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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
069 0380 Process No Effective Clinical Care
Registry

Measure Description

Percentage of patients aged 18 years and older with a diagnosis of multiple myeloma, not in remission, who were prescribed or received intravenous bisphosphonate therapy within the 12 month reporting period

Instructions

This measure is to be submitted a minimum of once per performance period for all multiple myeloma (not in remission) patients seen during the performance period. It is anticipated that eligible clinicians who provide services for the patients with the diagnosis of multiple myeloma (not in remission) will submit this measure.

NOTE: No notes related

Measure Submission

The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry submissions; however, these codes may be submitted for those registries that utilize claims data.

Numerator

Patients who were prescribed or received intravenous bisphosphonate therapy within the 12 month reporting period

Definition

Bisphosphonate Therapy – Includes the following medications: pamidronate and zoledronate.
Prescribed – Includes patients who are currently receiving medication(s) that follow the treatment plan recommended at an encounter during the performance period, even if the prescription for that medication was ordered prior to the encounter.

Numerator Quality-Data Coding Options

Performance Met:

Documentation of iron stores prior to initiating erythropoietin therapy (3160F)

Denominator Exception:

Documentation of system reason(s) for not documentingiron stores prior to initiating erythropoietin therapy(3160F with 3P)

Performance Not Met:

Iron stores prior to initiating erythropoietin therapy not documented, reason not otherwise specified (3160F with 8P)

NUMERATOR NOTE: Denominator Exception(s) are determined on the date of the denominator eligible encounter.

Denominator

All patients aged 18 years and older with a diagnosis of multiple myeloma, not in remission

Eligible cases are determined, and must be reported, if either of the following conditions

DENOMINATOR NOTE: *Signifies that this CPT Category I code is a non-covered service under the Medicare Part B Physician Fee Schedule (PFS). These non-covered services should be counted in the denominator population for registry-based measures

Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter

AND

Diagnosis for multiple myeloma – not in remission (ICD-10-CM): C90.00, C90.02

AND

Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99241*, 99242*, 99243*, 99244*, 99245*

WITHOUT

Telehealth Modifier: GQ, GT, 95, POS 02


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