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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
100 0392 Process Yes Effective Clinical Care Claims

Measure Description

Percentage of colon and rectum cancer resection pathology reports that include the pT category (primary tumor),the pN category (regional lymph nodes) and the histologic grade

Instructions

This measure is to be submitted each time a colorectal cancer resection surgical pathology examination is performed during the performance period for colorectal cancer patients. Each unique CPT Category I code submitted on the claim will be counted for denominator inclusion. It is anticipated that eligible clinicians who examine colorectal tissue specimens following resection in a laboratory or institution will submit this measure. If the specimen is not primary colorectal tissue (e.g., liver, lung), report only G8723.

NOTE: No notes related

Measure Submission

The listed denominator criteria is used to identify the intended patient population. The numerator quality-data codes included in this specification are used to submit the quality actions allowed by the measure. All measure-specific coding should be submitted on the claim(s) representing the eligible encounter

Numerator

Reports that include the pT category, the pN category and the histologic grade

Definition

No data related

Numerator Quality-Data Coding Options

Denominator Exclusion: G8723:
If Patient is not Eligible for this Measure because the Specimen is not Primary Colorectal Tissue (e.g., Liver, Lung) Report:

Specimen site is other than anatomic location of primary tumor

OR

Denominator Exception: G8722:
pT Category, pN Category and Histologic Grade not Documented for Medical Reasons:

Documentation of medical reason(s) for not including the pT category, the pN category or the histologic grade in the pathology report (e.g., re-excision without residual tumor; non-carcinomas, anal canal)

Performance Met: G8721:
pT Category, pN Category and Histologic Grade Documented

pT category (primary tumor), pN category (regional lymph nodes), and histologic grade were documented in pathology report

Performance Not Met: G8724:
pT Category, pN Category and Histologic Grade not Documented, Reason not Given:

pT category, pN category and histologic grade were not documented in the pathology report, reason not given

NUMERATOR NOTE: No notes related

Denominator

All colon and rectum cancer resection pathology reports

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

Option 1 – Denominator Criteria (Eligible Cases):

Diagnosis for colon or rectum cancer (ICD-10-CM): C18.0, C18.1, C18.2, C18.3, C18.4, C18.5,C18.6, C18.7, C18.8, C18.9, C19, C20, C21.2, C21.8

 

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