339 - Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
45345 - Sigmoidoscopy, flexible; with transendoscopic stent placement (includes predilation)
45330 - Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
45331 - Sigmoidoscopy, flexible; with biopsy, single or multiple
45332 - Sigmoidoscopy, flexible; with removal of foreign body(s)
45333 - Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
45334 - Sigmoidoscopy, flexible; with control of bleeding, any method
45335 - Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance
45337 - Sigmoidoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed
45338 - Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
45340 - Sigmoidoscopy, flexible; with transendoscopic balloon dilation
45341 - Sigmoidoscopy, flexible; with endoscopic ultrasound examination
45342 - Sigmoidoscopy, flexible; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s)
45346 - Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
45347 - Sigmoidoscopy, flexible; with placement of endoscopic stent (includes pre-and post-dilation and guide wire passage, when performed)
45349 - Sigmoidoscopy, flexible; with endoscopic mucosal resection
45350 - Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)
G0104 - Colorectal cancer screening; flexible sigmoidoscopy
CT Colonography during the measurement period or the four years prior to the measurement period LOINC Codes
60515-4 - CT Colon and Rectum W air contrast PR
72531-70 - CT Colon and Rectum W contrast IV and W air contrast PR
79069-1 - CT Colon and Rectum for screening WO contrast IV and W air contrast PR
79071-7 - CT Colon and Rectum WO contrast IV and W air contrast PR
79101-2 - CT Colon and Rectum for screening W air contrast PR
82688-3 - CT Colon and Rectum WO and W contrast IV and W air contrast PR
Colonoscopy during the measurement period or the nine years prior to the measurement period CPT and HCPCS Codes:
44397 - Colonoscopy through stoma; with transendoscopic stent placement (includes predilation)
45355 - Colonoscopy, rigid or flexible, transabdominal via colotomy, single or multiple
45383 - Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
45387 - Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent placement (includes predilation)
44388 - Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
44389 - Colonoscopy through stoma; with biopsy, single or multiple
44390 - Colonoscopy through stoma; with removal of foreign body(s)
44391 - Colonoscopy through stoma; with control of bleeding, any method
44392 - Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
44393 - Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
44394 - Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
44401 - Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre-and post-dilation and guide wire passage, when performed)
44402 - Colonoscopy through stoma; with endoscopic stent placement (including pre- and post-dilation and guide wire passage, when performed)
44403 - Colonoscopy through stoma; with endoscopic mucosal resection
44404 - Colonoscopy through stoma; with directed submucosal injection(s), any substance
44405 - Colonoscopy through stoma; with transendoscopic balloon dilation
44406 - Colonoscopy through stoma; with endoscopic ultrasound examination, limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures
44407 - Colonoscopy through stoma; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures
44408 - Colonoscopy through stoma; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed
45378 - Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)
45379 - Colonoscopy, flexible; with removal of foreign body(s)
45380 - Colonoscopy, flexible; with biopsy, single or multiple
45381 - Colonoscopy, flexible; with directed submucosal injection(s), any substance
45382 - Colonoscopy, flexible; with control of bleeding, any method
45384 - Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps
45385 - Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique
45386 - Colonoscopy, flexible; with transendoscopic balloon dilation
45388 - Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
45389 - Colonoscopy, flexible; with endoscopic stent placement (includes pre- and post-dilation and guide wire passage, when performed)
45390 - Colonoscopy, flexible; with endoscopic mucosal resection
45391 - Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures
45392 - Colonoscopy, flexible; with transendoscopic ultrasound guided intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures
45393 - Colonoscopy, flexible; with decompression (for pathologic distention) (eg, volvulus, megacolon), including placement of decompression tube, when performed
45398 - Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)
G0105 - Colorectal cancer screening; colonoscopy on individual at high risk
G0121 - Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk
Numerator Exclusions
Not applicable