| Measure Type | High Priority Measure? | NQS Domain |
|---|---|---|
| Process | Yes | Communication and Care Coordination |
| Data Submission Method(s) | ||
| Claims, Registry | ||
Measure Description
Pathology reports based on biopsy and/or cytology specimens with a diagnosis of primary nonsmall cell lung cancer classified into specific histologic type or classified as NSCLC-NOS with an explanation included in the pathology report
Instructions
This measure is to be submitted 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 may be submitted by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.
Measure Submission:
The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry submissions; however, these codes may be submitted for those registries that utilize claims data.
Denominator
Biopsy and cytology specimen reports with a diagnosis of primary non-small cell lung cancer
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 EXCLUSIONS:
Specimen sites 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 NSCLCNOS 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 nonsmall 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)