| Valid Data Submission Method(s) | Measure Type | High Priority Measure? | NQS Domain | Specialty Measure Sets |
|---|---|---|---|---|
| Registry | Process | No | Effective Clinical Care |
Measure Description
The percentage of clinically node negative (clinical stage T1N0M0 or T2N0M0) breast cancer patients who undergo a sentinel lymph node (SLN) procedure
Instruction
This measure is to be reported each time a procedure is performed during the performance period for patients age 18 years and older who are operated upon for invasive breast cancer that are clinically node negative (clinical stage T1N0M0 or T2N0M0). 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 aged 18 and older with primary invasive breast cancer
Denominator Criteria (Eligible Cases):
Patients aged 18 and older at date of encounter
AND
Diagnosis for Female/Male 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 encounter during the performance period (CPT): 19301, 19302, 19307, 38500, 38510, 38520,38525, 38530, 38542, 38740, 38745, 38900
AND
Clinically Node Negative (T1N0M0 or T2N0M0) Invasive Breast Cancer: G8879
Numerator
Patients who undergo a SLN procedure
Numerator Options:
Performance Met: Sentinel lymph node biopsy procedure performed (G8878)
OR
Denominator Exception: Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (LN) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, patient refusal after informed
consent) (G8880)
OR
Performance Not Met: Sentinel lymph node biopsy procedure not performed, reason not given (G8882)