Features Navigation

(800) 825-0224 Live Demo
 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

Experience AdvancedMD Software in a Live Demo.

Schedule a short and personalized overview, guided by a live expert.

“If we are waiting for a delivery or in between surgeries, we can log in, check messages or patient information and send electronic prescriptions as needed. Mobility is a good thing, and certainly being able to coordinate care with our patients from multiple locations is definitely a plus.”

Lisbeth Chang, MD
Sunrise Women’s Medical Group

Read the story  ›

“The nice thing about AdvancedMD is claims are cleared before they are forwarded to various insurance companies. We know very, very quickly if we have some defective portion on our claim.”

Dwight Romriell, DMD

Read the story  ›

“Our workflow has diminished as far as the redundancies, having to do the back-and-click here or check on this and check on that—it’s all right there!”

Johnette Lamborne
Office manager

“With AdvancedMD we got everything in one package, and the ability to ensure that we get maximum allowable Medicaid reimbursement.”

Charlotte Kientzy
Practice billing manager