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  1. eCQM Issue Tracker
  2. CQM-6528

Eligible Encounter for eCQM 143 Pain Screening

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
    • Icon: Moderate Moderate
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    • Lauren Kish
    • 703-328-1759
    • Florida Cancer Specialists
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      Thank you for your inquiry. The lookback period guidance included in CMS157 v11 (QID #143): Oncology: Medical and Radiation - Pain Intensity Quantified) only applies to CPT code 77427 as is reflected in the Numerator 2 logic. It does not apply to CPT codes 77431, 77432, and 77435.
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      Thank you for your inquiry. The lookback period guidance included in CMS157 v11 (QID #143): Oncology: Medical and Radiation - Pain Intensity Quantified) only applies to CPT code 77427 as is reflected in the Numerator 2 logic. It does not apply to CPT codes 77431, 77432, and 77435.
    • CMS0157v11
    • Need to determine eligibility requirements for patients in denominator for eCQM measure 143 submission criteria 2

      I am reviewing denominator requirements on eCQM #143: Oncology: Medical and Radiation - Pain Intensity Quantified. I recently opened a ticket to confirm that patients who qualify for submission criteria 2: patients receiving radiation treatment are episode-based criteria. CMS quality measure specifications state that when CPT 77427 is billed, the face-to-face encounter may not occur on DOS that CPT 77427 was billed and there is a lookback period of 6 days prior. Does that same logic apply to CPT codes 77431, 77432, and 77435?

            edave Mathematica EC eCQM Team
            laurenkish Lauren Kish
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