Percentage of women 50–74 years of age who had a mammogram to screen for breast cancer in the 27 months prior to the end of the measurement period.
– DENOMINATOR
Women 52 – 74 years of age by the end of the measurement period with a medical visit during the measurement period.
A qualifying medical visit in this case can include any of the following:
Office Visit
Annual Wellness Visit
Home Healthcare Services
Online Assessments
Telephone Visits
Preventive Care Services – Initial Office Visit, 18 and Up
Preventive Care Services – Established Office Visit, 18 and Up
– DENOMINATOR EXCLUSIONS
Women who had a bilateral mastectomy or who have a history of a bilateral mastectomy or for whom there is evidence of a right and a left unilateral mastectomy.
Patients who are in hospice care for any part of the measurement period.
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.
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
Patients receiving palliative care for any part of the measurement period.
– NUMERATOR
Women with one or more mammograms any time on or between October 1 two years prior to the measurement period and the end of the measurement period.
– APPLICATION WORKFLOW
For Denominator:
To record an encounter, navigate to Patient > Provider Notes > Create Superbill. Under the ‘Procedure- CPTs’ heading, enter the encounter code.
eSuperbill
For Numerator:
To document the Mammography, navigate to Patient > Provider Notes > Orders > Procedures or through Patient > Provider Notes > Orders > Radiology. Click ‘Add’ and search for the relevant procedure. Once done, click ‘Save & Accept’ or ‘Sign & Accept’.
Example of Mammography Procedure
Denominator Exclusions:
To document a bilateral or unilateral mastectomy performed, navigate to Patient > Provider Notes > Orders > Procedures. Search for the Mastectomy and click ‘Save & Accept’ or ‘Sign & Accept’.
Example of Mastectomy Procedure
To document a diagnosis for bilateral or unilateral mastectomy, navigate to Patient > Provider Notes > Diagnoses. Click ‘Add’ and search for the relevant diagnosis of mastectomy. Fill out any details if necessary and once done, click ‘Save’.
Example of Mastectomy Diagnosis
To document a patient receiving hospice care, navigate to Patient > Provider Notes > Evaluations. Hospice Care can also be recorded by the workflow Patient > Provider Notes > Create Superbill. Under the ‘Procedure-CPTs’ heading, add the relevant hospice care code.
Hospice Care Evaluation
To record an encounter for patients living long term in nursing homes, navigate to Patient > Provider Note > Create Superbill or head over to Patient > Provider Notes > Evaluations. Here, click ‘Add’ and search for the relevant finding.
Evaluation
To document an outpatient encounter for advanced illness, navigate to Patient > Provider Notes > Create Superbill. These outpatient encounter can include any of the following:
Outpatient
Observation
Emergency Department Visit
Nonacute Inpatient
To document an advanced illness, use the workflow: Patient > Provider Notes > Diagnoses. Click ‘Add’ and search for the relevant advanced illness.
Note: The advanced illness is to be diagnosed during the outpatient encounter.
Example of Advanced Illness Diagnosis
To record frailty criteria, the following workflows can be used:
Frailty device ordered/ applied during the measurement period: Patient > Provider Notes > Procedures or through Patient > Provider Notes > Evaluations.
Frailty Device Ordered via Procedures
Frailty diagnosis during the measurement period: Patient > Provider Notes > Diagnoses.
Example of Frailty Diagnosis
Frailty symptoms during the measurement period: Patient > Provider Notes > Diagnoses or Patient > Provider Notes > Evaluations
Frailty encounter during the measurement period: Patient > Provider Notes > Create Superbill
To document an inpatient encounter for advanced illness, navigate to Patient > Provider Notes > Create Superbill or document via Patient > Provider Notes > Evaluations.
To document the dementia medication, use the workflow Patient > Provider Notes > Medications.
Example of Dementia Medication Documentation
To record palliative assessment performed, navigate to Patient > Provider Notes > Evaluations or head over to Patient > Provider Notes > Assessments.
Example of Palliative Care Assessment
To record a palliative encounter, navigate to Patient > Provider Notes > Create Superbill or use the workflow Patient > Provider Notes > Diagnoses. Here, document a diagnosis for ‘Encounter for palliative care’.
Example of Palliative Encounter
To record palliative intervention performed, navigate to Patient > Provider Notes > Evaluations.
