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CMS129 Prostate Specific Antigen Test result value evaluation

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      Thank you for your question regarding CMS129v13 Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients. We recognize that the current Prostate Antigen Testing (2.16.840.1.113883.3.526.3.401) value set contains codes which may result in values in units other than ng/ML. The denominator criteria requires that a result be available in ng/mL to meet the threshold of less than 10 ng/mL as the threshold for low-risk patients in the National Comprehensive Cancer Network guideline is used for risk stratification. PSA values that are not available in the EHR as ng/ML will results in a patient not qualifying for the denominator. We are planning to reevaluate the codes in Prostate Antigen Testing value set in a future update.
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      Thank you for your question regarding CMS129v13 Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients. We recognize that the current Prostate Antigen Testing (2.16.840.1.113883.3.526.3.401) value set contains codes which may result in values in units other than ng/ML. The denominator criteria requires that a result be available in ng/mL to meet the threshold of less than 10 ng/mL as the threshold for low-risk patients in the National Comprehensive Cancer Network guideline is used for risk stratification. PSA values that are not available in the EHR as ng/ML will results in a patient not qualifying for the denominator. We are planning to reevaluate the codes in Prostate Antigen Testing value set in a future update.
    • CMS0129v13

      CMS129 specification includes a logic to identify 'Most Recent PSA Test Result is Low' using LastPSATest.result < 10 'ng/mL' as threshold. Some of the LOINC codes included in valueset "Prostate Specific Antigen Test" (2.16.840.1.113883.3.526.3.401) are not reported as result value with 'ng/mL' UOM.

      Examples:

      Ratio or percentage
      15323-9    Prostate specific Ag/Prostate volume calculated from height, width and length
      15324-7    Prostate specific Ag/Prostate volume calculated from planimetry
      15325-4    Prostate specific Ag/Prostate volume calculated

      IU/L
      19195-7    Prostate specific Ag [Units/volume] in Serum or Plasma
      19201-3    Prostate Specific Ag Free [Units/volume] in Serum or Plasma

      Stain:
      10508-0    Prostate specific Ag [Presence] in Tissue by Immune stain

      1.- Can you please provide additional guidance/point to reference document on how to 'convert' the results from the test listed above to a numeric 'ng/mL' to qualify and report to PSA logic properly?

      2.- Are there additional thresholds available to identify the result as 'low' when using the LOINC listed?

            edave Mathematica EC eCQM Team
            isbelia Isbelia Briceno
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