#156: Oncology: Radiation Dose Limits to Normal Tissues

Quality ID

156

NQF

0382

High Priority Measure

No

Specifications

Registry

Measure Type

Process

Specialty

Radiation Oncology

Measure description

Percentage of patients, regardless of age, with a diagnosis of breast, rectal, pancreatic or lung cancer receiving 3D conformal radiation therapy who had documentation in medical record that radiation dose limits to normaltissues were established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissues

 

Instructions

This measure is to be submitted a minimum of once per performance period for patients with a diagnosis of breast, rectal, pancreatic or lung cancer receiving 3D conformal radiation therapy seen during the performance period. It is anticipated that eligible clinicians providing radiation therapy for patients with cancer will submit this measure.

Measure Submission:

The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data. There are no allowable performance exclusions for this measure.

 

Denominator

All patients, regardless of age, with a diagnosis of breast, rectal, pancreatic or lung cancer receiving 3Dconformal radiation therapy

Denominator Criteria (Eligible Cases):

Diagnosis for breast, rectal, pancreatic or lung cancer (ICD-10-CM): C19, C20, C21.2, C21.8,C25.0, C25.1, C25.2, C25.3, C25.4, C25.7, C25.8, C25.9, C34.00, C34.01, C34.02, C34.10, C34.11,C34.12, C34.2, C34.30, C34.31, C34.32, C34.80, C34.81, C34.82, C34.90, C34.91, C34.92, C50.011,C50.012, C50.019, C50.021, C50.022, C50.029, C50.111, C50.112, C50.119, C50.121, C50.122, C50.129,C50.211, C50.212, C50.219, C50.221, C50.222, C50.229, C50.311, C50.312, C50.319, C50.321, C50.322,C50.329, C50.411, C50.412, C50.419, C50.421, C50.422, C50.429, C50.511, C50.512, C50.519, C50.521,C50.522, C50.529, C50.611, C50.612, C50.619, C50.621, C50.622, C50.629, C50.811, C50.812, C50.819,C50.821, C50.822, C50.829, C50.911, C50.912, C50.919, C50.921, C50.922, C50.929

AND

Patient procedure during the performance period (CPT): 77295

AND NOT

Diagnosis for metastatic cancer (ICD-10-CM): C77.0, C77.1, C77.2, C77.3, C77.4, C77.5, C77.8,C77.9, C78.00, C78.01, C78.02, C78.1, C78.2, C78.30, C78.39, C78.4, C78.5, C78.6, C78.7, C78.80,C78.89, C79.00, C79.01, C79.02, C79.10, C79.11, C79.19, C79.2, C79.31, C79.32, C79.40, C79.49, C79.51, C79.52, C79.60, C79.61, C79.62, C79.70, C79.71, C79.72, C79.81, C79.82, C79.89, C79.9

 

Numerator

Patients who had documentation in medical record that radiation dose limits to normal tissues were establishedprior to the initiation of a course of 3D conformal radiation for a minimum of two tissues

Numerator Options:

Performance Met: Radiation dose limits to normal tissues established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissue/organ (0520F)

OR

Performance Not Met: Radiation dose limits to normal tissues not established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissue/organ, reason not otherwise specified (0520F with 8P)

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