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

Last updated: September 14, 2018

CMS Measure ID: CMS645v2
Version: 2
NQF Number: None
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 (indicated by HCPCS code) 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 Patient Population:

Male patients with a diagnosis of prostate cancer and an order for ADT that is intended for greater than or equal to12 months during the measurement period. Also included are male patients with a diagnosis of prostate cancer with ADT that was administered with an intent of 12 months or greater therapy and began during the measurement period.

Denominator Statement:

Equals Initial Populationinfo-icon

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:

None

Denominator Exceptions:

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

Measure Steward: Oregon Urology
Domain: Effective Clinical Care
Previous Version:
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, the custom HCPCS code of J1950,cont was added to the First Androgen Deprivation Therapy definition as Procedure, Order. Each EHRinfo-icon can define this custom code as intended therapy for 12 months or greater with the practitioner indicating this code at the start of the intended therapy.

Quality ID: 462
Meaningful Measure: Management of Chronic Conditions

Specifications

Release Notes

Header

  • Updated 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

Logic

  • Added supplemental timing attributes to most datatypes in QDMinfo-icon 5.3 to facilitate accurate retrieval of time related information within CQLinfo-icon logic. Timing attributes now include a time interval, such as prevalence period or relevant period, and/or actual time of documentation with Author Datetime. Relevant period is the general method to describe start and stop times for datatypes. Prevalence period is used for some datatypes to more accurately define onset and abatement times.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Assigned cardinality to each attribute to be more explicit in guiding specificationinfo-icon and implementation of QDM data elements. Cardinality refers to the number of instances of the attribute that can be included in the measure description. Cardinality for most attributes is 0.. 1 (i.e., can occur up to 1 time), but some attributes have a cardinality of 0.. * (i.e., can occur multiple times).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • CQL libraries contain sets of CQL definitions, or CQL expression statements. A context statement, patient or population, can now be used in a CQL library to clearly establish how the subsequent list of CQL expressions will be interpreted. A 'Population' context will interpret the CQL expression with reference to the entire population of the item being counted, patients or encounters. A 'Patient' context will interpret the CQL expression with reference to a single patient. Context statements are not required, but one or more context statements may be used within a library to help clarify how the CQL expressions will be interpreted. Patient context is the default if none is specified.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated measure logic from Quality Data Model (QDM)-based logic to Clinical Quality Language (CQL)-based logic. Information on CQL can be found at the eCQI Resource centerinfo-icon (https://ecqi.healthit.gov/cql). Information about specific versions of the new standards in use for CMS reporting periods can be found at the eCQI Resource Center (https://ecqi.healthit.gov/ecqm-tools-key-resources). Switching from QDM to CQL brings with it many changes, as well as enhanced expression capability, but only those changes with significant impact will be outlined in technical release notes. For example, in the case of timing operators, changes may only be summarized if those changes impact the measure calculation.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

Value Setinfo-icon

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

  • Value set Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001): Added SNOMEDCT extensional value set (2.16.840.1.113883.3.464.1003.101.11.1264) including 7 codes.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Androgen deprivation therapy for Urology Care (2.16.840.1.113762.1.4.1151.48): Added 2 RXNORM codes (1946519, 1946521) and deleted RXNORM code (1115469).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Patient Reason Refused (2.16.840.1.113883.3.600.1.1503): Removed Patient Reason Refused.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Patient Reason refused (2.16.840.1.113883.3.600.791): Added Patient Reason refused.

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Payer (2.16.840.1.114222.4.11.3591): Added 11 SOP codes (299, 32127, 32128, 391, 517, 524, 614, 621, 622, 623, 629) and deleted 3 SOP codes (63, 64, 69).

    Measure Section: QDM Data Elements

    Source of Change: Annual Update

  • Value set Payer (2.16.840.1.114222.4.11.3591): Deleted 1 SOP code (24).

    Measure Section: QDM Data Elements

    Source of Change: 2019 Addendum

External Resources