Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
– DENOMINATOR
All patients 50-75 years of age with a visit during the measurement period.
– DENOMINATOR EXCLUSION
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 who are living long term in an institution for more than 90 consecutive days during the measurement period.
Exclude patients 66 and older with an indication of frailty for any part of the measurement period who meet any of the following 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 during the measurement period.
– 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.
– APPLICATION WORKFLOW
For Denominator:
The patient of age 50-75 with a qualifying encounter during the measurement year is considered for this measure. To record a visit, navigate to Patient > Provider Note > eSuperbill. Under the ‘Procedures- CPTs’ heading, enter the encounter code.
Annual Wellness Visit
Home Healthcare Services
Preventive Care Services-Initial Office Visit, 18 and Up
Preventive Care Services – Established Office Visit, 18 and Up
Office Visit
Online Assessments
Telephone Visits
eSuperbill
For Numerator:
Patients fulfilling any of the following criteria are considered for the numerator of this measure:
Patients who had colonoscopy procedure performed ten years or less on or before the end of the measurement period. To document the procedure, navigate to Patient > Provider Notes > Orders > Procedures. 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’.
Colonoscopy Procedure
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.
Add Procedure
Here, enter the ‘Code’ and ‘Name’ of the Procedure. Once done, click on the ‘Save’ button.
Add Procedure
Patients who had flexible sigmoidoscopy procedure performed five years or less on or before the end of the measurement period. To document the procedure, navigate to Patient > Provider Notes > Orders > Procedures. 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’.
Flexible Sigmoidoscopy Procedure
Patients who had ‘Fecal Occult Blood Test’ performed during the measurement period. The fecal occult test result must not be null. To perform a laboratory test, navigate to Patient > Clinical > Orders & Result > Labs to click on the ‘+ Add Order’ button. Select a Laboratory and search for a fecal occult blood test. Once done, click on the ‘Save’ button or hover over the ‘Sign’ button. If the user hovers over the ‘Sign’ button, then click ‘Queue’.
Fecal Occult Blood Test
Next, click on the ‘Mark as received’ button.
‘Mark As Received’ Button
On the lab result screen, add the observations and click on the ‘Save’ button.
Save Button
Note:
For LOINC Code Based Labs: Please ensure that the lab code is mapped to a LOINC Code from the Settings. To map a LOINC with the lab code, navigate to Settings > EHR > Laboratory. Select the Lab and navigate to the ‘Code’ tab. Then, click on the Lab Order. Under the ‘Result Codes and LOINCS’ heading, add a Code, LOINC and Description and click on the ‘Add’ button. Once done, click on ‘Save’.
Laboratory – Settings
For CPT Code Based Labs: When a CPT code is added to a lab order, please ensure that the CPT code is present in the ‘Procedures’.
CPT Codes
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’.
Procedure Components
Patients who had ‘FIT DNA’ test performed three years or less on or before the end of the measurement period. To perform a laboratory test, navigate to Patient > Clinical > Orders & Result > Labs to click on the ‘+ Add Order’ button. Select a Laboratory and search for a ‘FIT DNA’ test. Once done, click on the ‘Save’ button or hover over the ‘Sign’ button. If the user hovers over the ‘Sign’ button, then click ‘Queue’. Next, click on the ‘Mark as received’ button. On the lab result screen, add the observations and click on the ‘Save’ button.
Patients who had ‘CT Colonography’ diagnostic study performed five years or less on or before the end of the measurement period. To document a ‘CT Colonoscopy’ 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’.
CT Colonography
Mark the radiology order as completed by clicking the ‘Mark As Completed’ button.
‘Mark As Completed’ Button
Note:
For LOINC Code Based Radiology: 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’.
Edit Code Tab
For CPT Code Based Radiology: When a CPT code is added to a test order, please ensure that the CPT code is present in the ‘Procedures’.
CPT Codes
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’.
Procedure Components
For Denominator Exclusions:
Patients satisfying any of the following criteria are excluded from the denominator:
Patients who received hospice care during the measurement year. To document that patient is receiving hospice care outside of a hospital or long term care facility, navigate to Patient > Clinical > Evaluations. Use the below mentioned codes to order or perform an intervention:
385763009: Hospice Care (Regime/Therapy)
385765002: Hospice Care Management (Procedure)
Evaluation
To document an encounter inpatient, navigate to Patient > Clinical > Evaluations
Evaluation
Patients aged 65 years or older at the start of the measurement period who spent longer than 90 consecutive days in a long term care during the measurement period. To record the encounter, navigate to Patient > Provider Note > eSuperbill.
Patients 65 years of age or older with two or more outpatient encounters with advanced illness and fulfilling frailty criteria. Outpatient encounters should occur two years or less prior to the end of the measurement period. To document an outpatient encounter, navigate to Patient > Provider Note > eSuperbill. To document an advanced illness diagnosis, use the workflow: Patient > Clinical > Diagnoses. Workflows for recording frailty criteria:
Frailty device ordered/applied during the measurement period: Patient > Clinical > Evaluations
Frailty diagnosis during the measurement period: Patient > Clinical > Diagnoses
Frailty symptoms during the measurement period: Patient > Clinical > Diagnoses or Patient > Clinical > Evaluations
Frailty encounter during the measurement period: Patient > Provider Note > eSuperbill
Patients 65 years of age or older having an inpatient encounter with advanced illness and fulfilling frailty criteria. Inpatient encounter should occur two years or less prior to the end of the measurement period. To document an inpatient encounter, navigate to Patient > Provider Note > eSuperbill. To document an advanced illness diagnosis, use the workflow: Patient > Clinical > Diagnoses. Workflows for recording frailty criteria:
Frailty device ordered/applied during the measurement period: Patient > Clinical > Evaluations
Frailty diagnosis during the measurement period: Patient > Clinical > Diagnoses
Frailty symptoms during the measurement period: Patient > Clinical > Diagnoses or Patient > Clinical > Evaluations
Frailty encounter during the measurement period: Patient > Provider Note > eSuperbill
Patients 65 years of age or older taking dementia medication one year prior to or during the measurement period and fulfilling frailty criteria. Record the medication via the workflow Patient > Clinical > Prescription.Workflows for recording frailty criteria:
Frailty device ordered/applied during the measurement period: Patient > Clinical > Evaluations
Frailty diagnosis during the measurement period: Patient > Clinical > Diagnoses
Frailty symptoms during the measurement period: Patient > Clinical > Diagnoses or Patient > Clinical > Evaluations
Frailty encounter during the measurement period: Patient > Provider Note > eSuperbill
Patients diagnosed with malignant neoplasm of colon and who had colorectal cancer prevalence on or before the end of the measurement period. To record the cancer diagnosis, use the workflow Patient > Provider Note > Diagnoses, and click ‘Add’. Search for the malignant neoplasm of colon diagnosis and add the diagnosis details. Then click ‘Save’. The diagnosis is added to the provider note.
Patients who had ‘Total Colectomy’ procedure performed on or before the end of the measurement period. To document the procedure, navigate to Patient > Provider Note > Orders > Procedures. 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’.
Patients receiving palliative care in the measurement period.
To record palliative assessment performed, navigate to Patient > Clinical > Evaluations.
To record palliative encounter performed, navigate to Patient > Provider Note > eSuperbill.
To record palliative intervention performed, navigate to Patient > Clinical > Evaluations.
