Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients

Last updated: July 12, 2017

CMS Measure ID: CMS141v6
Version: 6
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: PCPI(R) Foundation (PCPI[R])
Domain: Effective Clinical Care
Previous Version: Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients
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.

For the eCQM version of this measure, the denominator for this measure has been limited to patients with a first ever lifetime diagnosis of colon cancer recorded 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 colon cancer diagnosis is defined as date of first pathologic diagnosis.

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

The denominator exception Clinical Trial Participant data element should be specific to colon cancer. For instance, the patient should be participating in a clinical trial related to colon cancer treatment in order to meet the Clinical Trial Participant data element in the denominator exceptions. In the given example, the reason the patient was not referred, prescribed, or previously administered adjuvant chemotherapy is because he or she is in a clinical trial and may be receiving different treatments.

Addendum Notes: Removed from Quality Payment Program

Specifications

Release Notes

Header

  • ​Updated Copyright.

    Section: Copyright

    Source: Annual Update

  • Updated Disclaimer.

    Section: Disclaimer

    Source: Measure Lead

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Annual Update

  • Added Guidance in reference to the 'Clinical Trial Participant' data element to clarify that the patient should be participating in a clinical trial related to colon cancer treatment in order to qualify as a denominator exception.

    Section: Guidance

    Source: JIRA (CQM-1809)

  • Updated Guidance to clarify that the denominator has been limited to patients with a first ever lifetime diagnosis of colon cancer recorded during the 12 month reporting period. The date of colon cancer diagnosis is defined as date of first pathologic diagnosis.

    Section: Guidance

    Source: Measure Lead

  • Updated Measure Developer.

    Section: Measure Developer

    Source: Measure Lead

  • Updated Measure Steward.

    Section: Measure Steward

    Source: Measure Lead

  • Updated Reference.

    Section: Reference

    Source: Measure Lead

Logic

  • Renamed 'Clinical Staging Procedure' value set to 'Pathology Evaluation' to align with value set content.

    Section: Denominator

    Source: JIRA (CQM-1497)

  • Renamed 'Clinical Staging Procedure' value set to 'Pathology Evaluation' to align with value set content.

    Section: Denominator

    Source: JIRA (CQM-1500)

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: Denominator Exceptions

    Source: QDM Standards

  • Renamed 'Clinical Staging Procedure' value set to 'Pathology Evaluation' to align with value set content.

    Section: Numerator

    Source: JIRA (CQM-1497)

  • Renamed 'Clinical Staging Procedure' value set to 'Pathology Evaluation' to align with value set content.

    Section: Numerator

    Source: JIRA (CQM-1500)

  • Renamed 'Clinical Staging Procedure' value set to 'Pathology Evaluation' (2.16.840.1.113883.3.526.3.1098) to align with value set content.

    Section: QDM Data Elements

    Source: JIRA (CQM-1497)

  • Renamed 'Clinical Staging Procedure' value set to 'Pathology Evaluation' (2.16.840.1.113883.3.526.3.1098) to align with value set content.

    Section: QDM Data Elements

    Source: JIRA (CQM-1500)

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Data Elements

    Source: QDM Standards

  • Replaced datatypes 'Diagnosis, Active; Diagnosis, Inactive; Diagnosis, Resolved' with the re-specified 'Diagnosis' datatype to conform to QDM 4.2 changes.

    Section: QDM Variables

    Source: QDM Standards

Value Set

  • Renamed 'Clinical Staging Procedure' value set to 'Pathology Evaluation' (2.16.840.1.113883.3.526.3.1098) to align with value set content.

    Section: None

    Source: JIRA (CQM-1497)

  • Renamed 'Clinical Staging Procedure' value set to 'Pathology Evaluation' (2.16.840.1.113883.3.526.3.1098) to align with value set content.

    Section: None

    Source: JIRA (CQM-1500)

  • Value set Chemotherapy for Colon Cancer - Leucovorin and Levo-Leucovorin (2.16.840.1.113883.3.526.3.1290): Added 3 RXNORM codes (1720760, 1720765, 1720773) and deleted 2 RXNORM codes (1113384, 250288).

    Section: None

    Source: None

  • Value set Clinical Trial Participant (2.16.840.1.113883.3.526.3.1125): Deleted 2 SNOMEDCT codes (399223003, 444734003).

    Section: None

    Source: None

  • Value set Medical Reason (2.16.840.1.113883.3.526.3.1007): Deleted 1 SNOMEDCT code (161590003).

    Section: None

    Source: None

  • Value set Patient Reason (2.16.840.1.113883.3.526.3.1008): Deleted 1 SNOMEDCT code (5015009).

    Section: None

    Source: None

External Resources