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  1. eCQM Issue Tracker
  2. CQM-1635

Changes to Breast Cancer Screening Measure (CMS125)

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Done
    • Icon: Minor Minor
    • Measure
    • The eCQM will be updated during the 2016 annual update process. The updated measure should be posted by May 2016.
    • CMS125v4/NQFna
    • CMS125v3/NQFna
    • See attached Word file.
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      1.Revise the age range from 40-69 to 50-74 years of age
              a.Agree 13/31 ( 42%)
              b.Disagree 1/31 ( 3%)


      2.Extend numerator timeframe from 24 months to 27 months to allow a 3-month grace period
              a.Agree 14/31 ( 45%)
              b.Disagree 1/31 ( 3%)


      3.Do NOT add the ““14 days apart” timing to the current exclusion “Exclude women who have had two unilateral mastectomies”
              a.Agree 14/31 ( 45%)
              b.Disagree 1/31 ( 3%)


      4.Add the following exclusion criteria:
      -Exclude women who have had a bilateral mastectomy or two unilateral mastectomies:
       --Right and left unilateral mastectomy
       --History of bilateral mastectomy

              a.Agree 12/31 ( 39%)
              b.Disagree 1/31 ( 3%)

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      1.Revise the age range from 40-69 to 50-74 years of age         a.Agree 13/31 ( 42%)         b.Disagree 1/31 ( 3%) 2.Extend numerator timeframe from 24 months to 27 months to allow a 3-month grace period         a.Agree 14/31 ( 45%)         b.Disagree 1/31 ( 3%) 3.Do NOT add the ““14 days apart” timing to the current exclusion “Exclude women who have had two unilateral mastectomies”         a.Agree 14/31 ( 45%)         b.Disagree 1/31 ( 3%) 4.Add the following exclusion criteria: -Exclude women who have had a bilateral mastectomy or two unilateral mastectomies:  --Right and left unilateral mastectomy  --History of bilateral mastectomy         a.Agree 12/31 ( 39%)         b.Disagree 1/31 ( 3%)

      The Breast Cancer Screening Measure (CMS125) will be discussed during the July Change Review Process (CRP) meeting. Recommendations from the CRP meeting will be posted afterwards for public comment.

      NCQA would like to discuss the following changes to the Breast Cancer Screening Measure (CMS124):

      • Modify age group to be women 50-74 years of age to align with the U.S Preventive Services Task Force clinical guideline and NCQA’s HEDIS health plan measure
      • Expand the time interval to 27 months to allow for grace period to align with NCQA’s HEDIS health plan measure
      • Possible addition of exclusions that are currently part of NCQA’s HEDIS health plan measure

            edave Mathematica EC eCQM Team
            edave Mathematica EC eCQM Team
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