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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 50-75 years of age who had appropriate screening for colorectal cancer.

Guidance

None

Patient Group Definitions

Group Description Instructions Links
Initial PopulationPatients 50-75 years of age with a visit during the measurement periodWebchart Instructions
DenominatorEquals Initial PopulationWebchart Instructions
Denominator ExclusionsPatients with a diagnosis or past history of total colectomy or colorectal cancerWebchart Instructions
NumeratorPatients 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 periodWebchart Instructions
Numerator ExclusionsNot ApplicableWebchart Instructions
Denominator ExceptionsNone

Details

Full eMeasure Code eMeasure Identifier Measure Year Version NQF # GUID
CMS130v5 130 2017 5.0.000 0034 aa2a4bbc-864f-45ee-b17a-7ebcc62e6aac
Steward Developer Endorsed By
National Committee for Quality Assurance National Committee for Quality Assurance National Quality Forum
Scoring Method Measure Type Stratification Risk Adjustment
Proportion PROCESS None None

Rate Aggregation

None

Improvement Notation

Higher score indicates better quality

Rationale

An estimated 132,700 men and women were diagnosed with colon or rectal cancer in 2015. In the same year, 49,700 were estimated to have died from the disease, making colorectal cancer the third leading cause of cancer death in the United States (National Cancer Institute 2015, American Cancer Society 2015). Screening for colorectal cancer is extremely important as there are no signs or symptoms of the cancer in the early stages. If the disease is caught in its earliest stages, it has a five-year survival rate of 90%; however, the disease is often not caught this early. While screening is extremely effective in detecting colorectal cancer, it remains underutilized (American Cancer Society 2015). The U.S. Preventive Services Task Force has identified fecal occult blood tests, colonoscopy, and flexible sigmoidoscopy as effective screening methods (United States Preventive Services Task Force 2008).

Clinical Recommendation Statement

The United States Preventive Services Task Force (2008): 

[1] The USPSTF recommends screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy, or colonoscopy in adults, beginning at age 50 years and continuing until age 75 years (A recommendation). 
[2] The USPSTF concludes that the evidence is insufficient to assess the benefits and harms of computed tomographic (CT) colonography and fecal DNA testing as screening modalities for colorectal cancer (I statement).

Definition

None

Transmission Format

TBD

Applicable Value Sets

Category Value Set OID
Diagnosis Malignant Neoplasm of Colon 2.16.840.1.113883.3.464.1003.108.12.1001
Encounter, Performed Annual Wellness Visit 2.16.840.1.113883.3.526.3.1240
Encounter, Performed Face-to-Face Interaction 2.16.840.1.113883.3.464.1003.101.12.1048
Encounter, Performed Home Healthcare Services 2.16.840.1.113883.3.464.1003.101.12.1016
Encounter, Performed Office Visit 2.16.840.1.113883.3.464.1003.101.12.1001
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
Laboratory Test, Performed Fecal Occult Blood Test (FOBT) 2.16.840.1.113883.3.464.1003.198.12.1011
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

References

American Cancer Society. 2015. "Cancer Prevention & Early Detection Facts & Figures 2015-2016." Atlanta: American Cancer Society.
National Cancer Institute. 2015. "SEER Stat Fact Sheets: Colon and Rectum Cancer." Bethesda, MD, http://seer.cancer.gov/statfacts/html/colorect.html
U.S. Preventive Services Task Force (USPSTF). 2008. "Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement." Ann Intern Med 149(9):627-37.

Disclaimer

These performance Measures are not clinical guidelines and do not establish a standard of medical care, and have not been tested for all potential applications. THE MEASURES AND SPECIFICATIONS ARE PROVIDED "AS IS" WITHOUT WARRANTY OF ANY KIND. Due to technical limitations, registered trademarks are indicated by (R) or [R] and unregistered trademarks are indicated by (TM) or [TM].

Copyright

Physician Performance Measure (Measures) and related data specifications were developed by the National Committee for Quality Assurance (NCQA). 

The Measures are copyrighted but can be reproduced and distributed, without modification, for noncommercial purposes (eg, use by healthcare providers in connection with their practices). Commercial use is defined as the sale, licensing, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain. Commercial use of the Measures requires a license agreement between the user and NCQA. NCQA is not responsible for any use of the Measures. 

(C) 2008-2016 National Committee for Quality Assurance. All Rights Reserved. 

Limited proprietary coding is contained in the Measure specifications for user convenience. Users of proprietary code sets should obtain all necessary licenses from the owners of the code sets. NCQA disclaims all liability for use or accuracy of any CPT or other codes contained in the specifications.

CPT(R) contained in the Measure specifications is copyright 2004-2015 American Medical Association. LOINC(R) copyright 2004-2015 Regenstrief Institute, Inc. This material contains SNOMED Clinical Terms(R) (SNOMED CT[R]) copyright 2004-2015 International Health Terminology Standards Development Organisation. ICD-10 copyright 2015 World Health Organization. All Rights Reserved.

Source: https://ecqi.healthit.gov/ecqm/measures/cms130v5