CMS645v4 – Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation Therapy

Male patients with a qualifying encounter in the measurement period AND with a diagnosis of prostate cancer AND with an order for ADT or an active medication of ADT with an intent for treatment greater than or equal to 12 months during the measurement period.

– DENOMINATOR EXCEPTIONS

Patient refused recommendation for a bone density evaluation after the start of ADT therapy.

– NUMERATOR

Patients with a bone density evaluation within the two years prior to the start of or less than three months after the start of ADT treatment.

For Denominator:

Male patients with a diagnosis of prostate cancer and an order/active medication for Androgen Deprivation Therapy (ADT) that is intended for greater than or equal to 12 months during the measurement period are included in the denominator.

• To record an encounter, navigate to Patient > Provider Note > eSuperbill. 

• To document an active medication for Androgen deprivation therapy for Urology Care, navigate to Patient > Provider Notes > Medications. Click ‘Add’ and search for ADT medication. Enter the medication details and click ‘Save’.

• To add diagnosis of prostate cancer, navigate to Patient > Provider Notes > Diagnoses and click ‘Add’. Search for prostate cancer diagnosis and add the diagnosis details. Then click ‘Save’. The diagnosis is added to the provider note.

• To record the procedure order of Leuprolide Acetate injection, navigate to Patient > Provider Notes > Orders > Procedure. Click ‘Add’ and search for the procedure. Add the procedure details and click on ‘Save & Accept’/hover over ‘Sign & Accept’. If the user hover over ‘Sign & Accept’, then click ‘Complete’. The procedure is added to the provider note.

Note:

Please ensure that the Procedure is present in the system. For this, navigate to Settings > Billing > Procedure. If the procedure is not added then, click on the ‘Add Procedure’ button. 

Here, enter the ‘Code’ and ‘Name’ of the Procedure. Once done, click on the ‘Save’ button. 

For Numerator:

Patients with a bone density scan within the two years prior to the start of or less than three months after the start of ADT treatment are included in the numerator.

• To document a ‘DEXA Dual Energy Xray Absorptiometry’ diagnostic study performed, use the workflow Patient > Clinical > Orders & Results > Radiology. Click ‘+ Order’ and add the radiology order details. Then hover over ‘Sign’ and click ‘Queue’.

Mark the radiology order as completed by clicking the ‘Mark As Completed’ button.

System displays the radiology order in the ‘Completed Results’ tab.

• To document a ‘DEXA Dual Energy Xray Absorptiometry’ diagnostic study ordered, use the workflow Patient > Clinical > Orders & Results > Radiology. Click ‘+ Order’ and add the radiology order details. Then hover over ‘Sign’ and click ‘Queue’. The radiology order is displayed in the ‘Pending Orders’ tab.

Note:

Please ensure that the test code is mapped to a LOINC Code from the Settings. To map a LOINC with the radiology test code, navigate to Settings > EHR > Radiology. Select the radiology test and navigate to the ‘Code’ tab. Then, click on a code. Under the ‘Result Codes and LOINCS’ heading, add a Code, LOINC and Description and click on the ‘Add’ button.

Once done, click on ‘Save’. 

When a CPT code is added to a test order, please ensure that the CPT code is present in the ‘Procedures’. 

Moreover, the CPT code should be mapped to a LOINC Code from the Settings. To map a LOINC with the CPT code, navigate to Settings > Billing > Procedure. Select the CPT code and navigate to the ‘Edit Procedure’ tab. Under the ‘Procedure Components’ heading, add a Code, LOINC and Description and click on the ‘Add’ button.

Once done, click on ‘Save’. 

For Denominator Exceptions:

Patients who refused to have a bone density scan ordered or performed within the three months or less time after the start of the ADT therapy are included in the denominator exception.

• To document a bone density scan not ordered/not performed, use the workflow Patient > Clinical > Evaluations. Click ‘+ Evaluation’ and search for a bone density evaluation. From the ‘Status’ dropdown, select ‘Not Ordered’ or ‘Not Performed’, and from the ‘Reason’ dropdown, select a reason. Then click ‘Sign’ or ‘Save.