| Measure: Percentage of adults 45-75 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 46-75 years of age by the end of the measurement period 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:
|
| Denominator Exceptions | None |
| Denominator Exclusions |
|
Setup Note
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.
Denominator
Patients who meet the following criteria will be included in the denominator:
Age is 46 years to 75 years at the end of the Measurement Period
AND
- Have at least one eligible encounter during the Measurement Period finalized by the EC
Encounter Codes Eligible for Denominator
CPT: 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99395, 99396, 99397, 99385, 99386, 99387, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 98969, 98970, 98971, 98972, 99421, 99422, 99423, 99458, 98966, 98967, 98968, 99441, 99442, 99443
HCPCS: G0438, G0439, G0071, G2010, G2012, G2061, G2062, G2063
Denominator Exclusions
A patient will be excluded from the measure if they meet any of the following conditions:
- Has an active diagnosis of colorectal cancer during the Measurement Period
- Had a total colectomy
- Is in hospice care for any part of the Measurement Period
- Is receiving palliative care for any part of the Measurement Period
- Age is ≥ 66 at the end of the Measurement Period and are living long term in a nursing home any time on or before the end of the Measurement Period
- Age is ≥ 66 at the end of the Measurement Period and has evidence of frailty and advanced illness
Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for malignant neoplasm of the colon can be located here.
Total Colectomy Performed
To document a total colectomy 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.
Hospice Care Services
To document hospice care ambulatory services, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
CPT: 99377, 99378
HCPCS: G0182
Order Status must be marked as Pending or Complete.
To document hospice care encounter services, go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
HCPCS: G9996, G9473, G9474, G9475, G9476, G9477, G9478, G9479, Q5003, Q5004, Q5005, Q5006, Q5007, Q5008, Q5010, S9126, T2042, T2043, T2044, T2045, T2046
Order Status must be marked as Complete.
Palliative Care
Palliative care services can be documented using the FACIT-Pal Questionnaire flowsheet, as an order, or as a diagnosis.
FACIT-Pal Questionnaire Flowsheet
Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
Click Add New Flowsheet
Select the FACIT-Pal Questionnaire flowsheet and click Add
Click Add Column
Populate the patient’s responses to the questions as appropriate
Click OK to save
Palliative Care Services Order
Go to Encounter > Orders/Procedure > Orders/Referrals and click Add to add one of the eligible codes listed below:
HCPCS: G9054
Order Status must be marked as Complete.
Palliative Care Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis code for palliative care is:
ICD-10: Z51.5
Living Long Term in a Nursing Home
To document a nursing home stay:
Go to Chart > Demographics > Patient Info
Click Update
Click Additional Info tab
Populate the Date field in the Pop. Info section
Select Patient lives in nursing home for Housing Status
Click Save
Frailty and Advanced Illness
Frailty
A patient has evidence of frailty if they meet any of the following criteria:
- Has an active diagnosis of Frailty during the Measurement Period
- Has an active diagnosis of Frailty Symptom during the Measurement Period
- Is using a frailty device during the Measurement Period
- Has a frailty encounter during the Measurement Period
Frailty Diagnosis
“Frailty” refers to a range of conditions that includes falls and problems affecting mobility.
Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for frailty can be located here.
Frailty Symptom Diagnosis
Diagnoses are documented in the Assessment tab of an encounter. The eligible diagnosis codes for frailty symptoms are:
ICD-10: R26.0, R26.1, R26.2, R26.89, R26.9, R41.81, R53.1, R53.81, R53.83, R54, R62.7, R63.4, R63.6, R64
Frailty Device Use
To document the patient’s use of a frailty device:
- Go to Encounter > Flowsheets/Labs > Standard or Chart > Flowsheets/Labs > Standard
- Click Add New Flowsheet
- Select the Frailty Device flowsheet and click Add
- Click Add Column
- Select a Device and the type (Value) of device
- Populate a usage Start Date for the device
- Optional: populate a usage Stop Date for the device
- The Stop Date cannot occur prior to the start of the Measurement Period
- Optional: populate a Reason for use of the device
- Click OK to save
Frailty Encounter Codes Eligible for Denominator Exclusion
CPT: 99504, 99509
HCPCS: G0162, G0299, G0300, G0493, G0494, S0271, S0311, S9123, S9124, T1000, T1001, T1002, T1003, T1004, T1005, T1019, T1020, T1021, T1022, T1030, T1031
Advanced Illness
A patient has evidence of advanced illness if they meet any of the following criteria:
- Had an inpatient encounter with an active diagnosis of Advanced Illness during the Measurement Period or in the year prior
- Had 2 or more outpatient encounters with an active diagnosis of Advanced Illness during the Measurement Period or in the year prior
- Encounters must have different dates of service
- Diagnosis must be active during all eligible encounters
- Was prescribed medication for dementia during the Measurement Period or in the year prior
Advanced Illness Diagnosis
“Advanced illness” refers to a wide range of conditions and includes diseases such as Alzheimer’s disease, cancer, and heart failure.
Diagnoses are documented in the Assessment tab of an encounter. A comprehensive list of eligible diagnosis codes for advanced illness can be located here.
Inpatient Encounter Codes Eligible for Denominator Exclusion
CPT: 99221, 99222, 99223, 99231, 99232, 99233, 99238, 99239, 99251, 99252, 99253, 99254, 99255, 99291
Outpatient Encounter Codes Eligible for Denominator Exclusion
CPT: 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99241, 99242, 99243, 99244, 99245, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, 99381, 99382, 99383, 99384, 99385, 99386, 99387, 99391, 99392, 99393, 99394, 99395, 99396, 99397, 99401, 99402, 99403, 99404, 99411, 99412, 99429, 99455, 99456, 99483, 99217, 99218, 99219, 99220, 99281, 99282, 99283, 99284, 99285, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99318, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
HCPCS: G0402, G0438, G0439, G0463, T1015
Medication
To prescribe a medication, go to Encounter > Medications > Manage/Prescribe Meds > New Prescription. A comprehensive list of eligible dementia medications can be located here.
Numerator
A patient will be counted in the numerator if they received at least one of the following colon cancer screenings:
- Colonoscopy during the Measurement Period or in the 9 years prior
- Flexible sigmoidoscopy during the Measurement Period or in the 4 years prior
- FOBT during the Measurement Period
- 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
Colonoscopy or Flexible Sigmoidoscopy Performed
To document a colonoscopy or flexible sigmoidoscopy 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.
Colonoscopy
CPT: 44388, 44389, 44390, 44391, 44392, 44393, 44394, 44397, 44401, 44402, 44403, 44404, 44405, 44406, 44407, 44408, 45355, 45378, 45379, 45380, 45381, 45382, 45383, 45384, 45385, 45386, 45387, 45388, 45389, 45390, 45391, 45392, 45393, 45398
HCPCS: G0105, G0121
Flexible Sigmoidoscopy
CPT: 44397, 45330, 45331, 45332, 45333, 45334, 45335, 45337, 45338, 45339, 45340, 45341, 45342, 45345, 45346, 45347, 45349, 45350
HCPCS: G0104
CT Colonography, FOBT, or FIT-DNA Test Results
To document that a CT Colonography, FOBT, or FIT-DNA test was performed, an e-Lab result for the test must be stored to the patient chart.
Store e-Lab Result
- From the Clinic Inbox, select the lab result to be stored and click View
- If the lab result is systematically matched to a patient, the Patient section will be populated in the lab result display
- If the lab result is not matched or the matched patient needs to be changed, the user will need to search for the patient
- Optional: click Select to search for and select a patient
- Select the I have verified the following lab results belong to the above patient checkbox
- Click Sign/Route
- 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.
eCQI Reference
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