Registry
| ID | NQF # | Measure Type | High Priority Measure? | NQS Domain | Data Submission Method(s) |
|---|---|---|---|---|---|
| 156 | 0382 | Process | Yes | Patient Safety | Claims |
Measure Description
Percentage of patients, regardless of age, with a diagnosis of breast, rectal, pancreatic or lung cancer receiving 3D conformal radiation therapy who had documentation in medical record that radiation dose limits to normal tissues were established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissues
Instructions
This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of breast,
rectal, pancreatic or lung cancer receiving 3D conformal radiation therapy seen during the performance period. It is
anticipated that eligible clinicians providing radiation therapy for patients with cancer will submit this measure.
NOTE: No notes for this Quality ID
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. There are no allowable performance exclusions for this measure.
Numerator
Patients who had documentation in medical record that radiation dose limits to normal tissues were established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissues
Numerator Instructions:
Data not available
Numerator Quality-Data Coding Options
Radiation Dose Limits to Normal Tissues Established
Performance Met: CPT II 0520F:
Radiation dose limits to normal tissues established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissue/organ
Performance Not Met: 0520F with 8P:
Radiation Dose Limits to Normal Tissues not Established, Reason not Otherwise Specified
Append a reporting modifier (8P) to CPT Category II code 0520F to report circumstances when the action described in the numerator is not performed and the reason is not otherwise specified.
Radiation dose limits to normal tissues not established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissue/organ, reason not otherwise specified
NUMERATOR NOTE:
Data not available
Denominator
All patients, regardless of age, with a diagnosis of breast, rectal, pancreatic or lung cancer receiving 3D conformal radiation therapy
Eligible cases are determined and must be reported, if either of the following conditions
Option 1 – Denominator Criteria (Eligible Cases):
Diagnosis for breast, rectal, pancreatic or lung cancer (ICD-10-CM): C19, C20, C21.2, C21.8,C25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, C25.9, 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, 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
AND
Patient procedure during the performance period (CPT): 77295
AND NOT
Diagnosis for metastatic cancer (ICD-10-CM): 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
