| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Registry | Process | Yes | Communication and Care Coordination | Dermatology |
Measure Description
Percentage of patient visits, regardless of age, with a new occurrence of melanoma who have a treatment plan documented in the chart that was communicated to the physician(s) providing continuing care within one month of diagnosis
Instruction
This measure is to be reported at each denominator eligible visit occurring during the performance period ending November 30th for melanoma patients seen during the performance period. It is anticipated that eligible clinicians providing care for patients with melanoma will submit this measure.
Denominator
THERE ARE TWO REPORTING CRITERIA FOR THIS MEASURE:
1) All visits for patients, regardless of age, diagnosed with a new occurrence of melanoma duringexcision of malignant lesion
OR
2) All visits for patients, regardless of age, diagnosed with a new occurrence of melanoma evaluated inan outpatient setting
DENOMINATOR (REPORTING CRITERIA 1)
All visits for patients, regardless of age, diagnosed with a new occurrence of melanoma
Denominator Criteria (Eligible Cases) 1:
Diagnosis for melanoma (ICD-10-CM): C43.0, C43.10, C43.11, C43.12, C43.20, C43.21, C43.22, C43.30, C43.31, C43.39, C43.4, C43.51, C43.52, C43.59, C43.60, C43.61, C43.62, C43.70, C43.71, C43.72, C43.8, C43.9, D03.0, D03.10, D03.11, D03.12, D03.20, D03.21, D03.22, D03.30, D03.39, D03.4, D03.51, D03.52, D03.59, D03.60, D03.61, D03.62, D03.70, D03.71, D03.72, D03.8, D03.9
AND
Patient encounter for excision of malignant melanoma (CPT): 11600, 11601, 11602, 11603, 11604, 11606, 11620, 11621, 11622, 11623, 11624, 11626, 11640, 11641, 11642, 11643, 11644, 11646, 14000, 14001, 14020, 14021, 14040, 14041, 14060, 14061, 14301, 17311, 17313
–OR–
DENOMINATOR: (REPORTING CRITERIA 2)
All visits for patients, regardless of age, diagnosed with a new occurrence of melanoma
Denominator Criteria (Eligible Cases) 2:
Diagnosis for melanoma (ICD-10-CM): C43.0, C43.10, C43.11, C43.12, C43.20, C43.21, C43.22, C43.30, C43.31, C43.39, C43.4, C43.51, C43.52, C43.59, C43.60, C43.61, C43.62, C43.70, C43.71, C43.72, C43.8, C43.9, D03.0, D03.10, D03.11, D03.12, D03.20, D03.21, D03.22, D03.30, D03.39, D03.4, D03.51, D03.52, D03.59, D03.60, D03.61, D03.62, D03.70, D03.71, D03.72, D03.8, D03.9
AND
Patient encounter during the performance period (CPT): 99201, 99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215
WITHOUT
Telehealth Modifier: GQ, GT
Numerator
THERE ARE TWO REPORTING CRITERIA FOR THIS MEASURE:
1) All visits for patients, regardless of age, diagnosed with a new occurrence of melanoma duringexcision of malignant lesion
OR
2) All visits for patients, regardless of age, diagnosed with a new occurrence of melanoma evaluated inan outpatient setting
NUMERATOR (REPORTING CRITERIA 1):
Patient visits with a treatment plan documented in the chart that was communicated to the physician(s) providing continuing care within one month of diagnosis
Numerator Instructions: A treatment plan should include the following elements: diagnosis, tumor thickness, and plan for surgery or alternate care.
Definition:
Communication – Communication may include: documentation in the medical record that the physician(s) treating the melanoma communicated (e.g., verbally, by letter, copy of treatment plan sent) with the physician(s) providing the continuing care OR a copy of a letter in the medical record outlining whether the patient was or should be treated for melanoma.
Numerator Options:
Performance Met: Treatment plan communicated t o provider(s) managing continuing care within 1 month of diagnosis (5050F)
OR
Denominator Exception: Documentation of patient reason(s) for not c ommunicating treatment plan to the Primary Care Physician(s) (PCP)(s) (eg, patient asks that treatment plan not be communicated to the physician(s) providing continuing care) (5050F with 2P)
OR
Denominator Exception: Documentation of system reason(s) for not c ommunicating treatment plan to the PCP(s) (eg, patient does not have a primary care physician or referring physician) (5050F with 3P)
OR
Performance Not Met: Treatment plan not communicated, reason not otherwise specified (5050F with 8P)
–OR–
NUMERATOR (REPORTING CRITERIA 2):
Patient visits with a treatment plan documented in the chart that was communicated to the physician(s) providing continuing care within one month of diagnosis
Numerator Instructions: A treatment plan should include the following elements: diagnosis, tumor thickness, and plan for surgery or alternate care.
Definition:
Communication – Communication may include: documentation in the medical record that the physician(s) treating the melanoma communicated (e.g., verbally, by letter, copy of treatment plan sent) with the physician(s) providing the continuing care OR a copy of a letter in the medical record outlining whether the patient was or should be treated for melanoma.
Numerator Options:
Performance Met: Treatment plan communicated to provider(s) managing continuing care within 1 month of diagnosis (5050F)
OR
Denominator Exception:Documentation of patient reason(s) for not communicating treatment plan to the Primary Care Physician(s) (PCP)(s) (eg, patient asks that treatment plan not be communicated to the physician(s) providing continuing care) (5050F with 2P)
OR
Denominator Exception:Documentation of system reason(s) for not communicating treatment plan to the PCP(s) (eg, patient does not have a primary care physician or referring physician) (5050F with 3P)
OR
Performance Not Met:Treatment plan not communicated, reason not otherwise specified (5050F with 8P)