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  2. CQM-7086

CMS 157 - Medical and Radiation Oncology Pain Intensity

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      Thank you for your question aboutCMS157v12 Oncology: Medical and Radiation - Pain Intensity Quantified. The measure has two population criteria:

      - Population 1: Visits for patients with a diagnosis of cancer who are currently receiving chemotherapy

      - Population 2: Visits for patients with a diagnosis of cancer who are currently receiving radiation therapy

      Population 1 is intended to be reported by medical oncologists. The patient-medical oncologist encounter is identified by the CPT E/M and SNOMED-CT office visit codes included in the measure. As specified in the measure logic, for an encounter to be eligible in population 1, there must be a cancer diagnosis that’s active at some point in time during an encounter and chemotherapy administered ("Chemotherapy Administration (OID 2.16.840.1.113883.3.526.3.1027)) on the same day as the encounter or during the 30 days before the date of the encounter AND during the 30 days after the date of the encounter.

      Population 2 is intended to be reported by radiation oncologists. The patient-radiation oncologist encounter is identified by the radiation treatment management codes included in the measure. These codes are used by the radiation oncologists only "Radiation Treatment Management" (OID 2.16.840.1.113883.3.526.3.1026). To be eligible for the measure, there must be a cancer diagnosis that’s active at some point in time during the radiation treatment management.

      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.
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      Thank you for your question aboutCMS157v12 Oncology: Medical and Radiation - Pain Intensity Quantified. The measure has two population criteria: - Population 1: Visits for patients with a diagnosis of cancer who are currently receiving chemotherapy - Population 2: Visits for patients with a diagnosis of cancer who are currently receiving radiation therapy Population 1 is intended to be reported by medical oncologists. The patient-medical oncologist encounter is identified by the CPT E/M and SNOMED-CT office visit codes included in the measure. As specified in the measure logic, for an encounter to be eligible in population 1, there must be a cancer diagnosis that’s active at some point in time during an encounter and chemotherapy administered ("Chemotherapy Administration (OID 2.16.840.1.113883.3.526.3.1027)) on the same day as the encounter or during the 30 days before the date of the encounter AND during the 30 days after the date of the encounter. Population 2 is intended to be reported by radiation oncologists. The patient-radiation oncologist encounter is identified by the radiation treatment management codes included in the measure. These codes are used by the radiation oncologists only "Radiation Treatment Management" (OID 2.16.840.1.113883.3.526.3.1026). To be eligible for the measure, there must be a cancer diagnosis that’s active at some point in time during the radiation treatment management. 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.
    • CMS0157v12
    • CMS 157-Measure currently including other encounters besides Medical and Radiation Oncology

      When will the logic get updated to count only encounters related to medical and radiation, oncology providers, as suggested by CMS in my 2022 Jira (CQM-5231)?
      In 2022 you said, While other providers might have the encounter codes included in the denominator criteria, the measure is intended to be reported by the clinicians performing the procedure codes in the measure (e.g., medical or radiation oncologist). (See attached Jira response.)

            edave Mathematica EC eCQM Team
            temmo1 Moyna P Temple
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