CMS130 - FOBTs inquiries

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your question regarding CMS130v14 (2026 Performance Period). Self-reported screenings are an acceptable criterion for this measure. Applicable screenings to meet the numerator criteria may include fecal occult blood test, FIT-DNA test, flexible sigmoidoscopy, CT colonography, or a colonoscopy. The applicable screenings mentioned above may count towards the numerator when performed within the required timeframe and documented via QDM datatypes and codes below. A result is not required for the flexible sigmoidoscopy, colonoscopy, or CT colonography to be numerator compliant. A "non-null" result is required using the QDM attribute "result" for screening options such as FOBT and sDNA FIT laboratory tests. 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. The information above must be documented in a structured field in the EHR and approved for entry by the provider. Please see details below regarding documentation required of the reporting provider to meet each measure's numerator requirements.

      - "Laboratory Test, Performed" using a code from "Fecal Occult Blood Test (FOBT)" value set (2.16.840.1.113883.3.464.1003.198.12.1011)"
      - "Laboratory Test, Performed" using a code from "sDNA FIT Test" value set (2.16.840.1.113883.3.464.1003.108.12.1039)
      - "Procedure, Performed" using a code from "Flexible Sigmoidoscopy" value set (2.16.840.1.113883.3.464.1003.198.12.1010)
      - "Diagnostic Study, Performed" using a code from "CT Colonography" value set (2.16.840.1.113883.3.464.1003.108.12.1038)
      - "Procedure, Performed" using a code from "Colonoscopy" value set (2.16.840.1.113883.3.464.1003.108.12.1020)

      If you have questions about reading the measure specification or understanding data requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. If you have questions regarding implementing the measure, you may refer to the "Implementation Checklist for eCQM Annual Update" for additional guidance. These resources can be found in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs
      Show
      Thank you for your question regarding CMS130v14 (2026 Performance Period). Self-reported screenings are an acceptable criterion for this measure. Applicable screenings to meet the numerator criteria may include fecal occult blood test, FIT-DNA test, flexible sigmoidoscopy, CT colonography, or a colonoscopy. The applicable screenings mentioned above may count towards the numerator when performed within the required timeframe and documented via QDM datatypes and codes below. A result is not required for the flexible sigmoidoscopy, colonoscopy, or CT colonography to be numerator compliant. A "non-null" result is required using the QDM attribute "result" for screening options such as FOBT and sDNA FIT laboratory tests. 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. The information above must be documented in a structured field in the EHR and approved for entry by the provider. Please see details below regarding documentation required of the reporting provider to meet each measure's numerator requirements. - "Laboratory Test, Performed" using a code from "Fecal Occult Blood Test (FOBT)" value set (2.16.840.1.113883.3.464.1003.198.12.1011)" - "Laboratory Test, Performed" using a code from "sDNA FIT Test" value set (2.16.840.1.113883.3.464.1003.108.12.1039) - "Procedure, Performed" using a code from "Flexible Sigmoidoscopy" value set (2.16.840.1.113883.3.464.1003.198.12.1010) - "Diagnostic Study, Performed" using a code from "CT Colonography" value set (2.16.840.1.113883.3.464.1003.108.12.1038) - "Procedure, Performed" using a code from "Colonoscopy" value set (2.16.840.1.113883.3.464.1003.108.12.1020) If you have questions about reading the measure specification or understanding data requirements, you may refer to the "Guide for Reading eCQMs" for additional guidance. If you have questions regarding implementing the measure, you may refer to the "Implementation Checklist for eCQM Annual Update" for additional guidance. These resources can be found in the eCQI Resource Center: https://ecqi.healthit.gov/ep-ec?qt-tabs_ep=ecqm-resources&global_measure_group=eCQMs
    • CMS0130v14
    • CMS0130v13
    • Could affect numerators and denominators for measure.

      Guidance for measure suggests "Do not count digital rectal exams (DRE), fecal occult blood tests (FOBTs) performed in an office setting or performed on a sample collected via DRE."

       

      In the practice a provider orders a POCT Occult Blood Stool and a kit is given to the patient to take home and perform the test. They return with the completed test/sample and it is then processed and resulted. Is this an acceptable test to include in the measure as it was not performed in the office setting? Rather it was performed outside the office and not by DRE.  

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Aya Ghazy
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