CMS130v7 – Colorectal Cancer Screening

All patients 50-75 years of age with a visit during the measurement period.

– DENOMINATOR EXCLUSION

Patients with a diagnosis or past history of total colectomy or colorectal cancer.
Exclude patients whose hospice care overlaps the measurement period.

– NUMERATOR

Patients with one or more screenings for colorectal cancer.
Appropriate screenings are defined by any one of the following criteria:

1. Fecal occult blood test (FOBT) during the measurement period
2. Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period
3. Colonoscopy during the measurement period or the nine years prior to the measurement period
4. FIT-DNA during the measurement period or the two years prior to the measurement period
5. CT Colonography during the measurement period or the four years prior to the measurement period

For Denominator:

The patient of age 50-75 with a visit in measurement year is considered for this measure. To record a visit, navigate to Patient > Provider Note > eSuperbill. 

For Numerator:

All patients with one or more of the following screenings for colorectal cancer are included in the numerator:

• Colonoscopy during the measurement period or nine years prior to the measurement period. To record this, navigate to Patient > Clinical > Orders and Results > Procedure > Order. Colonoscopy can be recorded using the relevant CPT code i.e.
• Fecal Occult Blood Test (FOBT) during the measurement period (Patient > Clinical > Orders and Results > Labs)
• FIT DNA during the measurement period or the two years prior to the measurement period (Patient > Clinical > Orders and Results > Labs)
• Flexible Sigmoidoscopy during the measurement period or the four years prior to the measurement period. To record this, navigate to Patient > Clinical > Orders and Results > Procedure > Order. Sigmoidoscopy can be recorded using its relevant CPT code i.e. 45331.

CT Colonography during the measurement period or four years prior to the measurement period. It can be recorded using CPT codes that include 74261, 74262, or 74263.  Follow the below mentioned workflow to document Colonography:
(Patient > Clinical > Orders and Results > Procedures)

For Denominator Exclusions:

Patients who received hospice care fall in the denominator exclusions. In order to document this, navigate to Patient > Clinical > Evaluations.

To record hospice care, navigate to Patient > Clinical > Evaluations and use the below mentioned codes:

• 385763009
• 385765002

To learn more about how to add Evaluations, click here.