CMS157v5: see 2 attachments 83755001

1. Cancer_Adult_Male_A
2. Question including procedure with SNOMED CT

For Cypress, they are expecting person ‘Cancer_Adult_Male A’ to meet IPP and DEM two times for CMS157v5. However, based on the measure requirement it will not as this patient has 2 Radiation Treatment Management procedure on the same encounter/visit date so it is not two unique instances. The data below has two procedure for radiation treatment management on the same encounter that are five minutes apart on April 23rd, 2015. Hence, should be counted as one encounter and not two, for each radiation treatment management encounter as per the specification. See measure specification guidance below:

Per guidance, “This measure is an episode-of-care measure; the level of analysis for this measure is every visit for patients with a diagnosis of cancer who are also receiving chemotherapy or radiation therapy during the measurement period. For patients receiving radiation therapy, pain intensity should be quantified at each radiation treatment management encounter. For patients receiving chemotherapy, pain intensity should be quantified at each face-to-face encounter with the physician while the patient is receiving treatment. For purposes of calculating this measure, eligible encounters for patients receiving chemotherapy will include those encounters where the patient has been administered chemotherapy within 30 days prior to the encounter and also been administered chemotherapy within 30 days after the date of the encounter. For example, at every visit for patients with a diagnosis of cancer who are also receiving chemotherapy or radiation therapy, the patient should have pain intensity quantified.”

Please confirm if the above instance should be counted as one or two encounters for radiation treatment management. The data below has two procedure for radiation treatment management on the same encounter that are five minutes apart on April 23rd, 2015.

Thank you

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