Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy

Measure Information	2023 Performance Period
CMS eCQM ID	CMS645v6
NQF Number	Not Applicable
MIPS Quality ID	462
Description	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.
Initial Population	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
Numerator	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
Numerator Exclusions	Not Applicable
Denominator	Equals Initial Population
Denominator Exclusions	None
Denominator Exceptions	Patient refused the bone density evaluation at the time ordered or did not have it performed within 3 months after the start of ADT
Steward	Oregon Urology
Measure Scoring	Proportion measure
Measure Type	Process measure
Improvement Notation	A higher score indicates better quality
Guidance	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 5.6. Please refer to the QDM page for more information on the QDM.
Telehealth Eligible	Yes
Next Version	CMS645v7
Previous Version	CMS645v5

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Measure Information	2021 Performance Period	2022 Performance Period	2023 Performance Period	2024 Performance Period
Title	Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy	Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy	Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy	Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy
CMS eCQM ID	CMS645v4	CMS645v5	CMS645v6	CMS645v7
NQF Number	Not Applicable	Not Applicable	Not Applicable	Not Applicable
Description	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.	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.	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.	Percentage of 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.
Initial Population	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	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	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	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
Denominator	Equals Initial Population	Equals Initial Population	Equals Initial Population	Equals Initial Population
Denominator Exclusions	None	None	None	None
Numerator	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	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	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	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
Numerator Exclusions	Not Applicable	Not Applicable	Not Applicable	Not Applicable
Denominator Exceptions	Patient refused recommendation for a bone density evaluation after the start of ADT therapy	Patient refused recommendation for a bone density evaluation after the start of ADT therapy	Patient refused the bone density evaluation at the time ordered or did not have it performed within 3 months after the start of ADT	Patient refused the bone density evaluation at the time ordered or did not have it performed within 3 months after the start of ADT
Measure Steward	Oregon Urology	Oregon Urology	Oregon Urology	Oregon Urology
Measure Scoring	Proportion measure	Proportion measure	Proportion measure	Proportion measure
Measure Type	Process measure	Process measure	Process measure	Process measure
Improvement Notation	A higher score indicates better quality	A higher score indicates better quality	A higher score indicates better quality	A higher score indicates better quality
Guidance	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.	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.	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 5.6. Please refer to the QDM page for more information on the QDM.	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 5.6. Please refer to the QDM page for more information on the QDM.
MIPS Quality ID	462	462	462	462
Telehealth Eligible	Yes	Yes	Yes	Yes
Next Version	CMS645v5	CMS645v6	CMS645v7	No Version Available
Previous Version	No Version Available	CMS645v4	CMS645v5	CMS645v6

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CMS645v6-TRN.xlsx	20.83 KB

Data Element Repository

Data Elements contained within CMS645v6

Value Sets

Value Sets to be used with CMS645v6

Release Notes

CMS645v6-TRN.xlsx

Header

Updated copyright.

Measure Section: Copyright

Source of Change: Annual Update
Removed reference to a value set within the definition to point to the terminology section as the source of truth.

Measure Section: Definition

Source of Change: Measure Lead
Updated grammar and formatting to improve readability.

Measure Section: Definition

Source of Change: Measure Lead
Revised grammar in reference to First Androgen Deprivation Therapy.

Measure Section: Definition

Source of Change: Measure Lead
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
Revised the narrative to better align with the logic.

Measure Section: Denominator Exceptions

Source of Change: Measure Lead

Logic

Added definition 'First ADT During Measurement Period and Order for 12 Months of ADT During Measurement Period' to correctly capture the initial population, and properly anchor the first ADT and the order for intended 12 months of treatment.

Measure Section: Definitions

Source of Change: Measure Lead
Replaced definition 'Androgen Deprivation Therapy Start Date With Prostate Cancer And Intended 12 Months Therapy' definition and logic to accurately capture measure intent of linking the ADT, prostate cancer diagnosis, and the provider's intention to continue treatment for 12 months.

Measure Section: Definitions

Source of Change: Measure Lead
Revised the timing in the 'Prostate Cancer Diagnosis' definition by replacing the timing of 'same day or before end' with 'overlaps' to anchor the timing of prostate cancer to the measurement period.

Measure Section: Definitions

Source of Change: ONC Project Tracking System (JIRA): CQM-4761
Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

Measure Section: Multiple Sections

Source of Change: Standards/Technical 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 value set Patient Declined (2.16.840.1.113883.3.600.791) with value set Patient Declined (2.16.840.1.113883.3.526.3.1582) based on new or changed coding guidelines.

Measure Section: Terminology

Source of Change: Annual Update