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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
144 0383 Process Yes Person and Caregiver-Centered Experience and Outcomes Registry

Measure Description

Percentage of visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy who report having pain with a documented plan of care to address pain

Instructions

This measure is to be submitted at each denominator eligible visit occurring during the performance period for patients with a diagnosis of cancer and in which pain is present who are seen during the performance period. It is anticipated that eligible clinicians providing care for patients with cancer will submit this measure.

NOTE: No additional 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

Patient visits that included a documented plan of care to address pain

Definition

Numerator Instructions:  A documented plan of care may include: use of opioids, nonopioid analgesics, psychological support, patient and/or family education, referral to a pain clinic, or reassessment of pain at an appropriate time interval.

Numerator Quality-Data Coding Options

Performance Met:

Plan of care to address pain documented (0521F)

Denominator Exception:

No data related

Performance Not Met:

Plan of care for pain not documented, reason not otherwise specified (0521F with 8P)

NUMERATOR NOTE: No data related

Denominator

All visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy who report having pain

Option 1 – Denominator Criteria (Eligible Cases):

All eligible instances when pain severity quantified; pain present (1125F) is submitted in the numerator for Measure #143

Diagnosis for cancer (ICD-10-CM): C00.0, C00.1, C00.2, C00.3, C00.4, C00.5, C00.6, C00.8, C00.9,C01,
C02.0, C02.1, C02.2, C02.3, C02.4, C02.8, C02.9, C03.0, C03.1, C03.9, C04.0, C04.1, C04.8, C04.9, C05.0,
C05.1, C05.2, C05.8, C05.9, C06.0, C06.1, C06.2, C06.80, C06.89, C06.9, C07, C08.0, C08.1, C08.9,
C09.0, C09.1, C09.8, C09.9, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C11.0, C11.1, C11.2, C11.3,
C11.8, C11.9, C12, C13.0, C13.1, C13.2, C13.8, C13.9, C14.0, C14.2, C14.8, C15.3, C15.4, C15.5, C15.8,
C15.9, C16.0, C16.1, C16.2, C16.3, C16.4, C16.5, C16.6, C16.8, C16.9, C17.0, C17.1, C17.2, C17.3,
C17.8, C17.9, C18.0, C18.1, C18.2, C18.3, C18.4, C18.5, C18.6, C18.7, C18.8, C18.9, C19, C20, C21.0,
C21.1, C21.2, C21.8, C22.0, C22.1, C22.2, C22.3, C22.4, C22.7, C22.8, C22.9, C23, C24.0, C24.1, C24.8,
C24.9, C25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, C25.9, C26.0, C26.1, C26.9, C30.0, C30.1, C31.0,
C31.1, C31.2, C31.3, C31.8, C31.9, C32.0, C32.1, C32.2, C32.3, C32.8, C32.9, C33, C34.00, C34.01,
C34.02, C34.10, C34.11, C34.12, C34.2, C34.30, C34.31, C34.32, C34.80, C34.81, C34.82, C34.90,
C34.91, C34.92, C37, C38.0, C38.1, C38.2, C38.3, C38.4, C38.8, C39.0, C39.9,C40.00, C40.01, C40.02,
C40.10, C40.11, C40.12, C40.20, C40.21, C40.22, C40.30, C40.31, C40.32,C40.80, C40.81, C40.82,
C40.90, C40.91, C40.92, C41.0, C41.1, C41.2, C41.3, C41.4, C41.9, C43.0,C43.10, C43.11, C43.12,
C43.20, C43.21, C43.22, C43.30, C43.31, C43.39, C43.4, C43.51, C43.52,C43.59, C43.60, C43.61,
C43.62, C43.70, C43.71, C43.72, C43.8, C43.9, C44.00, C44.01, C44.02, C44.09, C44.101, C44.102,
C44.109, C44.111, C44.112, C44.119, C44.121, C44.122, C44.129, C44.191, C44.192, C44.199, C44.201,
C44.202, C44.209, C44.211, C44.212, C44.219, C44.221, C44.222, C44.229, C44.291, C44.292, C44.299,
C44.300, C44.301, C44.309, C44.310, C44.311, C44.319, C44.320, C44.321, C44.329, C44.390, C44.391, C44.399, C44.40, C44.41, C44.42, C44.49, C44.500, C44.501, C44.509,C44.510, C44.511, C44.519,
C44.520, C44.521, C44.529, C44.590, C44.591, C44.599, C44.601, C44.602, C44.609, C44.611, C44.612,
C44.619, C44.621, C44.622, C44.629, C44.691, C44.692, C44.699, C44.701, C44.702, C44.709, C44.711,
C44.712, C44.719, C44.721, C44.722, C44.729, C44.791, C44.792, C44.799, C44.80, C44.81, C44.82,
C44.89, C44.90, C44.91, C44.92, C44.99, C45.0, C45.1, C45.2, C45.7, C45.9, C46.0, C46.1, C46.2, C46.3,
C46.4, C46.50, C46.51, C46.52, C46.7, C46.9, C47.0, C47.10, C47.11, C47.12, C47.20, C47.21, C47.22,
C47.3, C47.4, C47.5, C47.6, C47.8, C47.9, C48.0, C48.1, C48.2, C48.8, C49.0, C49.A0, C49.A1, C49.A2,
C49.A3, C49.A4, C49.A5, C49.A9, C49.10, C49.11, C49.12, C49.20, C49.21, C49.22, C49.3, C49.4, C49.5,
C49.6, C49.8, C49.9,C4A.0, C4A.10, C4A.11, C4A.12, C4A.20, C4A.21, C4A.22, C4A.30, C4A.31, C4A.39,
C4A.4, C4A.51, C4A.52, C4A.59, C4A.60, C4A.61, C4A.62, C4A.70, C4A.71, C4A.72, C4A.8, C4A.9,
C50.011, C50.012, C50.019, C50.021, C50.022, C50.029, C50.111, C50.112, C50.119, C50.121, C50.122,
C50.129, C50.211, C50.212, C50.219, C50.221, C50.222, C50.229, C50.311, C50.312, C50.319, C50.321,
C50.322, C50.329, C50.411, C50.412, C50.419, C50.421, C50.422, C50.429, C50.511, C50.512, C50.519,
C50.521, C50.522, C50.529, C50.611, C50.612, C50.619, C50.621, C50.622, C50.629, C50.811, C50.812,
C50.819, C50.821, C50.822, C50.829, C50.911, C50.912, C50.919, C50.921, C50.922, C50.929, C51.0,
C51.1, C51.2, C51.8, C51.9, C52, C53.0, C53.1, C53.8, C53.9, C54.0, C54.1, C54.2, C54.3, C54.8, C54.9,
C55, C56.1, C56.2,C56.9, C57.00, C57.01, C57.02, C57.10, C57.11, C57.12, C57.20, C57.21, C57.22,
C57.3, C57.4, C57.7,C57.8, C57.9, C58, C60.0, C60.1, C60.2, C60.8, C60.9, C61, C62.00, C62.01,
C62.02, C62.10, C62.11,C62.12, C62.90, C62.91, C62.92, C63.00, C63.01, C63.02, C63.10, C63.11,
C63.12, C63.2, C63.7, C63.8,C63.9, C64.1, C64.2, C64.9, C65.1, C65.2, C65.9, C66.1, C66.2, C66.9,
C67.0, C67.1, C67.2, C67.3, C67.4, C67.5, C67.6, C67.7, C67.8, C67.9, C68.0, C68.1, C68.8, C68.9,
C69.00, C69.01, C69.02, C69.10, C69.11, C69.12, C69.20, C69.21, C69.22, C69.30, C69.31, C69.32,
C69.40, C69.41, C69.42, C69.50,C69.51, C69.52, C69.60, C69.61, C69.62, C69.80, C69.81, C69.82,
C69.90, C69.91, C69.92, C70.0, C70.1, C70.9, C71.0, C71.1, C71.2, C71.3, C71.4, C71.5, C71.6, C71.7,
C71.8, C71.9, C72.0, C72.1, C72.20,C72.21, C72.22, C72.30, C72.31, C72.32, C72.40, C72.41, C72.42,
C72.50, C72.59, C72.9, C73, C74.00, C74.01, C74.02, C74.10, C74.11, C74.12, C74.90, C74.91, C74.92,
C75.0, C75.1, C75.2, C75.3, C75.4, C75.5, C75.8, C75.9, C76.0, C76.1, C76.2, C76.3, C76.40, C76.41,
C76.42, C76.50, C76.51, C76.52, C76.8, C77.0, C77.1, C77.2, C77.3, C77.4, C77.5, C77.8, C77.9, C78.00,
C78.01, C78.02, C78.1, C78.2, C78.30, C78.39, C78.4, C78.5, C78.6, C78.7, C78.80, C78.89, C79.00,
C79.01, C79.02, C79.10, C79.11, C79.19, C79.2, C79.31, C79.32, C79.40, C79.49, C79.51, C79.52,
C79.60, C79.61, C79.62, C79.70, C79.71, C79.72, C79.81, C79.82, C79.89, C79.9, C7A.00, C7A.010,
C7A.011, C7A.012, C7A.019, C7A.020, C7A.021, C7A.022, C7A.023, C7A.024, C7A.025, C7A.026,
C7A.029, C7A.090, C7A.091, C7A.092, C7A.093, C7A.094, C7A.095, C7A.096, C7A.098, C7A.1, C7A.8,
C7B.00, C7B.01, C7B.02, C7B.03, C7B.04, C7B.09, C7B.1, C7B.8, C80.0, C80.1, C80.2, C81.00, C81.01,
C81.02, C81.03, C81.04,C81.05, C81.06, C81.07, C81.08, C81.09, C81.10, C81.11, C81.12, C81.13,
C81.14, C81.15, C81.16,C81.17, C81.18, C81.19, C81.20, C81.21, C81.22, C81.23, C81.24, C81.25,
C81.26, C81.27, C81.28,C81.29, C81.30, C81.31, C81.32, C81.33, C81.34, C81.35, C81.36, C81.37,
C81.38, C81.39, C81.40,C81.41, C81.42, C81.43, C81.44, C81.45, C81.46, C81.47, C81.48, C81.49,
C81.70, C81.71, C81.72,C81.73, C81.74, C81.75, C81.76, C81.77, C81.78, C81.79, C81.90, C81.91,
C81.92, C81.93, C81.94,C81.95, C81.96, C81.97, C81.98, C81.99, C82.00, C82.01, C82.02, C82.03,
C82.04, C82.05, C82.06,C82.07, C82.08, C82.09, C82.10, C82.11, C82.12, C82.13, C82.14, C82.15,
C82.16, C82.17, C82.18,C82.19, C82.20, C82.21, C82.22, C82.23, C82.24, C82.25, C82.26, C82.27,
C82.28, C82.29, C82.30,C82.31, C82.32, C82.33, C82.34, C82.35, C82.36, C82.37, C82.38, C82.39,
C82.40, C82.41, C82.42,C82.43, C82.44, C82.45, C82.46, C82.47, C82.48, C82.49, C82.50, C82.51,
C82.52, C82.53, C82.54,C82.55, C82.56, C82.57, C82.58, C82.59, C82.60, C82.61, C82.62, C82.63,
C82.64, C82.65, C82.66,C82.67, C82.68, C82.69, C82.80, C82.81, C82.82, C82.83, C82.84, C82.85,
C82.86, C82.87, C82.88,C82.89, C82.90, C82.91, C82.92, C82.93, C82.94, C82.95, C82.96, C82.97,
C82.98, C82.99, C83.00,C83.01, C83.02, C83.03, C83.04, C83.05, C83.06, C83.07, C83.08, C83.09,
C83.10, C83.11, C83.12,C83.13, C83.14, C83.15, C83.16, C83.17, C83.18, C83.19, C83.30, C83.31,
C83.32, C83.33, C83.34,C83.35, C83.36, C83.37, C83.38, C83.39, C83.50, C83.51, C83.52, C83.53,
C83.54, C83.55, C83.56,C83.57, C83.58, C83.59, C83.70, C83.71, C83.72, C83.73, C83.74, C83.75,
C83.76, C83.77, C83.78,C83.79, C83.80, C83.81, C83.82, C83.83, C83.84, C83.85, C83.86, C83.87,
C83.88, C83.89, C83.90, C83.91, C83.92, C83.93, C83.94, C83.95, C83.96, C83.97, C83.98, C83.99,
C84.00, C84.01, C84.02, C84.03, C84.04, C84.05, C84.06, C84.07, C84.08, C84.09, C84.10, C84.11,
C84.12, C84.13, C84.14, C84.15, C84.16, C84.17, C84.18, C84.19, C84.40, C84.41, C84.42, C84.43,
C84.44, C84.45, C84.46,C84.47, C84.48, C84.49, C84.60, C84.61, C84.62, C84.63, C84.64, C84.65,
C84.66, C84.67, C84.68, C84.69, C84.70, C84.71, C84.72, C84.73, C84.74, C84.75, C84.76, C84.77,
C84.78, C84.79, C84.90, C84.91, C84.92, C84.93, C84.94, C84.95, C84.96, C84.97, C84.98, C84.99,
C84.A0, C84.A1, C84.A2,C84.A3, C84.A4, C84.A5, C84.A6, C84.A7, C84.A8, C84.A9, C84.Z0, C84.Z1,
C84.Z2, C84.Z3, C84.Z4, C84.Z5, C84.Z6, C84.Z7, C84.Z8, C84.Z9, C85.10, C85.11, C85.12, C85.13,
C85.14, C85.15, C85.16,C85.17, C85.18, C85.19, C85.20, C85.21, C85.22, C85.23, C85.24, C85.25,
C85.26, C85.27, C85.28, C85.29, C85.80, C85.81, C85.82, C85.83, C85.84, C85.85, C85.86, C85.87,
C85.88, C85.89, C85.90, C85.91, C85.92, C85.93, C85.94, C85.95, C85.96, C85.97, C85.98, C85.99,
C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.2, C88.3, C88.4, C88.8, C88.9, C90.00,
C90.01, C90.02, C90.10,C90.11, C90.12, C90.20, C90.21, C90.22, C90.30, C90.31, C90.32, C91.00,
C91.01, C91.02, C91.10, C91.11, C91.12, C91.30, C91.31, C91.32, C91.40, C91.41, C91.42, C91.50,
C91.51, C91.52, C91.60, C91.61, C91.62, C91.90, C91.91, C91.92, C91.A0, C91.A1, C91.A2, C91.Z0,
C91.Z1, C91.Z2, C92.00, C92.01, C92.02, C92.10, C92.11, C92.12, C92.20, C92.21, C92.22, C92.30,
C92.31, C92.32, C92.40,C92.41, C92.42, C92.50, C92.51, C92.52, C92.60, C92.61, C92.62, C92.90,
C92.91, C92.92, C92.A0, C92.A1, C92.A2, C92.Z0, C92.Z1, C92.Z2, C93.00, C93.01, C93.02, C93.10,
C93.11, C93.12, C93.30,C93.31, C93.32, C93.90, C93.91, C93.92, C93.Z0, C93.Z1, C93.Z2, C94.00,
C94.01, C94.02, C94.20,C94.21, C94.22, C94.30, C94.31, C94.32, C94.40, C94.41, C94.42, C94.6,
C94.80, C94.81, C94.82,C95.00, C95.01, C95.02, C95.10, C95.11, C95.12, C95.90, C95.91, C95.92,
C96.0, C96.20, C96.21, C96.22, C96.29, C96.4, C96.5, C96.6, C96.9, C96.A, C96.Z, D37.01, D37.02,
D37.030, D37.031, D37.032, D37.039, D37.04, D37.05,D37.09, D37.1, D37.2, D37.3, D37.4, D37.5, D37.6,
D37.8, D37.9, D38.0, D38.1, D38.2, D38.3, D38.4, D38.5, D38.6, D39.0, D39.10, D39.11, D39.12, D39.2,
D39.8, D39.9, D40.0, D40.10, D40.11, D40.12,D40.8, D40.9, D41.00, D41.01, D41.02, D41.10, D41.11,
D41.12, D41.20, D41.21, D41.22, D41.3, D41.4,D41.8, D41.9, D42.0, D42.1, D42.9, D43.0, D43.1, D43.2,
D43.3, D43.4, D43.8, D43.9, D44.0, D44.10, D44.11, D44.12, D44.2, D44.3, D44.4, D44.5, D44.6, D44.7,
D44.9, D45, D46.0, D46.1, D46.20, D46.21, D46.22, D46.4, D46.9, D46.A, D46.B, D46.C, D46.Z, D47.1,
D47.2, D47.3, D47.4, D47.9, D47.Z1, D47.Z2, D47.Z9, D48.0, D48.1, D48.2, D48.3, D48.4, D48.5, D48.60,
D48.61, D48.62, D48.7, D48.9, D49.0, D49.1, D49.2, D49.3, D49.4, D49.5, D49.511, D49.512, D49.519,
D49.59, D49.6, D49.7, D49.81, D49.89, D49.9, Q85.00, Q85.01, Q85.02, Q85.03,Q85.09

AND

Patient procedure during the performance period (CPT) – Procedure codes: 77427, 77431, 77432, 77435

OR

Patient encounter during the performance period (CPT) – Service codes: 99201, 99202, 99203,99204, 99205, 99212, 99213, 99214, 99215

WITHOUT

Telehealth Modifier: GQ, GT, 95, POS 02

AND

Patient procedure during the performance period (CPT) – Procedure codes: 51720, 96401, 96402, 96405, 96406, 96409, 96411, 96413, 96415, 96416, 96417, 96420, 96422, 96423, 96425, 96440, 96446, 96450, 96521, 96522, 96523, 96542, 96549

 

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