CMS 130v6: Colorectal Cancer Screening

Measure: Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Measure Type High Priority Measure Scoring
Process No A higher percentage indicates better quality
Denominator Patients 50-75 years of age with a visit during the measurement period
Numerator

Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria:

  • Fecal occult blood test (FOBT) during the measurement period
  • Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period
  • Colonoscopy during the measurement period or the nine years prior to the measurement period
  • FIT-DNA during the measurement period or the two years prior to the measurement period
  • CT Colonography during the measurement period or the four years prior to the measurement period
Denominator Exceptions None
Denominator Exclusions

Exclude patients:

  • With a diagnosis or past history of total colectomy or colorectal cancer
  • Who were in hospice care during the measurement year

A lab interface can be used to meet this eCQM but is not required. Customers interested in a lab interface should contact Sevocity Support to begin the process of a new interface setup. Interface setup requirements and fees vary per request.

Patients who meet the following criteria will be included in the denominator:

  • Age must be ≥ 50 years and < 75 years at the beginning of the Measurement Period

    AND

  • Must have at least one encounter during the Measurement Period finalized by the EC/EP

CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99385, 99386, 99387, 99395, 99396, 99397, 99221, 99222, 99223, 99231, 99232, 99233, 99241, 99242, 99243, 99244, 99245, 99281, 99282, 99283, 99284, 99285, 99305, 99306, 99307, 99308, 99309, 99310, 99251, 99252, 99253, 99254, 99255, 99381, 99382, 99383, 99384, 99024, 99391, 99392, 99393, 99394, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337

HCPCS: G0402, G0438, G0439

A patient will be excluded from the measure if they have an active diagnosis of malignant neoplasm of colon or if they received a total colectomy.

Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for malignant neoplasm of colon can be located here.

To document a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

CPT: 44150, 44151, 44152, 44153, 44155, 44156, 44157, 44158, 44210, 44211, 44212

Order Status must be marked as Complete in order to count as an exclusion.

Patients who were in hospice care during the measurement year will be excluded from the measure.

To document hospice care services as a procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:

SNOMED CT: 385763009, 385765002

Order Status must be marked as Complete.

SNOMED CT codes must be added as a Favorite in Preferences > Form Data > Orders to be accessible from the Orders/Referrals tab.

A patient will be counted in the numerator if they received at least one of the following colon cancer screenings:

  • FOBT during the Measurement Period
  • Flexible sigmoidoscopy during the Measurement Period or the 4 years prior
  • Colonoscopy during the Measurement Period or the 9 years prior
  • FIT-DNA test during the Measurement Period or in the 2 years prior
  • CT Colonography during the Measurement Period or in the 4 years prior

To document the performance of any of these procedure, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below. Order Status must be marked as Complete in order to count toward the numerator.

Colonoscopy

CPT: 44388, 44389, 44390, 44394, 44393, 44392, 44391, 45380, 45379, 45378, 45355, 44408, 44407, 44406, 44405, 44404, 44403, 44402, 44401, 44397, 45381, 45382, 45383, 45384, 45385, 45386, 45387, 45388, 45389, 45390, 45391, 45392, 45393, 45398

HCPCS: G0105, G0121

CT Colonography

CPT: 74263

Flexible Sigmoidoscopy

CPT: 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45339, 45340, 45341, 45342, 45345, 45346, 45347, 45349, 45350

HCPCS: G0104

FIT-DNA

CPT: 81528

HCPCS: G0464

To document that an FOBT test was performed, an e-Lab result for the test must be stored to the patient chart. FIT-DNA e-Lab results are also eligible for numerator inclusion.

  1. From the Clinic Inbox, select the lab result to be stored and click View
  2. Click Select to search for and select a patient
  3. Verify patient displayed matches the lab result and select the I have verified the following lab results belong to the above patient checkbox
  4. Click Sign/Route
  5. Select the Sign checkbox and click OK

Stored e-Lab results can be viewed in the Flowsheets/Labs > Scanned/E-Labs tab of the patient chart.

https://ecqi.healthit.gov/ecqm/ep/2018/cms130v6

 

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