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  2. CQM-6512

eCQM measure specifications for eCQM #143

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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    • Lauren Kish
    • 703-328-1759
    • Florida Cancer Specialists
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      Thank you for your question. CMS 157v11 (QID #143) (Oncology: Medical and Radiation - Pain Intensity Quantified) is an episode-based measure. It looks at each eligible visit for patients with cancer currently receiving chemotherapy or radiation therapy. For population 2 (submission criteria 2), visits for patients currently receiving radiation therapy, the measure does not look for the radiation treatment delivery code but rather looks for the following radiation treatment management code: 77427, 77431, 77432, or 77435. Each radiation treatment management code listed in the specification represents a “visit” that would qualify for population 2 (submission criteria 2). Therefore, regardless of the number of radiation treatment delivery codes the patient has during the performance period, the measure only looks for the radiation treatment management code (i.e., 77427, 77431, 77432, or 77435) billed during the performance period.
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      Thank you for your question. CMS 157v11 (QID #143) (Oncology: Medical and Radiation - Pain Intensity Quantified) is an episode-based measure. It looks at each eligible visit for patients with cancer currently receiving chemotherapy or radiation therapy. For population 2 (submission criteria 2), visits for patients currently receiving radiation therapy, the measure does not look for the radiation treatment delivery code but rather looks for the following radiation treatment management code: 77427, 77431, 77432, or 77435. Each radiation treatment management code listed in the specification represents a “visit” that would qualify for population 2 (submission criteria 2). Therefore, regardless of the number of radiation treatment delivery codes the patient has during the performance period, the measure only looks for the radiation treatment management code (i.e., 77427, 77431, 77432, or 77435) billed during the performance period.
    • CMS0157v11
    • We are trying to determine eligibility criteria for our MIPS QMs to provide adequate feedback to our providers on current performance.

      I am reviewing denominator requirements on eCQM #143: Oncology: Medical and Radiation - Pain Intensity Quantified. I noticed under the submission criteria 1: patients receiving chemotherapy that the patient needs to be "actively" on chemotherapy to qualify, i.e. needs to have CPT code billed for chemo on or before 30 days from qualifying encounter AND on or 30 days after qualifying encounter. However, for submission criteria 2: patients receiving radiation, it only states that the CPT code(s) used for billing radiation therapy needs to occur during the performance period. Do patients only need to have received radiation therapy once during the performance period, i.e. once during the calendar year to qualify for an eligible encounter for submission criteria 2? 

        1. 2023_Measure_143_MIPSCQM.pdf
          313 kB

            edave Mathematica EC eCQM Team
            laurenkish Lauren Kish (Inactive)
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