2017 MIPS Measure #343: Screening Colonoscopy Adenoma Detection Rate

Valid Data Submission Method(s) Measure Type High Priority Measure? NQS Domain Specialty Measure Sets
Registry Outcome Yes Effective Clinical Care Gastroenterology

Measure Description

The percentage of patients age 50 years or older with at least one conventional adenoma or colorectal cancer detected during screening colonoscopy

Instruction

This measure is to be reported each time a screening colonoscopy for colorectal cancer is performed during the performance period. 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

Patients age 50 years or older undergoing a screening colonoscopy

Definition:
Colorectal Cancer Precursor Lesions– Based on pathologic diagnosis, colorectal cancer precursor lesions include: adenomatous polyps [tubular, tubulovillous, villous] and traditional serrated adenomas, sessile serrated polyps and sessile serrated adenomas.

Denominator Criteria (Eligible Cases):
Patients 50 years of age or older on date of encounter
AND
Risk factors for colorectal cancer (ICD-10-CM): Z80.0, Z83.71, Z12.11
AND
Patient procedure during performance period (CPT or HCPCS): 45378, 45380, 45381, 45384, 45385, G0121
WITHOUT
Modifiers: 52, 53, 73, or 74

Numerator

Number of patients age 50 years or older with at least one conventional adenoma or colorectal cancer detected during screening colonoscopy

Numerator Options:
Performance Met: Adenoma(s) or other neoplasm detected during screening colonoscopy (3775F)
OR
Denominator Exception: Documentation of reason for not detecting adenoma(s) or other neoplasm (e.g., Neoplasm detected is only diagnosed as traditional serrated adenoma, sessile serrated polyp, or sessile serrated adenoma) (G9496)
OR
Performance Not Met: Adenoma(s) or other neoplasm not detected during screening colonoscopy (3776F)

Stay up to date with the latest news regarding MACRA and MIPS.

The Healthmonix Advisor is a free weekly news source, connecting you to the latest updates in the value-based care industry.