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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
396 0000 Process Yes Communication and Care Coordination Claims

Measure Description

Pathology reports based on resection specimens with a diagnosis of primary lung carcinoma that include the pT category, pN category and for non-small cell lung cancer, histologic type

Instructions

This measure is to be submitted each time a patient’s pathology report addresses specimens with a diagnosis of non-small cell lung cancer; however, only one quality-data code (QDC) per date of service for a patient is required. This measure may be submitted by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

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

Pathology reports based on resection specimens with a diagnosis of primary lung carcinoma that include the pT category, pN category and for non-small cell lung cancer, histologic type (squamous cell carcinoma, adenocarcinoma and NOT NSCLC-NOS)

Definition

No data

Numerator Quality-Data Coding Options

NUMERATOR 

If Patient is not Eligible for this Measure because the Specimen is not of Lung Origin, or is Classified
as NSCLC-NOS Report:

Denominator Exclusion: G9424:

Specimen site other than anatomic location of lung, ORclassified as NSCLC-NOS

OR

Primary Lung Carcinoma that Include the pT category, pN category and for Non- Small Cell Lung Cancer, Histologic Type (Squamous Cell Carcinoma, Adenocarcinoma) not Documented for Medical Reasons

Denominator Exception: G9423:

Documentation of medical reason for not including pT category, pN category and histologic type [For patient with appropriate exclusion criteria (e.g. metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)]

NUMERATOR 

Primary Lung Carcinoma that Include the pT category, pN category and for Non-Small Cell Lung Cancer, Histologic Type (Squamous Cell Carcinoma, Adenocarcinoma and NOT NSCLC-NOS)

Performance Met: G9422:

Primary lung carcinoma resection report documents pT category, pN category and for Non-small Cell Lung Cancer, Histologic Type (Squamous Cell Carcinoma, Adenocarcinoma and NOT NSCLC-NOS)

NUMERATOR:

Performance Not Met: G9425:
Primary Lung Carcinoma that Include the pT category, pN category and for Non-Small Cell Lung Cancer, Histologic Type (Squamous Cell Carcinoma, Adenocarcinoma) not Documented, Reason not Given

 

Primary lung carcinoma resection report does not document pT category, pN category and for Non-small Cell Lung Cancer, Histologic Type (Squamous Cell Carcinoma, Adenocarcinoma)

Numerator Note: No data

Denominator

Pathology reports for resection specimens for primary lung carcinoma

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

Option 1 – Denominator Criteria (Eligible Cases):

Patients aged ≥ 18 years on the date of encounter

AND
Diagnosis for lung cancer (ICD-10-CM): 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
AND
Patient procedure during performance period (CPT): 88309

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