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

General eCQM Information

CMS Measure ID CMS645v4
NQF Number Not Applicable
Measure 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
Denominator Statement

Equals Initial Population

Denominator Exclusions

None

Numerator Statement

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 Exceptions

Patient refused recommendation for a bone density evaluation after the start of ADT therapy

Measure Steward Oregon Urology
Domain Effective Clinical Care
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 5.5. Please refer to the eCQI resource center for more information on the QDM.

Quality ID 462
Meaningful Measure Management of Chronic Conditions
Telehealth Eligible Yes
Next Version
Previous Version

Release Notes

Header

  • Updated eCQM Version Number.

    Measure Section: eCQM Version Number

    Source of Change: Standards Update

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated disclaimer.

    Measure Section: Disclaimer

    Source of Change: Standards Update

  • Added definition for 'First Androgen Deprivation Therapy' for clarity.

    Measure Section: Definition

    Source of Change: Measure Lead

  • Added text to identify the Quality Data Model (QDM) version used in the measure specification.

    Measure Section: Guidance

    Source of Change: Standards Update

  • Added text to indicate whether the measure is patient-based or episode-based.

    Measure Section: Guidance

    Source of Change: Standards Update

  • Updated guidance to include new SNOMED CT code to capture the practitioner's intent of androgen deprivation therapy (ADT) for a period of 12 months or greater. SNOMED CT code is 456381000124102, Injection of leuprolide acetate for twelve month period (regime/therapy), which replaces a HCPCS code.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Changed Numerator Exclusion Header from 'None' to 'Not Applicable' to harmonize across measures and to align with CMS MMS Blueprint requirements.

    Measure Section: Numerator Exclusions

    Source of Change: Expert Work Group Review

Logic

  • Changed the 'First Androgen Deprivation Therapy' definition logic to consider the end of the cancer diagnosis and allowed a patient with a prior prostate cancer diagnosis that ended (not likely) to be in the Initial Population.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Revised qualifying encounter definition to align with style guide. Changed definition title from 'Qualifying Encounter' to 'Has Qualifying Encounter' and embedded the exists operator into the definition, clarifying the Boolean return type.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Changed the 'First Androgen Deprivation Therapy' definition logic to consider the end of the cancer diagnosis and allowed a patient with a prior prostate cancer diagnosis that ended (not likely) to be in the Initial Population.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Revised numerator definition to align with the Clinical Quality Language (CQL) style guide. Changed definition title from 'Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT' to 'Has Baseline DEXA Scan Two Years Prior to the Start of or Less than Three Months After the Start of ADT'; embedded the exists operator into the definition; linked the First Androgen Deprivation Therapy definition to both the DEXA ordered ('Diagnostic Study, Order') and performed ('Diagnostic Study, Performed'). Change also removed the 'Bone Density Scan Ordered or Performed' definition.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • QDM v5.5 standards update: Added 'relevantDatetime' attribute to QDM datatypes. 'RelevantDatetime' indicates when the action occurred whereas 'authorDatetime' indicates when the action was recorded.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated Clinical Quality Language (CQL) expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • 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 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 Androgen deprivation therapy for Urology Care (2.16.840.1.113762.1.4.1151.48): Added 1 RxNorm code (571914) based on new or changed coding guidelines and deleted 1 RxNorm code (284986) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Prostate Cancer (2.16.840.1.113883.3.526.3.319): Deleted 1 ICD-9-CM code (185). Removed ICD-9 codes from all measures that do not have lookback periods or removed ICD-9 codes from all measures with lookback period for which the ICD-9 codes were no longer relevant.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Replaced value set Male (2.16.840.1.113883.3.560.100.1) with direct reference code AdministrativeGender Code (M) to align with best practices for replacing single code value sets with direct reference codes.

    Measure Section: Terminology

    Source of Change: Standards Update

Last Updated: May 05, 2021