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Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients

Measure Information 2023 Performance Period
CMS Measure ID CMS129v12
NQF Number 0389e
Measure Description

Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy who did not have a bone scan performed at any time since diagnosis of prostate cancer

Initial Population

All patients, regardless of age, with a diagnosis of prostate cancer

Denominator Statement

Equals Initial Population at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy

Denominator Exclusions

None

Numerator Statement

Patients who did not have a bone scan performed at any time since diagnosis of prostate cancer

Numerator Exclusions

Not Applicable

Denominator Exceptions

Documentation of reason(s) for performing a bone scan (including documented pain, salvage therapy, other medical reasons, or bone scan ordered by someone other than reporting clinician)

Measure Steward Centers for Medicare & Medicaid Services (CMS)
Quality Domain Efficiency and Cost Reduction
Measure Scoring Proportion measure
Measure Type Process measure
Improvement Notation

Higher score indicates better quality

Guidance

A higher score indicates appropriate treatment of patients with prostate cancer at low (or very low) risk of recurrence. Only patients with prostate cancer with low (or very low) risk of recurrence will be counted in the performance denominator of this measure.

This eCQM is a patient-based measure.

Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes.

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 102
Meaningful Measure Appropriate Use of Healthcare
Telehealth Eligible No
Next Version No Version Available
Previous Version

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Measure Information 2021 Performance Period 2022 Performance Period 2023 Performance Period
CMS Measure ID CMS129v10 CMS129v11 CMS129v12
NQF Number 0389e 0389e 0389e
Measure Description

Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy who did not have a bone scan performed at any time since diagnosis of prostate cancer

Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy who did not have a bone scan performed at any time since diagnosis of prostate cancer

Percentage of patients, regardless of age, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy who did not have a bone scan performed at any time since diagnosis of prostate cancer

Initial Population

All patients, regardless of age, with a diagnosis of prostate cancer

All patients, regardless of age, with a diagnosis of prostate cancer

All patients, regardless of age, with a diagnosis of prostate cancer

Denominator Statement

Equals Initial Population at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy

Equals Initial Population at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy

Equals Initial Population at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy

Denominator Exclusions None None None
Numerator Statement

Patients who did not have a bone scan performed at any time since diagnosis of prostate cancer

Patients who did not have a bone scan performed at any time since diagnosis of prostate cancer

Patients who did not have a bone scan performed at any time since diagnosis of prostate cancer

Numerator Exclusions

Not Applicable

Not Applicable

Not Applicable

Denominator Exceptions

Documentation of reason(s) for performing a bone scan (including documented pain, salvage therapy, other medical reasons, bone scan ordered by someone other than reporting physician)

Documentation of reason(s) for performing a bone scan (including documented pain, salvage therapy, other medical reasons, or bone scan ordered by someone other than reporting clinician)

Documentation of reason(s) for performing a bone scan (including documented pain, salvage therapy, other medical reasons, or bone scan ordered by someone other than reporting clinician)

Measure Steward PCPI(R) Foundation (PCPI[R]) Centers for Medicare & Medicaid Services (CMS) Centers for Medicare & Medicaid Services (CMS)
Quality Domain Efficiency and Cost Reduction Efficiency and Cost Reduction Efficiency and Cost Reduction
Measure Scoring Proportion measure Proportion measure Proportion measure
Measure Type Process measure Process measure Process measure
Improvement Notation

Higher score indicates better quality

Higher score indicates better quality

Higher score indicates better quality

Guidance

A higher score indicates appropriate treatment of patients with prostate cancer at low (or very low) risk of recurrence. Only patients with prostate cancer with low (or very low) risk of recurrence will be counted in the performance denominator of this measure.

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.

A higher score indicates appropriate treatment of patients with prostate cancer at low (or very low) risk of recurrence. Only patients with prostate cancer with low (or very low) risk of recurrence will be counted in the performance denominator of this measure.

This eCQM is a patient-based measure.

Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes.

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.

A higher score indicates appropriate treatment of patients with prostate cancer at low (or very low) risk of recurrence. Only patients with prostate cancer with low (or very low) risk of recurrence will be counted in the performance denominator of this measure.

This eCQM is a patient-based measure.

Telehealth encounters are not eligible for this measure because the measure does not contain telehealth-eligible codes.

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 102 102 102
Meaningful Measure Appropriate Use of Healthcare Appropriate Use of Healthcare Appropriate Use of Healthcare
Telehealth Eligible No No No
Next Version CMS129v11 CMS129v12 No Version Available
Previous Version No Version Available

Release Notes

Header

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated version number of the Quality Data Model (QDM) used in the measure specification to v5.6.

    Measure Section: Guidance

    Source of Change: Standards/Technical Update

Logic

  • Replaced direct reference code SNOMED CT code (258232002) with direct reference code SNOMED CT code (254292007) based on terminology updates and review by technical experts, SMEs, and/or public feedback.

    Measure Section: Denominator

    Source of Change: Annual Update

  • Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v7.0.000.

    Measure Section: Multiple Sections

    Source of Change: Standards/Technical Update

  • Updated the version of the Quality Data Model (QDM) to 5.6 and Clinical Quality Language (CQL) to 1.5.

    Measure Section: Multiple Sections

    Source of Change: Standards/Technical 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.

  • Replaced direct reference code SNOMED CT code (258232002) with direct reference code SNOMED CT code (254292007) based on terminology updates and review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Annual Update

Last Updated: May 04, 2022