Measure: CMS130
Colorectal Cancer Screening
Measure Versions
eMeasure Code |
Measure Year |
Full Version Number |
Title |
CMS130v12 |
2024 |
12.0.000 |
Colorectal Cancer Screening |
CMS130v11 |
2023 |
11.0.000 |
Colorectal Cancer Screening |
CMS130v10 |
2022 |
10.0.000 |
Colorectal Cancer Screening |
CMS130v9 |
2021 |
9.2.000 |
Colorectal Cancer Screening |
CMS130v8 |
2020 |
8.4.000 |
Colorectal Cancer Screening |
CMS130v7 |
2019 |
7.2.000 |
Colorectal Cancer Screening |
CMS130v6 |
2018 |
6.1.000 |
Colorectal Cancer Screening |
CMS130v5 |
2017 |
5.0.000 |
Colorectal Cancer Screening |
Description
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
Guidance
Patient self-report for procedures as well as diagnostic studies should be recorded in "Procedure, Performed" template or "Diagnostic Study, Performed" template in QRDA-1.
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.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.5. Please refer to the eCQI resource center (https://ecqi.healthit.gov/qdm) for more information on the QDM.
Patient Group Definitions
Group |
Description |
Instructions Links |
Initial Population | Patients 50-75 years of age with a visit during the measurement period | Webchart Instructions |
Denominator | Equals Initial Population | Webchart Instructions |
Denominator Exclusions | Exclude patients whose hospice care overlaps the measurement period.
Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer.
Exclude patients 66 and older who are living long term in an institution for more than 90 consecutive days during the measurement period.
Exclude patients 66 and older with advanced illness and frailty because it is unlikely that patients will benefit from the services being measured. | Webchart Instructions |
Numerator | Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria:
- Fecal occult blood test (FOBT) during the measurement period
- Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period
- Colonoscopy during the measurement period or the nine years prior to the measurement period
- FIT-DNA during the measurement period or the two years prior to the measurement period
- CT Colonography during the measurement period or the four years prior to the measurement period | Webchart Instructions |
Numerator Exclusions | Not Applicable | Webchart Instructions |
Denominator Exceptions | None | |
Details
Full eMeasure Code |
eMeasure Identifier |
Measure Year |
Version |
NQF # |
GUID |
CMS130v9 |
130 |
2021 |
9.2.000 |
Not Applicable |
aa2a4bbc-864f-45ee-b17a-7ebcc62e6aac |
Steward |
Developer |
Endorsed By |
National Committee for Quality Assurance |
National Committee for Quality Assurance |
|
Scoring Method |
Measure Type |
Stratification |
Risk Adjustment |
Proportion |
PROCESS |
None |
None |
Rate Aggregation
None
Improvement Notation
Higher score indicates better quality
Rationale
Colorectal cancer represents eight percent of all new cancer cases and is the second leading cause of cancer deaths in the United States. In 2019, an estimated 145,600 new cases of colorectal cancer and an estimated 51,020 deaths attributed to it. According to the National Cancer Institute, about 4.2 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (National Cancer Institute, 2019).
Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society, 2018).
Clinical Recommendation Statement
The U.S. Preventive Services Task Force (2016) recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2016).
Appropriate screenings are defined by any one of the following:
-Colonoscopy (every 10 years)
-Flexible sigmoidoscopy (every 5 years)
-Fecal occult blood test (annually)
-FIT-DNA (every 3 years)
-Computed tomographic colonography (every 5 years)
Definition
None
Transmission Format
TBD
Applicable Value Sets
Category |
Value Set |
OID |
Diagnosis |
Frailty Diagnosis |
2.16.840.1.113883.3.464.1003.113.12.1074 |
Diagnosis |
Malignant Neoplasm of Colon |
2.16.840.1.113883.3.464.1003.108.12.1001 |
Diagnostic Study, Performed |
CT Colonography |
2.16.840.1.113883.3.464.1003.108.12.1038 |
Encounter, Performed |
Acute Inpatient |
2.16.840.1.113883.3.464.1003.101.12.1083 |
Encounter, Performed |
Annual Wellness Visit |
2.16.840.1.113883.3.526.3.1240 |
Encounter, Performed |
Care Services in Long-Term Residential Facility |
2.16.840.1.113883.3.464.1003.101.12.1014 |
Encounter, Performed |
ED |
2.16.840.1.113883.3.464.1003.101.12.1085 |
Encounter, Performed |
Encounter Inpatient |
2.16.840.1.113883.3.666.5.307 |
Encounter, Performed |
Frailty Encounter |
2.16.840.1.113883.3.464.1003.101.12.1088 |
Encounter, Performed |
Home Healthcare Services |
2.16.840.1.113883.3.464.1003.101.12.1016 |
Encounter, Performed |
Nonacute Inpatient |
2.16.840.1.113883.3.464.1003.101.12.1084 |
Encounter, Performed |
Nursing Facility Visit |
2.16.840.1.113883.3.464.1003.101.12.1012 |
Encounter, Performed |
Observation |
2.16.840.1.113883.3.464.1003.101.12.1086 |
Encounter, Performed |
Office Visit |
2.16.840.1.113883.3.464.1003.101.12.1001 |
Encounter, Performed |
Outpatient |
2.16.840.1.113883.3.464.1003.101.12.1087 |
Encounter, Performed |
Preventive Care Services - Established Office Visit, 18 and Up |
2.16.840.1.113883.3.464.1003.101.12.1025 |
Encounter, Performed |
Preventive Care Services-Initial Office Visit, 18 and Up |
2.16.840.1.113883.3.464.1003.101.12.1023 |
Intervention, Order |
Hospice care ambulatory |
2.16.840.1.113762.1.4.1108.15 |
Intervention, Performed |
Hospice care ambulatory |
2.16.840.1.113762.1.4.1108.15 |
Laboratory Test, Performed |
Fecal Occult Blood Test (FOBT) |
2.16.840.1.113883.3.464.1003.198.12.1011 |
Laboratory Test, Performed |
FIT DNA |
2.16.840.1.113883.3.464.1003.108.12.1039 |
Medication, Active |
Dementia Medications |
2.16.840.1.113883.3.464.1003.196.12.1510 |
Patient Characteristic Ethnicity |
Ethnicity |
2.16.840.1.114222.4.11.837 |
Patient Characteristic Payer |
Payer |
2.16.840.1.114222.4.11.3591 |
Patient Characteristic Race |
Race |
2.16.840.1.114222.4.11.836 |
Patient Characteristic Sex |
ONC Administrative Sex |
2.16.840.1.113762.1.4.1 |
Procedure, Performed |
Colonoscopy |
2.16.840.1.113883.3.464.1003.108.12.1020 |
Procedure, Performed |
Flexible Sigmoidoscopy |
2.16.840.1.113883.3.464.1003.198.12.1010 |
Procedure, Performed |
Total Colectomy |
2.16.840.1.113883.3.464.1003.198.12.1019 |
Symptom |
Frailty Symptom |
2.16.840.1.113883.3.464.1003.113.12.1075 |
References
American Cancer Society. (2018). Can Colorectal Polyps and Cancer Be Found Early? Retrieved October 17, 2019, from https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/detection.html
National Cancer Institute. (2019). SEER Cancer Statistics Review, 1975-2016. Retrieved October 17, 2019, from SEER website: https://seer.cancer.gov/csr/1975_2016/index.html
US Preventive Services Task Force, Bibbins-Domingo, K., Grossman, D. C., Curry, S. J., Davidson, K. W., Epling, J. W., … Siu, A. L. (2016). Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 315(23), 2564–2575. https://doi.org/10.1001/jama.2016.5989
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Source:
https://ecqi.healthit.gov/ecqm/measures/cms130v9