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

Last updated: May 9, 2019

CMS Measure ID: CMS129v9
Version: 9
NQF Number: 389e
Measure 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 since diagnosis of prostate cancer

Initial Patient Population:

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

Denominator Statement:

Equals Initial Populationinfo-icon 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 Statement:

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, bone scan ordered by someone other than reporting physician)

Measure Steward: PCPI(R) Foundation (PCPI[R])
Domain: Efficiency and Cost Reduction
Previous Version:
Measure Scoring: Proportion
Measure Type: Process
Improvement Notation:

Higher score indicates better quality

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 denominatorinfo-icon of this measure.

Quality ID: 102
Meaningful Measure: Appropriate Use of Healthcare

Specifications

Release Notes

Header

  • Updated eCQMinfo-icon version number.

    Measure Section: eCQM Version number

    Source of Change: Measure Lead

  • Added 'e' to NQFinfo-icon number.

    Measure Section: NQF Number

    Source of Change: Standards Update

  • Updated description statement with removal of references to cryotherapy to align with the updated guideline.

    Measure Section: Description

    Source of Change: Expert Work Group Review

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated disclaimer.

    Measure Section: Disclaimer

    Source of Change: Measure Lead

  • Updated rationale statement with in-text citation date to reflect updated reference.

    Measure Section: Rationale

    Source of Change: Measure Lead

  • Updated clinical recommendation statement to align with current guidelines.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Updated references to align with American Psychological Association (APA) style.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated references.

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated definition statement to align with current guideline.

    Measure Section: Definition

    Source of Change: Measure Lead

  • Updated denominatorinfo-icon statement with removal of references to cryotherapy from the denominator statement to align with updated guideline.

    Measure Section: Denominator

    Source of Change: Expert Work Group Review

  • Updated parenthetical citations to align with American Psychological Association (APA) style.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Logic

  • Replaced value setinfo-icon Cancer Staging (2.16.840.1.113883.3.526.3.1536) with direct reference code SNOMED CT code (258232002).

    Measure Section: Denominator

    Source of Change: Measure Lead

  • Updated the names of Clinical Quality Language (CQL)info-icon definitions, functions, and/or aliases for clarification and to align with CQL Style Guideinfo-icon.

    Measure Section: Definitions and Functions

    Source of Change: Standards Update

  • Updated Clinical Quality Language (CQL) expression to conform with the HL7info-icon Standard: Clinical Quality Language Specificationinfo-icon, Release 1 STUinfo-icon 3 (CQL 1.3).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

Value Set

The VSACinfo-icon is the source of truth for the value set content, please visit the VSAC for downloads of current value setsinfo-icon.

  • Value set Prostate Cancer Treatment (2.16.840.1.113883.3.526.3.398): Deleted 1 CPT code (55873). Added 2 SNOMED CT codes (427541000119103, 764675000) and deleted 8 SNOMED CT codes (169374002, 176319004, 265589001, 29860002, 420529003, 427357007, 433225000, 64978007).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Pain Related to Prostate Cancer (2.16.840.1.113883.3.526.3.451): Deleted 2 ICD-9-CM codes (V76.44, V84.03). Deleted 2 ICD-10-CM codes (Z12.5, Z15.03).

    Measure Section: Terminology

    Source of Change: Annual Update

  • Replaced value set Cancer Staging (2.16.840.1.113883.3.526.3.1536) with direct reference code SNOMED CT code (258232002).

    Measure Section: Terminology

    Source of Change: Measure Lead

  • ​Removed code systeminfo-icon versions from direct reference codes. Please refer to Appendix A of the Electronic Clinical Quality Measureinfo-icon Logic and Implementation Guidance document for a list of code system versions used in the eCQM specificationsinfo-icon for 2020 reporting/performance.

    Measure Section: Terminology

    Source of Change: Standards Update

  • Standardized purpose statement language in value sets across eCQMsinfo-icon. Value set purpose statements are visible in the Value Set Authority Center (VSAC) as well as the downloadable eCQM value set files.

    Measure Section: Terminology

    Source of Change: Measure Lead

External Resources