Patients determined as having prostate cancer who are currently starting or undergoing androgen deprivation therapy (ADT), for an anticipated period of 12 months or greater and who receive an initial bone density evaluation. The bone density evaluation must be prior to the start of ADT or within 3 months of the start of ADT.
Male patients with a qualifying encounter in the measurement period AND with a diagnosis of prostate cancer AND with an order for ADT or an active medication of ADT with an intent for treatment greater than or equal to 12 months during the measurement period
Equals Initial Population
None
Patients with a bone density evaluation within the two years prior to the start of or less than three months after the start of ADT treatment
Not Applicable
Patient refused recommendation for a bone density evaluation after the start of ADT therapy
A higher score indicates better quality
In order to capture the practitioner's intent of androgen deprivation therapy (ADT) for a period of 12 months or greater, SNOMEDCT 456381000124102 which is Injection of leuprolide acetate for twelve month period (regime/therapy) is the correct code.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center for more information on the QDM.
The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.
Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.
Patient refused the bone density evaluation at the time ordered or did not have it performed within 3 months after the start of ADT
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
Updated eCQM Version Number.
Measure Section: eCQM Version Number
Source of Change: Standards Update
Updated copyright.
Measure Section: Copyright
Source of Change: Annual Update
Updated disclaimer.
Measure Section: Disclaimer
Added definition for 'First Androgen Deprivation Therapy' for clarity.
Measure Section: Definition
Source of Change: Measure Lead
Added text to identify the Quality Data Model (QDM) version used in the measure specification.
Measure Section: Guidance
Added text to indicate whether the measure is patient-based or episode-based.
Updated guidance to include new SNOMED CT code to capture the practitioner's intent of androgen deprivation therapy (ADT) for a period of 12 months or greater. SNOMED CT code is 456381000124102, Injection of leuprolide acetate for twelve month period (regime/therapy), which replaces a HCPCS code.
Changed Numerator Exclusion Header from 'None' to 'Not Applicable' to harmonize across measures and to align with CMS MMS Blueprint requirements.
Measure Section: Numerator Exclusions
Source of Change: Expert Work Group Review
Changed the 'First Androgen Deprivation Therapy' definition logic to consider the end of the cancer diagnosis and allowed a patient with a prior prostate cancer diagnosis that ended (not likely) to be in the Initial Population.
Measure Section: Initial Population
Revised qualifying encounter definition to align with style guide. Changed definition title from 'Qualifying Encounter' to 'Has Qualifying Encounter' and embedded the exists operator into the definition, clarifying the Boolean return type.
Measure Section: Definitions
Revised numerator definition to align with the Clinical Quality Language (CQL) style guide. Changed definition title from 'Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT' to 'Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT'; embedded the exists operator into the definition; linked the First Androgen Deprivation Therapy definition to both the DEXA ordered ('Diagnostic Study, Order') and performed ('Diagnostic Study, Performed'). Change also removed the 'Bone Density Scan Ordered or Performed' definition.
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
Updated Clinical Quality Language (CQL) expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).
Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.
The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.
Value set Androgen deprivation therapy for Urology Care (2.16.840.1.113762.1.4.1151.48): Added 1 RxNorm code (571914) based on new or changed coding guidelines and deleted 1 RxNorm code (284986) based on terminology update.
Measure Section: Terminology
Value set Prostate Cancer (2.16.840.1.113883.3.526.3.319): Deleted 1 ICD-9-CM code (185). 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.
Replaced value set Male (2.16.840.1.113883.3.560.100.1) with direct reference code AdministrativeGender Code (M) to align with best practices for replacing single code value sets with direct reference codes.