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International Prostate Symptom Score (IPSS) or American Urological Association-Symptom Index (AUA-SI) Change 6-12 Months After Diagnosis of Benign Prostatic Hyperplasia

CMS Measure ID
NQF Number
Not Applicable
Measure Description

Percentage of patients with an office visit within the measurement period and with a new diagnosis of clinically significant Benign Prostatic Hyperplasia who have International Prostate Symptoms Score (IPSS) or American Urological Association (AUA) Symptom Index (SI) documented at time of diagnosis and again 6-12 months later with an improvement of 3 points

Initial Population

Male patients with an initial diagnosis of benign prostatic hyperplasia 6 months prior to, or during the measurement period, and a urinary symptom score assessment within 1 month of initial diagnosis and a follow-up urinary symptom score assessment within 6-12 months, who had a qualifying visit during the measurement period.

Denominator Statement
Denominator Exclusions

Patients with urinary retention that starts within 1 year of initial BPH diagnosis

Patients with an initial BPH diagnosis that starts during, or within 30 days of hospitalization

Patients with a diagnosis of morbid obesity, or with a BMI Exam >40 before the follow up urinary symptom score.

Numerator Statement

Patients with a documented improvement of at least 3 points in their urinary symptom score during the measurement period

Numerator Exclusions


Denominator Exceptions


Measure Scoring
Measure Type
Improvement Notation

A meaningful improvement is a negative 3 point change in the urinary symptom score. The quality improves when a higher proportion of people meet the meaningful improvement definition.


The IPSS is inclusive of the symptom index score and the quality of life score. The AUA-SI is the symptom index score alone and must be added to the QOL score. The AUA-SI with the QOL equals the IPSS. Both of these are the urinary symptom score.

The patient must have a urinary symptom score (USS) within 1 month after initial diagnosis. If more than one USS in the initial one month, then the first USS counts. The patient must have a USS again at 6-12 months after the initial diagnosis and if more than one USS in this time frame, then the last USS counts.

Hospitalization within 30 days of Initial BPH Diagnosis refers to a 30 day period between the end of the hospitalization and the clinical office setting BPH diagnosis. This is due to aggravating factors from hospitalization, such as bed rest, medications, surgery, and altered body functions.

Quality ID
Meaningful Measure


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Last Updated: Nov 13, 2019