CMS645v6 – Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation Therapy

Bone Density Evaluation for Patients with Prostate Cancer and Receiving Androgen Deprivation Therapy CMS645v6 Patients determined as having prostate cancer who are currently starting or undergoing androgen deprivation therapy (ADT), for an anticipated period of 12 months or greater and who receive an initial bone density evaluation. The bone density evaluation must be prior to the start of ADT or within 3 months of the start of ADT.
DENOMINATOR

Male patients with:

  1. A qualifying encounter in the measurement period. A qualifying encounter in this case is an Office Visit.
  2. A diagnosis of prostate cancer.
  3. An order for ADT (Androgen Deprivation Therapy) 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 the bone density evaluation at the time ordered or did not have it performed within 3 months after the start of ADT.

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.

APPLICATION WORKFLOW

For Denominator:

  • To record an encounter, navigate to Patient > Provider Notes > Create Superbill. Under the ‘Procedure-CPTs’, enter the relevant encounter code.
eSuperbill for Encounter
  • For documenting a prostate cancer diagnosis, use the workflow Patient > Provider Notes > Diagnoses. Click ‘Add’ and search for the relevant diagnosis and fill out the details. Once done, click ‘Save’.
Example of Prostate Cancer Diagnosis
  • The documentation of the procedure for administering ADT can be done via Patient > Provider Notes > Orders > Procedures. Here, click ‘Add’ and search for the relevant procedure. Fill out the details and once done, click ‘Save’.

For Numerator:

To order or document the DEXA diagnostic study, use the workflow Patient > Provider Notes > Evaluations. Click ‘Add’ and search for the relevant bone density diagnostic study. From the ‘Status’ drop-down either select ‘Ordered’ or ‘Performed’. Once done, either click ‘Save & Accept’ or ‘Sign & Accept’.

Example of DEXA Diagnostic Study

For Denominator Exceptions:

To document patient refusal to have bone density study ordered or performed, head over to Patient > Provider Notes > Evaluations. Here, click ‘Add’ and search for the relevant bone density evaluation and from the status drop-down select ‘Not ordered’ or ‘Not performed’. Then, from the result drop-down, select the appropriate reason. Once done, click ‘Save & Accept’ or ‘Sign & Accept’.

Documenting Patient Reason for Refusal