| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Registry | Process | No | Effective Clinical Care |
Measure Description
Percentage of patients aged 18 years and older with a diagnosis of myelodysplastic syndrome (MDS) who are receiving erythropoietin therapy with documentation of iron stores within 60 days prior to initiating erythropoietin therapy
Instruction
This measure is to be reported a minimum of once per performance period for all myelodysplastic syndrome (MDS) patients seen during the performance period, regardless of when erythropoietin therapy is initiated; the quality action being measured is that iron stores were documented for each MDS patient receiving erythropoietin therapy within 60 days of starting erythropoietin therapy, regardless of how far back the erythropoietin therapy initiated. It is anticipated that eligible clinicians who provide services for patients with the diagnosis of myelodysplastic syndromes will submit this measure.
Denominator
All patients aged 18 years and older with a diagnosis of myelodysplastic syndrome (MDS) who are receiving erythropoietin therapy
Definition:
Erythropoietin Therapy – Includes the following medications: epoetin and darbepoetin for the purpose of this measure.
Denominator Criteria (Eligible Cases):
Patients aged ≥ 18 years on date of encounter
AND
Diagnosis for MDS (ICD-10-CM): D46.0, D46.1, D46.20, D46.21, D46.22, D46.4, D46.9, D46.A, D46.B,
D46.C, D46.Z
AND
Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212,
99213, 99214, 99215
WITHOUT
Telehealth Modifier: GQ, GT
AND
Patient receiving erythropoietin therapy: 4090F
Numerator
Patients with documentation of iron stores within 60 days prior to initiating erythropoietin therapy
Definition:
Documentation of Iron Stores – Includes either: 1) bone marrow examination including iron stain OR 2)serum iron measurement including ferritin, serum iron and total iron-binding capacity (TIBC).
Numerator Options:
Performance Met: Documentation of iron stores prior to initiating erythropoietin therapy (3160F)
OR
Denominator Exception: Documentation of system reason(s) for not documenting iron stores prior to initiating erythropoietin therapy (3160F with 3P)
OR
Performance Not Met: Iron stores prior to initiating erythropoietin therapy not cumented, reason not otherwise specified (3160F with 8P)