2017 MIPS Measure #251: Quantitative Immunohistochemical (IHC) Evaluation of Human Epidermal Growth Factor Receptor 2 Testing (HER2) for Breast Cancer Patients

Valid Data Submission Method(s) Measure Type High Priority Measure? NQS Domain Specialty Measure Sets
Claims, Registry Structure No Effective Clinical Care Pathology

Measure Description

This is a measure based on whether quantitative evaluation of Human Epidermal Growth Factor Receptor 2 Testing (HER2) by immunohistochemistry (IHC) uses the system recommended in the current ASCO/CAP Guidelines for Human Epidermal Growth Factor Receptor 2 Testing in breast cancer

Instruction

This measure should be reported each time a quantitative HER2 IHC pathology examination is performed during the performance period for patients with breast cancer; however, only one quality-data code (QDC) per date of service for a patient is required. This measure may be 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

All breast cancer patients with quantitative breast tumor evaluation by HER2 IHC

Denominator Criteria (Eligible Cases):
Diagnosis for breast cancer (ICD-10-CM): C50.011, C50.012, C50.019, C50.021, C50.022, C50.029, C50.111, C50.112, C50.119, C50.121, C50.122, C50.129, C50.211, C50.212, C50.219, C50.221, C50.222, C50.229, C50.311, C50.312, C50.319, C50.321, C50.322, C50.329, C50.411, C50.412, C50.419, C50.421, C50.422, C50.429, C50.511, C50.512, C50.519, C50.521, C50.522, C50.529, C50.611, C50.612, C50.619, C50.621, C50.622, C50.629, C50.811, C50.812, C50.819, C50.821, C50.822, C50.829, C50.911, C50.912, C50.919, C50.921, C50.922, C50.929
AND
Patient procedure during the performance period (CPT): 88360, 88361
AND NOT
DENOMINATOR EXCLUSION:
Quantitative non-HER2 IHC evaluation (eg, testing for estrogen or progesterone receptors, [ER/PR]) performed: 3395F

Numerator

Breast cancer patients receiving quantitative breast tumor HER2 IHC evaluation using the ASCO/CAP recommended manual system or a computer-assisted system consistent with the optimal algorithm for HER2 testing as described in the current ASCO/CAP guideline

Numerator Options:
Performance Met: Quantitative HER2 by IHC evaluation consistent with
scoring system defined in the ASCO/CAP guidelines
(3394F)
OR
Performance Not Met: Quantitative evaluation of HER2 did not use the system
recommended in the ASCO/CAP Guidelines for Human
Epidermal Growth Factor Receptor 2 Testing in breast
cancer, reason not otherwise specified (3394F with 8P)

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