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

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

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.

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Table Options
Measure Information 2024 Performance Period
Title Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients
CMS eCQM ID CMS129v13
CBE ID* Not Applicable
MIPS Quality ID 102
Measure Steward Centers for Medicare & Medicaid Services (CMS)
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...

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Measure Scoring Proportion measure
Measure Type Process
Stratification

None

Risk Adjustment

None

Rationale

Multiple studies have indicated that a bone scan is not clinically necessary for staging prostate cancer in men with a low (or very low) risk of recurrence and receiving primary therapy. For patients who are categorized as low-risk, bone scans are unlikely to identify their disease....

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Clinical Recommendation Statement

For symptomatic patients and/or those with a life expectancy of greater than 5 years, bone imaging is appropriate for patients with unfavorable intermediate-risk prostate cancer, high-risk and very-high-risk prostate cancer (National Comprehensive Cancer Network, 2022) (Evidence Level:...

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Improvement Notation

Higher score indicates better quality

Definition

Risk Strata Definitions: Very Low, Low, Intermediate, High, or Very High

Very Low/Low Risk - PSA < 10 ng/mL; AND Gleason score 6 or less/Gleason grade group 1; AND clinical stage T1 to T2a.

Intermediate Risk - PSA 10 to 20 ng/mL; OR Gleason score 7/Gleason grade group 2-3; OR clinical...

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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.

In 2022, the American...

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Initial Population

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

Denominator

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

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)

Telehealth Eligible No
Next Version
Previous Version

Header

  • Removed NQF number, re-endorsement was not pursued.

    Measure Section: NQF Number

    Source of Change: Measure Lead

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Revised wording in rationale for clarity and consistency with clinical recommendation statement.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Revised clinical recommendation statement to align with updated National Comprehensive Cancer Network guidelines.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated grammar, wording, and/or formatting to improve readability and consistency.

    Measure Section: Definition

    Source of Change: Annual Update

  • Updated guidance to clarify the patient population in reference to an updated American Urological Association guideline.

    Measure Section: Guidance

    Source of Change: Measure Lead

Logic

  • Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Definitions

    Source of Change: Standards/Technical Update

  • Updated the timing precision in definitions by adding 'day of' to align with the measure intent.

    Measure Section: Definitions

    Source of Change: Measure Lead

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Value set (2.16.840.1.113883.3.526.3.451): Renamed to Pain Warranting Further Investigation for Prostate Cancer based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Pain Warranting Further Investigation for Prostate Cancer (2.16.840.1.113883.3.526.3.451): Added 3 ICD-10-CM codes (M25.551, M25.552, M25.559) based on review by technical experts, SMEs, and/or public feedback. Added 1 SNOMED CT code (49218002) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Payer (2.16.840.1.114222.4.11.3591): Added 5 SOP codes (1111, 1112, 142, 344, 141) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: Jun 03, 2024