| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Claims, Registry | Outcome | Yes | Communication and Care Coordination | Pathology |
Measure Description
Pathology reports based on biopsy and/or cytology specimens with a diagnosis of primary non-small cell lung cancer classified into specific histologic type or classified as NSCLC-NOS with an explanation included in the pathology report
Instruction
This measure is to be reported each time a patient’s pathology report addresses specimens with a diagnosis of non- small cell lung cancer; however, only one quality-data code (QDC) per date of service for a patient is required. This measure maybe reported by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.
Denominator
Biopsy and cytology specimen reports with a diagnosis of primary non-small cell lungcancer
Denominator Criteria (Eligible Cases):
Patients ≥ 18 years of age on date of encounter
AND
Diagnosis for lung cancer (ICD-10-CM): C34.00, C34.01, C34.02, C34.10, C34.11, C34.12, C34.2, C34.30, C34.31, C34.32, C34.80, C34.81, C34.82, C34.90, C34.91,C34.92
AND
Patient encounter during performance period (CPT): 88104, 88108, 88112, 88173, 88305
AND NOT
DENOMINATOR EXCLUSION:
Specimen site other than anatomic location of lung or is not classified as primary non-small cell lung cancer: G9420
Numerator
Biopsy and cytology specimen reports with a diagnosis of primary non-small cell lung cancer classified into specific histologic type (squamous cell carcinoma, adenocarcinoma) OR classified as NSCLC-NOS with an explanation included in the pathology report
Numerator Options:
Performance Met: Primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type OR classified as NSCLC-NOS with an explanation (G9418)
OR
Denominator Exception: Documentation of medical reason(s) for not including the histological type OR NSCLC-NOS classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of primary non-small cell lung cancer or other documented medical reasons) (G9419)
OR
Performance Not Met: Primary non-small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type OR classified as NSCLC-NOS with an explanation (G9421)