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

Last updated: May 9, 2019

CMS Measure ID: CMS645v3
Version: 3
NQF Number: Not Applicable
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 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 qualifying encounter in the measurement period AND with a diagnosis of prostate cancer AND with an order for ADT or an active medication of ADT with an intent for treatment greater than or equal to 12 months 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:
Measure Scoring: Proportion
Measure Type: Process
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 removed in 2019 from to the First Androgen Deprivation Therapy definition as Procedure, Order and replaced by SNOMEDCT 456381000124102 which is Injection of leuprolide acetate for twelve month period (regime/therapy)

Quality ID: 462
Meaningful Measure: Management of Chronic Conditions

Specifications

Release Notes

Header

  • Updated eCQMinfo-icon version number.

    Measure Section: eCQM Version number

    Source of Change: Measure Lead

  • Updated the description statement with removal of '(indicated by HCPCS code)' because the code is being replaced by new SNOMED CT code. This change is also listed in guidance.

    Measure Section: Description

    Source of Change: Measure Lead

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

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

    Measure Section: Reference

    Source of Change: Measure Lead

  • Updated guidance statement to reflect that the new SNOMED CT code 456381000124102 replaces the custom J1950,cont code to align with updates in the logic.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Updated initial populationinfo-icon statement to 'Male patients with a qualifying encounter in the measurement period AND with a diagnosis of prostate cancer AND with an order for ADT or an active medication of ADT with an intent for treatment greater than or equal to 12 months during the measurement period' to clarify the qualifying encounter occurs in the measurement period.

    Measure Section: Initial Population

    Source of Change: Measure Lead

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

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Logic

  • Added Definition 'No Bone Density Scan Performed Due to Patient Refusal' and updated timeframe for measure's denominator exceptioninfo-icon. Logic adjusted to reflect the description is 'after the start of ADT.' Timing changes to 3 months or less after the start of ADT which is consistent with the denominator exception and timing of requirement for DEXA scan after ADT.

    Measure Section: Definitions

    Source of Change: ONC Project Tracking System (JIRA)info-icon: CQMinfo-icon-3468

  • 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 Setinfo-icon

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

  • Replaced Procedure, Order: Injection leuprolide Acetate using 'Injection Leuprolide Acetate (2.16.840.1.113762.1.4.1151.16)' value set with the direct reference SNOMED CT code 456381000124102, which is Injection of leuprolide acetate for twelve month period (regime/therapy) that just recently became available and is most appropriate.

    Measure Section: Terminology

    Source of Change: ONC Project Tracking System (JIRA): CQM-2935

  • 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