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 |
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 45-75 years of age who had appropriate screening for colorectal cancer
Guidance
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.
Please note the measure may include screenings performed outside the age range of patients referenced in the initial population. Screenings that occur prior to the measurement period are valid to meet measure criteria.
This eCQM is a patient-based measure.
This version of the eCQM uses QDM version 5.6. 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 46-75 years of age by the end of the measurement period with a visit during the measurement period | Webchart Instructions |
| Denominator | Equals Initial Population | Webchart Instructions |
| Denominator Exclusions | Exclude patients who are in hospice care for any part of the measurement period.
Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer.
Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following advanced illness criteria:
- Advanced illness with two outpatient encounters during the measurement period or the year prior
- OR advanced illness with one inpatient encounter during the measurement period or the year prior
- OR taking dementia medications during the measurement period or the year prior
Exclude patients receiving palliative care for any part of the measurement period. | 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
- Stool DNA (sDNA) with FIT test during the measurement period or the two years prior to the measurement period
- Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period
- CT Colonography 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 | Webchart Instructions |
| Numerator Exclusions | Not Applicable | Webchart Instructions |
| Denominator Exceptions | None | |
Details
| Full eMeasure Code |
eMeasure Identifier |
Measure Year |
Version |
NQF # |
GUID |
| CMS130v12 |
|
2024 |
12.0.000 |
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 |
Report a total rate, and each of the following age strata:
Stratum 1: Patients age 46-49 by the end of the measurement period
Stratum 2: Patients age 50-75 by the end of the measurement period |
None |
Rate Aggregation
None
Improvement Notation
Higher score indicates better quality
Rationale
Colorectal cancer represents eight percent of all new cancer cases in the United States. In 2020, there were an estimated 147,950 new cases of colorectal cancer and an estimated 53,200 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, 2020).
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 (SEERS, 2022).
Clinical Recommendation Statement
The U.S. Preventive Services Task Force (2021) recommends screening for colorectal cancer in adults aged 45 to 49 years. This is a Grade B recommendation (U.S. Preventive Services Task Force, 2021).
The U.S. Preventive Services Task Force (2021) recommends screening for colorectal cancer in adults aged 50 to 75 years. This is a Grade A recommendation (U.S. Preventive Services Task Force, 2021).
Appropriate screenings are defined by any one of the following:
- Fecal occult blood test (annually)
- Stool DNA (sDNA) with FIT test (every 3 years)
- Flexible sigmoidoscopy (every 5 years)
- Computed tomographic (CT) colonography (every 5 years)
- Colonoscopy (every 10 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 |
Hospice Diagnosis |
2.16.840.1.113883.3.464.1003.1165 |
| Diagnosis |
Malignant Neoplasm of Colon |
2.16.840.1.113883.3.464.1003.108.12.1001 |
| Diagnosis |
Palliative Care Diagnosis |
2.16.840.1.113883.3.464.1003.1167 |
| 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 |
Emergency Department Visit |
2.16.840.1.113883.3.464.1003.101.12.1010 |
| 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 |
Hospice Encounter |
2.16.840.1.113883.3.464.1003.1003 |
| Encounter, Performed |
Nonacute Inpatient |
2.16.840.1.113883.3.464.1003.101.12.1084 |
| 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 |
Online Assessments |
2.16.840.1.113883.3.464.1003.101.12.1089 |
| Encounter, Performed |
Outpatient |
2.16.840.1.113883.3.464.1003.101.12.1087 |
| Encounter, Performed |
Palliative Care Encounter |
2.16.840.1.113883.3.464.1003.101.12.1090 |
| 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 |
| Encounter, Performed |
Telephone Visits |
2.16.840.1.113883.3.464.1003.101.12.1080 |
| Intervention, Order |
Hospice Care Ambulatory |
2.16.840.1.113883.3.526.3.1584 |
| Intervention, Performed |
Hospice Care Ambulatory |
2.16.840.1.113883.3.526.3.1584 |
| Intervention, Performed |
Palliative Care Intervention |
2.16.840.1.113883.3.464.1003.198.12.1135 |
| 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
CITATIONNational Cancer Institute. (2020). SEER Cancer Statistics Review, 195-2017. Retrieved September 22, 2020, from SEER website: https://seer.cancer.gov/csr/1975_2017/
CITATIONSEER. “Cancer of the Colon and Rectum - Cancer Stat Facts.” Accessed December 15, 2022. https://seer.cancer.gov/statfacts/html/colorect.html
CITATIONUS Preventive Services Task Force, Davidson, K. W., Barry, M. J., Mangione, C. M., Cabana, M., Caughey, A. B., Davis, E. M., Donahue, K. E., Doubeni, C. A., Krist, A. H., Kubik, M., Li, L., Ogedegbe, G., Owens, D. K., Pbert, L., Silverstein, M., Stevermer, J., Tseng, C. W., & Wong, J. B. (2021). Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA, 325(19), 1965–1977. https://doi.org/10.1001/jama.2021.6238
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Source:
https://ecqi.healthit.gov/ecqm/measures/cmsv1