Colorectal Cancer Screening

Last updated: May 3, 2018

CMS Measure ID: CMS130v6
Version: 6
NQF Number: 0034
Measure Description:

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

Initial Patient Population:

Patients 50-75 years of age with a visit during the measurement period

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients with a diagnosis or past history of total colectomy or colorectal cancer.

Exclude patients who were in hospice care during the measurement year.

Numerator Statement:

Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria:

- Fecal occult blood test (FOBT) during the measurement period

- Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period

- Colonoscopy during the measurement period or the nine years prior to the measurement period

- FIT-DNA during the measurement period or the two years prior to the measurement period

- CT Colonography during the measurement period or the four years prior to the measurement period

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

None

Measure Steward: National Committee for Quality Assurance
Domain: Effective Clinical Care
Next Version:
Previous Version:
Improvement Notation:

Higher score indicates better quality

Guidance:

Patient self-report for procedures as well as diagnostic studies should be recorded in Procedure, Performed template or Diagnostic Study, Performed template in QRDA-1. Patient self-report is not allowed for laboratory tests.

Notes: Value Set content updated Sept 2017

Specifications

Release Notes

Header

  • ​Incremented eMeasure Version number.

    Measure Section: eMeasure Version number

    Source of Change: Measure Lead

  • ​Updated Copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • ​Updated Disclaimer.

    Measure Section: Disclaimer

    Source of Change: Measure Lead

  • Updated Guidance.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Added language to the Guidance to clarify how patient-reported information regarding procedures and diagnostic studies should be documented for calculation of the measure.

    Measure Section: Guidance

    Source of Change: JIRA (CQM-1739)

  • ​Updated the exclusion statement in the header to exclude patients in hospice care from the Denominator. Measures that focus on screenings and procedures may not be appropriate or a priority for those who are at end of life (ie, on hospice).

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Updated the Numerator header statement to include FIT-DNA lab test or CT Colonography procedure as acceptable screenings for this measure.

    Measure Section: Numerator

    Source of Change: JIRA (CQM-2122)

Logic

  • Added new lines of logic to the Denominator Exclusions for all NCQA-stewarded measures (except CMS82) to ensure patients in hospice care are excluded from the Denominator.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Replaced the 'starts before start of' and 'starts before end of' logical operator to address situations where time stamps are not attached to procedures, diagnosis, and immunizations. Wherever applicable, the operators have been changed to 'starts before or concurrent with start of' or 'starts before or concurrent with end of' respectively.

    Measure Section: Denominator Exclusions

    Source of Change: JIRA (CQM-1936)

  • Added logic to include FIT DNA laboratory test and CT Colonography procedure as acceptable screenings for this measure.

    Measure Section: Numerator

    Source of Change: JIRA (CQM-2122)

  • Replaced the 'starts before start of' and 'starts before end of' logical operator to address situations where time stamps are not attached to procedures, diagnosis, and immunizations. Wherever applicable, the operators have been changed to 'starts before or concurrent with start of' or 'starts before or concurrent with end of' respectively.

    Measure Section: Numerator

    Source of Change: JIRA (CQM-1936)

Value Set

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

  • Added new value set FIT DNA (2.16.840.1.113883.3.464.1003.108.12.1039). Value set contains two LOINC codes (77353-1, 77354-9).

    Measure Section: QDM Data Elements

    Source of Change: JIRA (CQM-2122)

  • Added new value set CT Colonography (2.16.840.1.113883.3.464.1003.108.12.1038). Value set contains 1 CPT code (74263) and 1 SNOMED code (418714002).

    Measure Section: QDM Data Elements

    Source of Change: JIRA (CQM-2122)

  • Value set Malignant Neoplasm of Colon (2.16.840.1.113883.3.464.1003.108.12.1001): Deleted 3 ICD9CM codes (154.2, 154.3, 154.8). Deleted 2 ICD10CM codes (C21.0, C21.1).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Colonoscopy (2.16.840.1.113883.3.464.1003.108.12.1020): Added 13 CPT codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Flexible Sigmoidoscopy (2.16.840.1.113883.3.464.1003.198.12.1010): Added 4 CPT codes (45346, 45347, 45349, 45350).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Fecal Occult Blood Test (FOBT) (2.16.840.1.113883.3.464.1003.198.12.1011): Added 1 LOINC code (80372-6).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Encounter Inpatient (2.16.840.1.113883.3.666.5.307): Added Encounter Inpatient.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Hospice care ambulatory (2.16.840.1.113762.1.4.1108.15): Added Hospice care ambulatory.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Discharged to Health Care Facility for Hospice Care (2.16.840.1.113883.3.117.1.7.1.207): Added Discharged to Health Care Facility for Hospice Care.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Discharged to Home for Hospice Care (2.16.840.1.113883.3.117.1.7.1.209): Added Discharged to Home for Hospice Care.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Malignant Neoplasm of Colon (2.16.840.1.113883.3.464.1003.108.12.1001): Added 13 SNOMEDCT codes.

    Measure Section: QDM Data Elements

    Source of Change: 2018 Addendum

External Resources