2014 Oncology Measures Group Overview
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- Rosalyn Wade
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1 2014 Oncology Measures Group Overview The Oncology Measures Group is a reporting option that significantly reduces the burden of participation in the Physician Quality Reporting System (PQRS). Source: 2014 Physician Quality Reporting System (PQRS) Measures Groups Specifications Manual: Instruments/PQRS/MeasuresCodes.html
2 Reporting Requirements 20 Patient Sample Method A minimum of 20 unique patients. Minimum 11 of the 20 must be Medicare Part B fee-for-service (FFS) patients. Be 18 years old or older. Have a specific diagnosis of cancer. Billed one of the following radiation treatment management CPT codes: 77427, 77431, 77432, 77435, or Reporting Periods January 1, 2014 December 31, 2014, OR July 1, 2014 December 31, 2014 Measures There are a total of 8 s in the Oncology Measures Group. All applicable s must be reported at least once (for at least one patient that falls into the denominator for a ). The quality actions for each applicable must be performed at least once during the reporting period.
3 Oncology Measures Group Measures 71 Breast Cancer: Hormonal Therapy for Stage IC-IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer. 72 Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients. 110 Preventive Care and Screening: Influenza Immunization. 130 Documentation of Current Medications in the Medical Record. 143 Oncology: Medical and Radiation Pain Intensity Quantified. 144 Oncology: Medical and Radiation Plan of Care for Pain. 194 Oncology: Cancer Stage Documented. 226 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention.
4 71 Breast Cancer: Hormonal Therapy for Stage IC-IIIC ER/PR Positive Breast Cancer (s is applicable) Percentage of female patients 18 and older with Stage IC-IIIC ER or PR positive breast cancer who were prescribed tamoxifen or aromatase inhibitor (AI) during the reporting period. Female 18 years old or older, AND Has AJCC Stage IC-IIIC breast cancer, AND Applicable diagnosis codes: 174.0, 174.1, 174.2, 174.3, 174.4, 174.5, 174.6, 174.8, Is ER or PR positive to breast cancer. Patient seen during 2014 reporting period. Tamoxifen or AI prescribed AND AJCC breast cancer stage IC-IIIC documented. Tamoxifen or AI NOT prescribed, medical reason documented, AND AJCC breast cancer stage IC-IIIC documented. Tamoxifen or AI NOT prescribed, patient reason(s) documented, AND AJCC breast cancer stage IC-IIIC documented. Tamoxifen or AI NOT prescribed, system reason documented, AND AJCC breast cancer stage IC-IIIC documented. Tamoxifen or AI NOT prescribed, reason not specified, AND AJCC breast cancer stage IC-IIIC documented. Prescribed may include prescription given to patient for tamoxifen or AI at one or more visits during the reporting period OR patient already taking tamoxifen or AI as documented in the current medication list.
5 72 Colon Cancer: Chemotherapy for Stage III Colon Cancer Patients (s is applicable) Percentage of patients aged 18 through 80 years with AJCC Stage III colon cancer who are referred for adjuvant chemotherapy, prescribed adjuvant chemotherapy, or have previously received adjuvant chemotherapy within the reporting period years old, AND Has AJCC Stage IIIC colon cancer, AND Applicable diagnosis codes: 153.0, 153.1, 153.2, 153.3, 153.4, 153.6, 153.7, 153.8, Patient seen during 2014 reporting period. Adjuvant chemotherapy referred or prescribed AND AJCC Stage III colon cancer documented. Adjuvant chemotherapy NOT referred or prescribed, reason documented, AND AJCC Stage III colon cancer documented. Adjuvant chemotherapy NOT referred or prescribed, reason not given, AND AJCC Stage III colon cancer documented. This may not be applicable to many radiation oncologists patients. It is possible that no patients fall in the. Prescribed may include prescription ordered for the patient for adjuvant chemotherapy at one or more visits in the 12 month period OR patient already receiving adjuvant chemotherapy as documented in the current medication list.
6 110 Preventive Care and Screening: Influenza Immunization (s is applicable) Percentage of patients aged 6 months and older, seen during the flu season, who received an influenza immunization OR who reported previous receipt of an influenza immunization. 18 years or older AND Patient seen during either: January 1, 2014 March 31, 2014, OR October 1, 2014 December 31, Patient received influenza immunization or influenza immunization was previously received. Patient DID NOT receive influenza immunization or influenza immunization was NOT previously received, reason documented. Influenza immunization or influenza immunization ordered or recommended. Influenza immunization or influenza immunization NOT ordered or administered, reason not given. If patient visit date is between April 1, 2014 and September 31, 2014, the is not applicable. Influenza immunization must be documented for at least 1 patient if patients are seen between January and March, and October and December. Previous receipt is the receipt of current season s influenza immunization from another provider OR from same provider prior to the visit to which the is applied (typically, prior vaccination would include influenza vaccine given since August 1st).
7 130 Documentation of Current Medications in the Medical Record (s is applicable) Patients aged 18 years and older for which provider attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications name, dosage, frequency and route of administration. 18 years or older. Patient seen during 2014 reporting period. Current list of medications documented, OR there is documentation that no medications are currently being taken. Current list of medications NOT documented, AND documented that patient not eligible for a current list of medications being obtained, updated, or reviewed. Current list of medications NOT documented, reason not specified/given. Current medications must be documented for at least 1 patient. Current medications include all prescriptions, over-the counters, herbals and vitamin/mineral/dietary (nutritional) supplements with each medication s name, dosage, frequency and administered route.
8 143 Oncology: Medical and Radiation Pain Intensity Quantified (s is applicable) Patients with a diagnosis of cancer, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy in which intensity is quantified. Patient with a diagnosis of cancer. Patient seen during 2014 reporting period Pain present AND pain severity quantified. No pain present AND pain severity quantified (0). Pain severity NOT quantified, reason not otherwise specified. Pain must be quantified for at least 1 patient using a standard scale, such as 0-10 numerical rating scale.
9 144 Oncology: Medical and Radiation Plan of Care for Pain (s is applicable) Patients with a diagnosis of cancer currently receiving chemotherapy or radiation therapy who report having pain with a documented plan of care to address the pain. Patient with a diagnosis of cancer. Pain intensity has been quantified using a standard scale, such as 0-10 numerical rating scale. Patient seen during 2014 reporting period. Plan of care to address pain documented. Plan of care to address pain NOT documented, reason not otherwise specified. This is ONLY to be reported if pain was present for s #143 Oncology: Medical and Radiation Pain Intensity Quantified. DO NOT REPORT if no pain present for s #143. Plan of care must be documented for at least 1 patient for whom pain was present as identified in s #143.
10 194 Oncology: Cancer Stage Documented (s is applicable) Patients with a diagnosis of cancer, regardless of age, who are seen in the ambulatory setting who have a baseline AJCC cancer stage or documentation that cancer is metastatic in the medical record at least once during the reporting period. Patient with a diagnosis of cancer. Patient seen during 2014 reporting period. AJCC stage documented and reviewed. Cancer stage documented in medical record as metastatic and reviewed. Cancer stage NOT documented, reason not otherwise specified. Cancer stage must be documented for at least 1 patient. Cancer stage refers to stage at diagnosis. Documentation that cancer is metastatic at diagnosis also satisfies the requirements for this.
11 226 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (s is applicable) Patients, 18 or older, who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user. 18 years old or older. Patient seen during 2014 reporting period. Patient screened AND is a current tobacco user AND received cessation counseling intervention. Patient screened AND is not a current tobacco user. Patient NOT screened, medical reason documented for not screening. Patient NOT screened, reason not otherwise specified for not screening, OR the patient is a current tobacco but DID NOT receive cessation counseling intervention. Tobacco use screening and cessation intervention must be reported for at least 1 patient. Tobacco use includes any type of tobacco. Counseling intervention includes brief counseling (3 minutes or less), and/or pharmacotherapy.
12 One of the following diagnosis codes indicating cancer: ICD-9-CM 140.0, 140.1, 140.3, 140.4, 140.5, 140.6, 140.8, 140.9, 141.0,141.1, 141.2, 141.3, 141.4, 141.5, 141.6, 141.8, 141.9, 142.0, 142.1, 142.2, 142.8, 142.9, 143.0, 143.1,143.8, 143.9, 144.0, 144.1, 144.8, 144.9, 145.0, 145.1, 145.2, 145.3, 145.4, 145.5, 145.6, 145.8, 145.9,146.0, 146.1, 146.2, 146.3, 146.4, 146.5, 146.6, 146.7, 146.8, 146.9, 147.0, 147.1, 147.2, 147.3, 147.8,147.9, 148.0, 148.1, 148.2, 148.3, 148.8, 148.9, 149.0, 149.1, 149.8, 149.9, 150.0, 150.1, 150.2, 150.3,150.4, 150.5, 150.8, 150.9, 151.0, 151.1, 151.2, 151.3, 151.4, 151.5, 151.6, 151.8, 151.9, 152.0, 152.1,152.2, 152.3, 152.8, 152.9, 153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154.0,154.1, 154.2, 154.3, 154.8, 155.0, 155.1, 155.2, 156.0, 156.1, 156.2, 156.8, 156.9, 157.0, 157.1, 157.2,157.3, 157.4, 157.8, 157.9, 158.0, 158.8, 158.9, 159.0, 159.1, 159.8, 159.9, 160.0, 160.1, 160.2, 160.3,160.4, 160.5, 160.8, 160.9, 161.0, 161.1, 161.2, 161.3, 161.8, 161.9, 162.0, 162.2, 162.3, 162.4, 162.5,162.8, 162.9, 163.0, 163.1, 163.8, 163.9, 164.0, 164.1, 164.2, 164.3, 164.8, 164.9, 165.0, 165.8, 165.9,170.0, 170.1, 170.2, 170.3, 170.4, 170.5, 170.6, 170.7, 170.8, 170.9, 171.0, 171.2, 171.3, 171.4, 171.5,171.6, 171.7, 171.8, 171.9, 172.0, 172.1, 172.2, 172.3, 172.4, 172.5, 172.6, 172.7, 172.8, 172.9, 73.00,173.01, , , , , , , , , ,173.29, , ,173.32, , , , , , , , , , , , ,173.69, , , , , , , , , , , , , 174.0, 174.1, 174.2, 174.3, 174.4, 174.5, 174.6, 174.8, 174.9, 175.0, 175.9, 176.0, 176.1, 176.2, 176.3, 176.4, 176.5, 176.8, 176.9, 179, 180.0, 180.1, 180.8, 180.9, 181, 182.0, 182.1, 182.8, 183.0, 183.2, 183.3, 183.4, 183.5, 183.8, 183.9, 184.0, 184.1, 184.2, 184.3, 184.4, 184.8, 184.9, 185, 186.0, 186.9, 187.1, 187.2,187.3, 187.4, 187.5, 187.6, 187.7, 187.8, 187.9, 188.0, 188.1, 188.2, 188.3, 188.4, 188.5, 188.6, 188.7, 188.8, 188.9, 189.0, 189.1, 189.2, 189.3, 189.4, 189.8, 189.9, 190.0, 190.1, 190.2, 190.3, 190.4, 190.5,190.6, 190.7, 190.8, 190.9, 191.0, 191.1, 191.2, 191.3, 191.4, 191.5, 191.6, 191.7, 191.8, 191.9, 192.0,192.1, 192.2, 192.3, 192.8, 192.9, 193, 194.0, 194.1, 194.3, 194.4, 194.5, 194.6, 194.8, 194.9, 195.0, 195.1,195.2, 195.3, 195.4, 195.5, 195.8, 196.0, 196.1, 196.2, 196.3, 196.5, 196.6, 196.8, 196.9, 197.0, 197.1,197.2, 197.3, 197.4, 197.5, 197.6, 197.7, 197.8, 198.0, 198.1, 198.2, 198.3, 198.4, 198.5, 198.6, 198.7,198.81, , , 199.0, 199.1, 199.2, , , , , , , , , , , , , , , , , , , , ,200.22, , , , , , , , , , , , ,200.36, , , , , , , , , , , , ,200.51, , , , , , CONTINUED ON NEXT SLIDE.
13 200.57, , , , , , ,200.65, , , , , , , , , , , , ,200.80, , , , , , , , , , , , ,201.04, , , , , , , , , , , , ,201.18, , , , , , , , , , , , ,201.43, , , , , , , , , , , , ,201.57, , , , , , , , , , , , ,201.72, , , , , , , , , , , , ,201.96, , , , , , , , , , , , ,202.11, , , , , , , , , , , , ,202.25, , , , , , , , , , , , , , , , , , , , , , , , , ,202.54, , , , , , , , , , , , ,202.68, , , , , , , , , , , , ,202.83, , , , , , , , , , , , ,202.97, , , , , , , , , , , , ,204.02, , , , , , , , , , , , ,205.00, , , , , , , , , , , , ,205.81, , , , , , , , , , , , ,206.22, , , , , , , , , , , , ,207.20, , , , , , , , , , , , ,208.21, , , , , , , , , , , , ,209.11, , , , , , , , , , , , ,209.26, , , , , , , , , , , , ,209.73, , , , 235.0, 235.1, 235.2, 235.3, 235.4, 235.5, 235.6, 235.7, 235.8, 235.9, 236.0, 236.1, 236.2, 236.3, 236.4, 236.5, 236.6, 236.7, , , , 237.0, 237.1, 237.2, 237.3, 237.4, 237.5, 237.6, , , , , , , 237.9, 238.0, 238.1, 238.2, 238.3, 238.4, 238.5, 238.6, , , , , , , , 238.8, 238.9, 239.0, 239.1, 239.2,239.3, 239.4, 239.5, 239.6, 239.7, , ,
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