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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.

Compare 2025 version to

Table Options
Measure Information 2025 Performance Period
Title Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients
CMS eCQM ID CMS129v14
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 after diagnosis of prostate cancer and before the end of the measurement period

Numerator Exclusions

Not Applicable

Denominator Exceptions

Documentation of reason(s) for performing a bone scan (including documented pain, salvage therapy, or other medical reasons)

Telehealth Eligible No
Next Version No Version Available
Previous Version

Header

  • Updated the eCQM version number.

    Measure Section:

    eCQM Version Number

    Source of Change:

    Annual Update

  • Changed all references from NQF to CBE to identify the consensus-based entity role.

    Measure Section:

    CBE Number

    Source of Change:

    Annual Update

  • Updated copyright.

    Measure Section:

    Copyright

    Source of Change:

    Annual Update

  • Added prostate-specific membrane antigen PET/CT to the definition of bone scan based on recommendation from clinical experts.

    Measure Section:

    Definition

    Source of Change:

    Measure Lead

  • Updated Guidance language to clarify that only the favorable intermediate risk prostate cancer population is included in the American Urological Association and American Society for Radiation Oncology guideline as not indicated for bone scan to provide clarity.

    Measure Section:

    Guidance

    Source of Change:

    Measure Lead

  • Updated Numerator to clarify that the measure only evaluates whether a bone scan occurred during the measurement period to align with program requirements that the Numerator action not extend beyond the end of the measurement period.

    Measure Section:

    Numerator

    Source of Change:

    Measure Lead

  • Removed exception for bone scan ordered by someone other than reporting clinician as measure logic is unable to successfully capture this exclusion.

    Measure Section:

    Denominator Exceptions

    Source of Change:

    Measure Lead

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

    Measure Section:

    Multiple Sections

    Source of Change:

    Annual Update

  • Updated references and measure header to reflect current evidence and new or updated literature.

    Measure Section:

    Multiple Sections

    Source of Change:

    Measure Lead

Logic

  • Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'

    Measure Section:

    Definitions

    Source of Change:

    Annual Update

  • Renamed value set to 'Payer Type' to more accurately reflect the contents and intent of the value set.

    Measure Section:

    Definitions

    Source of Change:

    Standards/Technical Update

  • Changed the definition name for prostate cancer staging to 'Most Recent Prostate Cancer Staging T1a to T2a' to reflect coding changes and added a requirement of a prostate cancer diagnosis to the definition, as the new staging codes are not specific to prostate cancer.

    Measure Section:

    Definitions

    Source of Change:

    ONC Project Tracking System (JIRA): CQM-6200

  • Added logic to the 'Bone Scan Study Performed' definition to require that the bone scan occurs during the measurement period to align with program requirements that the Numerator action not extend beyond the end of the measurement period.

    Measure Section:

    Definitions

    Source of Change:

    Measure Lead

  • Updated the version number of the Measure Authoring Tool (MAT) Global Common Functions Library to v8.0.000 and the library name from 'MATGlobalCommonFunctions' to 'MATGlobalCommonFunctionsQDM.'

    Measure Section:

    Functions

    Source of Change:

    Annual 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.

  • Value set Bone Scan (2.16.840.1.113883.3.526.3.320): Added 6 CPT codes (78811, 78812, 78813, 78814, 78815, 78816) based on review by technical experts, SMEs, and/or public feedback. Added 3 HCPCS codes (A9593, A9594, A9595) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set (2.16.840.1.114222.4.11.3591): Renamed to Payer Type based on recommended value set naming conventions.

    Measure Section:

    Terminology

    Source of Change:

    Annual Update

  • Value set Prostate Cancer (2.16.840.1.113883.3.526.3.319): Deleted 1 SNOMED CT code (369486003) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Prostate Cancer Treatment (2.16.840.1.113883.3.526.3.398): Added 1 CPT code (55880) based on review by technical experts, SMEs, and/or public feedback. Deleted 2 SNOMED CT codes (169349000, 399124002) based on applicability of a single code to represent clinical data.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Value set Prostate Specific Antigen Test (2.16.840.1.113883.3.526.3.401): Added 1 LOINC code (83112-3) based on review by technical experts, SMEs, and/or public feedback. Deleted 9 LOINC codes (10508-0, 10886-0, 12841-3, 15323-9, 15324-7, 15325-4, 19201-3, 33667-7, 34611-4) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    Measure Lead

  • Replaced direct reference code SNOMED CT code (369833007) with direct reference code SNOMED CT code (1228892002) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    ONC Project Tracking System (JIRA): CQM-6200

  • Replaced direct reference code SNOMED CT code (369834001) with direct reference code SNOMED CT code (1228895000) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    ONC Project Tracking System (JIRA): CQM-6200

  • Replaced direct reference code SNOMED CT code (433351000124101) with direct reference code SNOMED CT code (1228899006) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    ONC Project Tracking System (JIRA): CQM-6200

  • Replaced direct reference code SNOMED CT code (433361000124104) with direct reference code SNOMED CT code (1228931008) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section:

    Terminology

    Source of Change:

    ONC Project Tracking System (JIRA): CQM-6200

Last Updated: Aug 01, 2024