#395: Lung Cancer Reporting (Biopsy/Cytology Specimens)

Quality ID

395

High Priority Measure

Yes

Specifications

Registry

Measure Type

Outcome

Specialty

Pathology

Measure description

Pathology reports based on biopsy and/or cytology specimens with a diagnosis of primary non-small cell lung cancer classified into specific histologic type or classified as NSCLC-NOS with an explanation included in thepathology report

 

Instructions

This measure is to be submitted each time a patient’s pathology report addresses specimens with a diagnosis of non- small cell lung cancer; however, only one quality-data code (QDC) per date of service for a patient is required. This measure maybe submitted by eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

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 submissions; however, these codes may be submitted for those registries that utilize claims data.

 

Denominator

Biopsy and cytology specimen reports with a diagnosis of primary non-small cell lungcancer

Denominator Criteria (Eligible Cases):

Patients ≥ 18 years of age on date of encounter

AND

Diagnosis for lung cancer (ICD-10-CM): 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

AND

Patient encounter during performance period (CPT): 88104, 88108, 88112, 88173, 88305

AND NOT

DENOMINATOR EXCLUSIONS:

Specimen sites other than anatomic location of lung oris not classified as primary non-small cell lung cancer: G9420

 

Numerator

Biopsy and cytology specimen reports with a diagnosis of primary non-small cell lung cancer classified into specific histologic type (squamous cell carcinoma, adenocarcinoma) OR classified as NSCLC-NOS with an explanation included in the pathology report

Numerator Options:

Performance Met: Primary non-small cell lung cancer biopsy and cytology specimen report documents classification into specific histologic type OR classified as NSCLCNOS with an explanation (G9418)

OR

Denominator Exception: Documentation of medical reason(s) for not including the histological type OR NSCLC-NOS classification with an explanation (e.g., biopsy taken for other purposes in a patient with a history of primary nonsmall cell lung cancer or other documented medical reasons) (G9419)

OR

Performance Not Met: Primary non-small cell lung cancer biopsy and cytology specimen report does not document classification into specific histologic type OR classified as NSCLC-NOS with an explanation (G9421)

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