Back to top
Top
U.S. flag

An official website of the United States government

Dot gov

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

Https

Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

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

Compare Versions of: "Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy"

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.

Compare version to

Table Options
Measure Information 2022 Performance Period 2023 Performance Period 2024 Performance Period 2025 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 CMS645v5 CMS645v6 CMS645v7 CMS645v8
CBE ID* Not Applicable Not Applicable Not Applicable Not Applicable
MIPS Quality ID 462 462 462 462
Measure Steward Oregon Urology Oregon Urology Oregon Urology Oregon Urology
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.

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.

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.

Measure Scoring Proportion measure Proportion measure Proportion measure Proportion measure
Measure Type Process Process Process Process
Stratification *See CMS645v5.html *See CMS645v6.html

None

None

Risk Adjustment *See CMS645v5.html *See CMS645v6.html

None

None

Rationale *See CMS645v5.html *See CMS645v6.html

Androgen suppression as a treatment for prostate cancer can cause osteoporosis (Qaseem, 2008). Men undergoing prolonged androgen deprivation therapy (ADT) incur bone loss at a rate higher than menopausal women (Guise, 2007). In preserving bone health, the goal is to prevent or treat osteopenia/osteoporosis for the patient on ADT and to prevent or delay skeletal related events. The National Osteoporosis Foundation recommendations including a baseline assessment of bone density with a dual energy X-ray absorptiometry (DEXA) scan and daily calcium and Vitamin D supplementation (Watts, 2012). The DEXA scan is the gold standard for bone density screening. Men at risk for adverse bone consequences from chronic ADT do not always receive care according to evidence-based guidelines. These findings call for improved processes that standardize evidence-based practice including baseline and follow up bone density assessment (Watts, 2012).

Androgen suppression as a treatment for prostate cancer can cause osteoporosis (Qaseem, 2008). Men undergoing prolonged androgen deprivation therapy (ADT) incur bone loss at a rate higher than menopausal women (Guise, 2007). In preserving bone health, the goal is to prevent or treat osteopenia/osteoporosis for the patient on ADT and to prevent or delay skeletal related events. The National Osteoporosis Foundation recommendations including a baseline assessment of bone density with a dual energy X-ray absorptiometry (DEXA) scan and daily calcium and Vitamin D supplementation (Watts, 2012). The DEXA scan is the gold standard for bone density screening. Men at risk for adverse bone consequences from chronic ADT do not always receive care according to evidence-based guidelines. These findings call for improved processes that standardize evidence-based practice including baseline and follow up bone density assessment (Watts, 2012).

Clinical Recommendation Statement *See CMS645v5.html *See CMS645v6.html

Bone density screening should be performed at the start of Androgen Deprivation Therapy (ADT) for prostate cancer. It should also be performed every 2 years for the patient with continued ADT or for patients with known osteoporosis. Current insurance practice is to possibly cover the cost of bone density screening if osteoporosis is known or if there is a high-risk drug. Some patients choose to delay bone density screening until after ADT is started and they therefore have insurance authorization due to the administration of a high-risk drug.

Bone density screening should be performed at the start of Androgen Deprivation Therapy (ADT) for prostate cancer. It should also be performed every 2 years for the patient with continued ADT or for patients with known osteoporosis. Current insurance practice is to possibly cover the cost of bone density screening if osteoporosis is known or if there is a high-risk drug. Some patients choose to delay bone density screening until after ADT is started and they therefore have insurance authorization due to the administration of a high-risk drug.

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

Definition *See CMS645v5.html *See CMS645v6.html

DEXA - Dual Energy X-ray Absorptiometry - A scan that measures the bone of the spine, hip or total body and measures bone mineral density. It is considered one of the most accurate measurements.

PDXA - Peripheral Dual Energy X-ray Absorptiometry - Bone mineral density measurement of the wrist, heel or finger.

First Androgen Deprivation Therapy - The first Androgen Deprivation Therapy (ADT) is measured as the first order or administration of ADT for an anticipated period of 12 months or greater to a patient with prostate cancer.

DEXA - Dual Energy X-ray Absorptiometry - A scan that measures the bone of the spine, hip or total body and measures bone mineral density. It is considered one of the most accurate measurements.

PDXA - Peripheral Dual Energy X-ray Absorptiometry - Bone mineral density measurement of the wrist, heel or finger.

First Androgen Deprivation Therapy - The first Androgen Deprivation Therapy (ADT) is measured as the first order or administration of ADT for an anticipated period of 12 months or greater to a patient with prostate cancer.

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 5.6. 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.

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.

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

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 AND order for ADT in 3 months before to 9 months after the start of 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 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

Patient refused the bone density evaluation at the time ordered or did not have it performed within 3 months after the start of ADT

Telehealth Eligible Yes Yes Yes Yes
Next Version No Version Available
Previous Version No Version Available

Header

  • Updated language in the description to use 'percentage of patients' for consistency with measure intent.

    Measure Section: Description

    Source of Change: Measure Lead

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

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

    Measure Section: Rationale

    Source of Change: Annual Update

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

Logic

  • Updated timing of ADT order or active start date to anchor all data to the measurement period or the prior year.

    Measure Section: Initial Population

    Source of Change: Measure Lead

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

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Updated timing of ADT order or active start date to anchor all data to the measurement period or the prior year.

    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 Patient Declined (2.16.840.1.113883.3.526.3.1582): Added 1 SNOMED CT code (895451009) based on terminology update. Deleted 3 SNOMED CT codes (183944003, 413310006, 413312003) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • 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: Sep 24, 2024