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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
397 0000 Process Yes Communication and Care Coordination Claims

Measure Description

Pathology reports for primary malignant cutaneous melanoma that include the pT category and a statement on thickness and ulceration and for pT1, mitotic rate

Instructions

This measure is to be submitted each time a patient’s pathology report addresses specimens with a diagnosis of malignant cutaneous melanoma; 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 for primary malignant cutaneous melanoma that include the pT category and a statement on thickness and ulceration and for pT1, mitotic rate

Definition

No data

Numerator Quality-Data Coding Options

NUMERATOR 

If Patient is not Eligible for this Measure because the Specimen is not of Cutaneous Origin:

Denominator Exclusion: G9430:

Specimen site other than anatomic cutaneous location

OR

Pathology Reports that does not Include the pT Category and a Statement on Thickness and Ulceration
and for pT1, mitotic rate, not Documented for Medical Reasons

Denominator Exception: G9429:

Documentation of medical reason(s) for not including pT Category and a statement on thickness and ulceration and for pT1, mitotic rate (e.g., negative skin biopsies in a patient with a history of melanoma or other documented medical reasons)

NUMERATOR 

Pathology Reports that Include the pT Category and a Statement on Thickness and Ulceration and for pT1, mitotic rate

Performance Met: G9428:

Pathology report includes the pT Category and a statement on thickness and ulceration and for pT1, mitotic rate

NUMERATOR:

Performance Not Met: G9431:
Pathology Reports that does not Include the pT Category and a Statement on Thickness and Ulceration and for pT1, mitotic rate, Reason not given

Pathology report does not include the pT Category and a statement on thickness and ulceration and for pT1, mitotic rate

Numerator Note: No data

Denominator

All melanoma pathology reports for primary malignant cutaneous melanoma

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 malignant cutaneous melanoma (ICD-10-CM): C43.0, 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
AND
Patient procedure during performance period (CPT): 88305

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