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Measure Specifications eCQM CMS645v6 - Bone Density Androgen Deprivation Therapy

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    • Resolution: Answered
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    • Vera Laquanda Macon
    • 4075296364
    • Mckesson Corporation
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      Thank you for your question regarding CMS645v6, Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy.

       

      If the SNOMED CT code 456381000124102 is not assigned to the case(s), the patient(s) will not meet the Initial Population. The RXNorm codes found in the Androgen deprivation therapy for Urology Care value set would not apply because the SNOMED CT code (456381000124102) is only used to meet the Order for 12 Months of ADT During Measurement Period definition. There is no equivalent for SNOMED CT 456381000124102 that would meet the stated criteria.

       

      As referred to in the Guidance section of the measure, in order to capture the practitioner's intent of androgen deprivation therapy (ADT) for a period of 12 months or greater, SNOMEDCT 456381000124102 which is Injection of leuprolide acetate for twelve month period (regime/therapy) is the correct code.

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      Thank you for your question regarding CMS645v6, Bone density evaluation for patients with prostate cancer and receiving androgen deprivation therapy.   If the SNOMED CT code 456381000124102 is not assigned to the case(s), the patient(s) will not meet the Initial Population. The RXNorm codes found in the Androgen deprivation therapy for Urology Care value set would not apply because the SNOMED CT code (456381000124102) is only used to meet the Order for 12 Months of ADT During Measurement Period definition. There is no equivalent for SNOMED CT 456381000124102 that would meet the stated criteria.   As referred to in the Guidance section of the measure, in order to capture the practitioner's intent of androgen deprivation therapy (ADT) for a period of 12 months or greater, SNOMEDCT 456381000124102 which is Injection of leuprolide acetate for twelve month period (regime/therapy) is the correct code.
    • CMS0645v6
    • Inability to apply QDM Data Elements as written.

      What is the guidance on applying "intent" of SNOMED CT code 456381000124102 when an EHR does not use nor capture said data element?*+

       

      +*Are the RxNorm codes in the value set for OID 2.16.840.1.113762.1.4.1151.48 sufficiently capturing the "intent"? If not, please provide the RxNorm code that is the equivalent of the SNOMED CT code listed above.

       

      Reference (last line for "Procedure, Order": Data Criteria (QDM Data Elements) "Diagnosis: Prostate Cancer" using "Prostate Cancer (2.16.840.1.113883.3.526.3.319)" "Diagnostic Study, Not Ordered: DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care" using "DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care (2.16.840.1.113762.1.4.1151.38)" "Diagnostic Study, Not Performed: DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care" using "DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care (2.16.840.1.113762.1.4.1151.38)" "Diagnostic Study, Order: DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care" using "DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care (2.16.840.1.113762.1.4.1151.38)" "Diagnostic Study, Performed: DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care" using "DEXA Dual Energy Xray Absorptiometry, Bone Density for Urology Care (2.16.840.1.113762.1.4.1151.38)" "Encounter, Performed: Office Visit" using "Office Visit (2.16.840.1.113883.3.464.1003.101.12.1001)" "Medication, Active: Androgen deprivation therapy for Urology Care" using "Androgen deprivation therapy for Urology Care (2.16.840.1.113762.1.4.1151.48)" "Medication, Order: Androgen deprivation therapy for Urology Care" using "Androgen deprivation therapy for Urology Care (2.16.840.1.113762.1.4.1151.48)" "Patient Characteristic Ethnicity: Ethnicity" using "Ethnicity (2.16.840.1.114222.4.11.837)" "Patient Characteristic Payer: Payer" using "Payer (2.16.840.1.114222.4.11.3591)" "Patient Characteristic Race: Race" using "Race (2.16.840.1.114222.4.11.836)" "Patient Characteristic Sex: Male" using "Male (AdministrativeGender Code M)" "Patient Characteristic Sex: ONC Administrative Sex" using "ONC Administrative Sex (2.16.840.1.113762.1.4.1)" "Procedure, Order: Injection of leuprolide acetate for twelve month period (regime/therapy)" using "Injection of leuprolide acetate for twelve month period (regime/therapy) (SNOMEDCT Code 456381000124102)"

       

      Thank you, Vera Macon

            edave Mathematica EC eCQM Team
            vmacon Vera Macon (Inactive)
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