Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients

Last updated: July 12, 2017

CMS Measure ID: CMS141v5
Version: 5
NQF Number: 0385
Measure Description:

Percentage of patients aged 18 through 80 years with AJCC Stage III colon cancer who are referred for adjuvant chemotherapy, prescribed adjuvant chemotherapy, or have previously received adjuvant chemotherapy within the 12-month reporting period.

Initial Patient Population:

All patients aged 18 through 80 years with colon cancer

Denominator Statement:

Equals Initial Population with AJCC Stage III colon cancer

Denominator Exclusions:

None

Numerator Statement:

Patients who are referred for adjuvant chemotherapy, prescribed adjuvant chemotherapy, or who have previously received adjuvant chemotherapy within the 12 month reporting period

Numerator Exclusions:

Not Applicable

Denominator Exceptions:
  • Documentation of medical reason(s) for not referring for or prescribing adjuvant chemotherapy (eg, medical co-morbidities, diagnosis date more than 5 years prior to the current visit date, patient's diagnosis date is within 120 days of the end of the 12 month reporting period, patient's cancer has metastasized, medical contraindication/allergy, poor performance status, other medical reasons)
  • Documentation of patient reason(s) for not referring for or prescribing adjuvant chemotherapy (eg, patient refusal, other patient reasons)
  • Documentation of system reason(s) for not referring for or prescribing adjuvant chemotherapy (eg, patient is currently enrolled in a clinical trial that precludes prescription of chemotherapy, other system reasons)
Measure Steward: American Medical Association-convened Physician Consortium for Performance Improvement(R) (AMA-PCPI)
Domain: Effective Clinical Care
Next Version: Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients
Previous Version: Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients
Measure Score: Proportion
Improvement Notation:

Higher score indicates better quality

Guidance:

The measure logic option that includes the combination of 5-FU/LV/oxaliplatin will capture either FOLFOX or FLOX.

The denominator for this measure has been limited to patients with a first recorded colon cancer diagnosis during the 12 month reporting period. The numerator captures patients who are prescribed adjuvant chemotherapy or received adjuvant chemotherapy during the 12 month period. Referred for Chemotherapy is not separately specified, as this option can be captured either through the Medication Order: Chemotherapy for Colon Cancer numerator option or the patient reason exception: Medication, Administered not done: Patient reason for Chemotherapy for Colon Cancer. Additional valid medical reason exceptions might include acute renal insufficiency, neutropenia, or leukopenia. Date of diagnosis is defined as the date of pathologic diagnosis.

The requirement of Count >=2 of Encounter, Performed is to establish that the eligible professional has an existing relationship with the patient.

Specifications

Release Notes

Header

  • Clinical Recommendation Statement updated.
  • Copyright updated.
  • Definition updated.
  • Disclaimer updated.
  • eMeasure version number incremented.
  • Guidance updated.
  • Reference updated.

Logic

  • Changed data type of 'result' or 'finding' to 'performed'.
  • Introduced function 'satisfies all' to specify that qualifying events must meet all conditions from a set of conditions or 'satisfies any' to specify that qualifying events must meet at least one condition from a set of conditions to streamline expression logic.
  • Introduced 'Intersection' clause to build clause logic.
  • Introduced occurrencing on variables to enforce that the same instance of a clinical event is used throughout the measure when the logic within the variable does not limit the event to a single instance, e.g., FIRST or MOST RECENT.
  • Introduced the new timing operator 'overlaps' to replace two lines of logic (AND/AND NOT) or to enforce when an event or set of events occur to meet the measure intent.
  • Introduced variables $FirstDxColonCancerMP and $OVorF2FEncounter to allow re-use of logical expressions and reduce redundancy/complexity.
  • Replaced 'Measurement Start Date' and 'Measurement End Date' with 'Measurement Period' and as necessary replaced existing timing operator (e.g., replacing 'starts before start of' with 'starts before end of').
  • Replaced 'ORs' with 'Union of' operator to provide a mechanism for specifying that qualifying event(s) must be a member of at least one of the data elements being unioned (if appropriate for measure intent).
  • Replaced 'Patient Characteristic Birthdate' with 'Age at' operator.
  • Replaced 'starts before or during' (SBOD) with 'starts before end of' (SBE).
  • The top level logical operator for the Numerator Exclusions, Denominator Exclusions, Denominator Exceptions, and Measure Population Exclusions defaults to 'OR'.

Value Sets

  • Value set Patient Reason (OID 2.16.840.1.113883.3.526.3.1008): Deleted 1 SNOMED code (30164005).

External Resources