#405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions

Quality ID

405

High Priority Measure

Yes

Specifications

Registry

Measure Type

Process

Specialty

Diagnostic Radiology

Measure description

Percentage of final reports for abdominal imaging studies for patients aged 18 years and older with one or more of the following noted incidentally with follow‐up imaging recommended:

  • Liver lesion ≤ 0.5 cm
  • Cystic kidney lesion < 1.0 cm
  • Adrenal lesion ≤ 1.0 cm

 

Instructions

This measure is to be submitted each time a patient undergoes an imaging study with an incidental abdominal lesion finding during the performance period. There is no diagnosis associated with this measure. It is anticipated that eligible clinicians who provide the professional component of diagnostic imaging studies 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 submissions; however, these codes may be submitted for those registries that utilize claims data

 

Denominator

All final reports for abdominal imaging studies for patients aged 18 years and older with one or more of the following noted: Liver lesion ≤ 0.5 cm, Cystic kidney lesion < 1.0 cm or Adrenal lesion ≤ 1.0 cm

DENOMINATOR NOTE: The intent of this measure is to ensure patients with incidental findings that are highly likely to be benign do not receive follow up imaging routinely. Denominator eligible patients would be those for whom one or more of the following incidental findings is noted in the final report:

  • Liver lesion ≤ 0.5 cm
  • Cystic kidney lesion < 1.0 cm
  • Adrenal lesion ≤ 1.0 cm

Denominator Criteria (Eligible Cases):

Patients aged ≥ 18 years on date of encounter

AND

Patient procedure during the performance period (CPT): 74150, 74160, 74170, 74176, 74177, 74178, 74181, 74182, 74183, 76700, 76705, 76770, 76775

AND

Incidental finding: Liver lesion ≤ 0.5 cm, Cystic kidney lesion < 1.0 cm or Adrenal lesion ≤ 1.0 cm: G9547

 

Numerator

Final reports for abdominal imaging studies with follow-up imaging recommended

Numerator Instructions:

INVERSE MEASURE - A lower calculated performance rate for this measure indicates better clinical care or control. The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. Reporting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. For inverse measures, a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control.

Numerator Options:

Performance Met: Final reports for abdominal imaging studies with follow- up imaging recommended (G9548)

OR

Denominator Exception: Documentation of medical reason(s) that follow-up imaging is indicated (e.g., patient has a known malignancy that can metastasize, other medical reason(s) such as fever in an immunocompromised patient) (G9549)

OR

Performance Not Met: Final reports for abdominal imaging studies with follow-up imaging not recommended (G9550)

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