| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Claims, EHR, CMS Web Interface, Registry | Process | No | Effective Clinical Care | Internal Medicine, Obstetrics/Gynecology, Preventive Medicine, General Practice/Family Medicine |
Measure Description
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer.
Instruction
This measure is to be reported a minimum of once per performance period for female patients seen during the performance period. There is no diagnosis associated with this measure. The patient should either be screened for breast cancer on the date of service OR there should be documentation that the patient was screened for breast cancer at least once within 27 months prior to the date of service. Performance for this measure is not limited to the performance period. This measure may be reported by eligible clinicians who perform the quality actions described in the measure based on services provided and the measure-specific denominator coding.
Denominator
Women 51 – 74 years of age with a visit during the measurement period
DENOMINATOR NOTE: The intent of the measure is that starting at age 50 women should have one or more mammograms every 24 months with a 3 month grace period.
Denominator Criteria (Eligible Cases):
Patients 51 to 74 years of age on date of encounter
AND
Patient encounter during the performance period (CPT or HCPCS): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215, 99341, 99342, 99343, 99344, 99345, 99347, 99348, 99349, 99350, G0402, G0438, G0439
AND NOT
DENOMINATOR EXCLUSIONS:
Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy: G9708
OR
Hospice services used by patient any time during the measurement period: G9709
Numerator
Women with one or more mammograms during the measurement period or the 15 months prior to the measurement period
Numerator Options:
Performance Met: Screening mammography results documented and
reviewed (3014F)
OR
Performance Not Met: Screening mammography results were not
documented and reviewed, reason not otherwise
specified (3014F with 8P)