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  2. CQM-6279

CMS-124 Inclusion of value sets and for Pap Tests with HPV Testing

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    • Resolution: Answered
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    • Stephanie Smith
    • 3053928052
    • Health Choice Network
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      Thank you for your inquiry about CMS124v11 Cervical Cancer Screening. The measure counts a Pap Test with or without any type of HPV test. The measure requires a cervical cytology or HPV test via QDM datatype "Laboratory Test, Performed" using any codes from the value set "HPV Test" (2.16.840.1.113883.3.464.1003.110.12.1059) or "Pap Test" ( 2.16.840.1.113883.3.464.1003.108.12.1017), and requires a non-null test result using QDM attribute "Result". A non-null result can be interpreted as a result that is present in the electronic record in which any entry is acceptable; no specific value or code is required. You can reference the applicable codes containing these value sets on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/. Click on the “Search Value Sets” tab and enter the value set ID to review codes included in the respective value set. The applicable screenings mentioned above may count towards the numerator when performed within the required time frame. Equivalent services can be mapped to the measure's value set. If mapping is done, you should maintain documentation in case of a CMS audit. We will consider any updates to the codes in a future annual update cycle.

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      Thank you for your inquiry about CMS124v11 Cervical Cancer Screening. The measure counts a Pap Test with or without any type of HPV test. The measure requires a cervical cytology or HPV test via QDM datatype "Laboratory Test, Performed" using any codes from the value set "HPV Test" (2.16.840.1.113883.3.464.1003.110.12.1059) or "Pap Test" ( 2.16.840.1.113883.3.464.1003.108.12.1017), and requires a non-null test result using QDM attribute "Result". A non-null result can be interpreted as a result that is present in the electronic record in which any entry is acceptable; no specific value or code is required. You can reference the applicable codes containing these value sets on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/ . Click on the “Search Value Sets” tab and enter the value set ID to review codes included in the respective value set. The applicable screenings mentioned above may count towards the numerator when performed within the required time frame. Equivalent services can be mapped to the measure's value set. If mapping is done, you should maintain documentation in case of a CMS audit. We will consider any updates to the codes in a future annual update cycle.
    • CMS0124v12
    • CMS0124v11
    • Currently, the CMS-124 measure does not include a LOINC value set of Pap tests with HPV reflex. There is also no mention of counting these tests in the CQL code for numerator. These labs are ordered most often compared to an independent Pap or HPV test.

      Including the CQL code and value set for these Cervical Cytology with HPV co-testing will help to provide a more complete picture of compliance in the numerator for this measure and align with USPTF guideline recommendations.

            edave Mathematica EC eCQM Team
            sdsmith Stephanie Ann Smith (Inactive)
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