Oncology: Medical and Radiation - Pain Intensity Quantified
Measure Information | 2021 Performance Period |
---|---|
CMS eCQM ID | CMS157v9 |
NQF Number | 0384e |
MIPS Quality ID | 143 |
Description |
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified |
Initial Population |
All patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy |
Numerator |
Patient visits in which pain intensity is quantified |
Numerator Exclusions |
Not Applicable |
Denominator |
Equals Initial Population |
Denominator Exclusions |
None |
Denominator Exceptions |
None |
Steward | PCPI(R) Foundation (PCPI[R]) |
Measure Scoring | Proportion measure |
Measure Type | Process measure |
Improvement Notation |
Higher score indicates better quality |
Guidance |
This eCQM is an episode-of-care measure; the level of analysis for this measure is every visit for patients with a diagnosis of cancer who are also currently receiving chemotherapy or radiation therapy during the measurement period. For patients receiving radiation therapy, pain intensity should be quantified at each radiation treatment management encounter where the patient and physician have a face-to-face interaction. Due to the nature of some applicable coding related to radiation therapy (e.g., delivered in multiple fractions), the billing date for certain codes may or may not be the same as the face-to-face encounter date. In this instance, for the reporting purposes of this measure, the billing date should be used to pull the appropriate patients into the initial population. It is expected, though, that the numerator criteria would be performed at the time of the actual face-to-face encounter during the series of treatments. A lookback (retrospective) period of 7 days, including the billing date, may be used to identify the actual face-to-face encounter, which is required to assess the numerator. Therefore, pain intensity should be quantified during the face-to-face encounter occurring on the actual billing date or within the 6 days prior to the billing date. For patients receiving chemotherapy, pain intensity should be quantified at each face-to-face encounter with the physician while the patient is currently receiving chemotherapy. For purposes of identifying eligible encounters, patients "currently receiving chemotherapy" refers to patients administered chemotherapy within 30 days prior to the encounter AND administered chemotherapy within 30 days after the date of the encounter. Pain intensity should be quantified using a standard instrument, such as a 0-10 numerical rating scale, visual analog scale, a categorical scale, or pictorial scale. Examples include the Faces Pain Rating Scale and the Brief Pain Inventory (BPI). This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM. |
Telehealth Eligible | Yes |
Next Version | |
Previous Version | No Version Available |
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Measure Information | 2021 Performance Period | 2022 Performance Period | 2023 Performance Period | 2024 Performance Period |
---|---|---|---|---|
Title | Oncology: Medical and Radiation - Pain Intensity Quantified | Oncology: Medical and Radiation - Pain Intensity Quantified | Oncology: Medical and Radiation - Pain Intensity Quantified | Oncology: Medical and Radiation - Pain Intensity Quantified |
CMS eCQM ID | CMS157v9 | CMS157v10 | CMS157v11 | CMS157v12 |
NQF Number | 0384e | 0384e | 0384e | 0384e |
Description |
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified |
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified |
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified |
Percentage of patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which pain intensity is quantified |
Initial Population |
All patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy |
All patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy |
All patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy |
All patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy |
Denominator |
Equals Initial Population |
Equals Initial Population |
Equals Initial Population |
Equals Initial Population |
Denominator Exclusions | None | None | None | None |
Numerator |
Patient visits in which pain intensity is quantified |
Patient visits in which pain intensity is quantified |
Patient visits in which pain intensity is quantified |
Patient visits in which pain intensity is quantified |
Numerator Exclusions |
Not Applicable |
Not Applicable |
Not Applicable |
Not Applicable |
Denominator Exceptions |
None |
None |
None |
None |
Measure Steward | PCPI(R) Foundation (PCPI[R]) | American Society of Clinical Oncology | American Society of Clinical Oncology | American Society of Clinical Oncology |
Measure Scoring | Proportion measure | Proportion measure | Proportion measure | Proportion measure |
Measure Type | Process measure | Process measure | Process measure | Process measure |
Improvement Notation |
Higher score indicates better quality |
Higher score indicates better quality |
Higher score indicates better quality |
Higher score indicates better quality |
Guidance |
This eCQM is an episode-of-care measure; the level of analysis for this measure is every visit for patients with a diagnosis of cancer who are also currently receiving chemotherapy or radiation therapy during the measurement period. For patients receiving radiation therapy, pain intensity should be quantified at each radiation treatment management encounter where the patient and physician have a face-to-face interaction. Due to the nature of some applicable coding related to radiation therapy (e.g., delivered in multiple fractions), the billing date for certain codes may or may not be the same as the face-to-face encounter date. In this instance, for the reporting purposes of this measure, the billing date should be used to pull the appropriate patients into the initial population. It is expected, though, that the numerator criteria would be performed at the time of the actual face-to-face encounter during the series of treatments. A lookback (retrospective) period of 7 days, including the billing date, may be used to identify the actual face-to-face encounter, which is required to assess the numerator. Therefore, pain intensity should be quantified during the face-to-face encounter occurring on the actual billing date or within the 6 days prior to the billing date. For patients receiving chemotherapy, pain intensity should be quantified at each face-to-face encounter with the physician while the patient is currently receiving chemotherapy. For purposes of identifying eligible encounters, patients "currently receiving chemotherapy" refers to patients administered chemotherapy within 30 days prior to the encounter AND administered chemotherapy within 30 days after the date of the encounter. Pain intensity should be quantified using a standard instrument, such as a 0-10 numerical rating scale, visual analog scale, a categorical scale, or pictorial scale. Examples include the Faces Pain Rating Scale and the Brief Pain Inventory (BPI). This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM. |
This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients with a diagnosis of cancer who are also currently receiving chemotherapy or radiation therapy during the measurement period. For patients receiving radiation therapy, pain intensity should be quantified at each radiation treatment management encounter where the patient and physician have a face-to-face or telehealth interaction. Due to the nature of some applicable coding related to radiation therapy (e.g., delivered in multiple fractions), the billing date for certain codes may or may not be the same as the face-to-face or telehealth encounter date. In this instance, for the reporting purposes of this measure, the billing date should be used to pull the appropriate patients into the initial population. It is expected, though, that the numerator criteria would be performed at the time of the actual face-to-face or telehealth encounter during the series of treatments. A lookback (retrospective) period of 7 days, including the billing date, may be used to identify the actual face-to-face or telehealth encounter, which is required to assess the numerator. Therefore, pain intensity should be quantified during the face-to-face or telehealth encounter occurring on the actual billing date or within the 6 days prior to the billing date. For patients receiving chemotherapy, pain intensity should be quantified at each face-to-face or telehealth encounter with the physician while the patient is currently receiving chemotherapy. For purposes of identifying eligible encounters, patients "currently receiving chemotherapy" refers to patients administered chemotherapy on the same day as the encounter or during the 30 days before the date of the encounter AND during the 30 days after the date of the encounter. Pain intensity should be quantified using a standard instrument, such as a 0-10 numerical rating scale, visual analog scale, a categorical scale, or pictorial scale. Examples include the Faces Pain Rating Scale and the Brief Pain Inventory (BPI). This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM. |
This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients with a diagnosis of cancer who are also currently receiving chemotherapy or radiation therapy during the measurement period. For patients receiving radiation therapy, pain intensity should be quantified at each radiation treatment management encounter where the patient and physician have a face-to-face or telehealth interaction. Due to the nature of some applicable coding related to radiation therapy (e.g., delivered in multiple fractions), the billing date for certain codes may or may not be the same as the face-to-face or telehealth encounter date. In this instance, for the reporting purposes of this measure, the billing date should be used to pull the appropriate patients into the initial population. It is expected, though, that the numerator criteria would be performed at the time of the actual face-to-face or telehealth encounter during the series of treatments. A lookback (retrospective) period of 7 days, including the billing date, may be used to identify the actual face-to-face or telehealth encounter, which is required to assess the numerator. Therefore, pain intensity should be quantified during the face-to-face or telehealth encounter occurring on the actual billing date or within the 6 days prior to the billing date. For patients receiving chemotherapy, pain intensity should be quantified at each face-to-face or telehealth encounter with the physician while the patient is currently receiving chemotherapy. For purposes of identifying eligible encounters, patients "currently receiving chemotherapy" refers to patients administered chemotherapy on the same day as the encounter or during the 30 days before the date of the encounter AND during the 30 days after the date of the encounter. Pain intensity should be quantified using a standard instrument, such as a 0-10 numerical rating scale, visual analog scale, a categorical scale, or pictorial scale. Examples include the Faces Pain Rating Scale and the Brief Pain Inventory (BPI). This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
This eCQM is an episode-based measure. An episode is defined as each eligible encounter for patients with a diagnosis of cancer who are also currently receiving chemotherapy or radiation therapy during the measurement period. For patients receiving radiation therapy, pain intensity should be quantified at each radiation treatment management encounter where the patient and physician have a face-to-face or telehealth interaction. Due to the nature of some applicable coding related to radiation therapy (e.g., delivered in multiple fractions), the billing date for certain codes may or may not be the same as the face-to-face or telehealth encounter date. In this instance, for the reporting purposes of this measure, the billing date should be used to pull the appropriate patients into the initial population. It is expected, though, that the numerator criteria would be performed at the time of the actual face-to-face or telehealth encounter during the series of treatments. A lookback (retrospective) period of 7 days, including the billing date, may be used to identify the actual face-to-face or telehealth encounter, which is required to assess the numerator. Therefore, pain intensity should be quantified during the face-to-face or telehealth encounter occurring on the actual billing date or within the 6 days prior to the billing date. For patients receiving chemotherapy, pain intensity should be quantified at each face-to-face or telehealth encounter with the physician while the patient is currently receiving chemotherapy. For purposes of identifying eligible encounters, patients "currently receiving chemotherapy" refers to patients administered chemotherapy on the same day as the encounter or during the 30 days before the date of the encounter AND during the 30 days after the date of the encounter. Pain intensity should be quantified using a standard instrument, such as a 0-10 numerical rating scale, visual analog scale, a categorical scale, or pictorial scale. Examples include the Faces Pain Rating Scale and the Brief Pain Inventory (BPI). This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM. |
MIPS Quality ID | 143 | 143 | 143 | 143 |
Telehealth Eligible | Yes | Yes | Yes | Yes |
Next Version | CMS157v10 | CMS157v11 | CMS157v12 | No Version Available |
Previous Version | No Version Available | |||
Notes |
Data Element Repository
Header
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Updated eCQM Version Number.
Measure Section: eCQM Version Number
Source of Change: Standards Update
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Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
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Updated disclaimer.
Measure Section: Disclaimer
Source of Change: Standards Update
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Updated rationale to align with most recent National Quality Forum (NQF) submission.
Measure Section: Rationale
Source of Change: Measure Lead
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Updated clinical recommendation statements to align with updated guidelines and most recent NQF submission.
Measure Section: Clinical Recommendation Statement
Source of Change: Measure Lead
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Updated references to align with updated guidelines and most recent NQF submission.
Measure Section: Reference
Source of Change: Measure Lead
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Added guidance related to the lookback period for the face-to-face encounter for CPT 77427 to clarify reporting expectations in instances where the encounter date is not the same as the billing date.
Measure Section: Guidance
Source of Change: Measure Lead
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Added text to identify the Quality Data Model (QDM) version used in the measure specification.
Measure Section: Guidance
Source of Change: Standards Update
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Added text to indicate whether the measure is patient-based or episode-based.
Measure Section: Guidance
Source of Change: Standards Update
Logic
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Added a Clinical Quality Language (CQL) definition 'Chemotherapy Within 31 days Prior and After Measurement Period' to apply an initial filter for the chemotherapy procedures to reduce implementation system burden.
Measure Section: Definitions
Source of Change: ONC Project Tracking System (Jira): CQM-3600
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QDM v5.5 standards update: Added 'relevantDatetime' attribute to QDM datatypes. 'RelevantDatetime' indicates when the action occurred whereas 'authorDatetime' indicates when the action was recorded.
Measure Section: Multiple Sections
Source of Change: Standards Update
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Revised CQL definition construction to reduce the overall complexity of the measure logic without changing the intent and/or application of data element. These revisions were intended to make the definition logic less complex, easier to understand, and more meaningful.
Measure Section: Multiple Sections
Source of Change: Measure Lead
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Updated CQL expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).
Measure Section: Multiple Sections
Source of Change: Standards Update
Value Set
The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.
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Value set Cancer (2.16.840.1.113883.3.526.3.1010): Deleted 796 ICD-9-CM codes. Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant. Added 3 SNOMED CT codes (709031009, 725049005, 773995001) based on terminology update.
Measure Section: Terminology
Source of Change: Annual Update
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Removed ICD-9-CM extensional value sets from applicable Groupings due to ICD-9-CM no longer being maintained and the measure not requiring historical lookback period.
Measure Section: Terminology
Source of Change: Measure Lead
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Value set Chemotherapy Administration (2.16.840.1.113883.3.526.3.1027): Deleted 1 CPT code (96402) based upon feedback that this code is used for administration of other agents and is not limited to chemotherapy.
Measure Section: Terminology
Source of Change: Measure Lead