CMS157v11 – Oncology: Medical and Radiation – Pain Intensity Quantified

All patient visits, regardless of patient age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy. A qualifying visit in this case is a face to face or telehealth encounter with ongoing chemotherapy.

Two chemotherapy sessions should be performed and the dates of the first and second chemotherapy sessions must not overlap. First chemotherapy session should be performed 30 days or less on or before the day of face to face/telehealth encounter and second chemotherapy session should be performed 30 days or less on or after the day of face to face/telehealth encounter.

Note: The cancer diagnosis is to be established at the time of the encounter.

– NUMERATOR

Patient visits in which pain intensity is quantified.

For Denominator:

• To record a face to face/telehealth encounter, navigate to Patient > Provider Note > Create Superbill. Under the ‘Procedures-CPTs’ heading, enter the relevant encounter code.

• The cancer diagnosis can be documented via Patient > Provider Note > Diagnoses. Click ‘Add’ and search for the relevant diagnosis. Fill out any necessary details and once done, click ‘Save’. Then click ‘Accept’ to add the diagnosis to the provider note.

• To record the ‘Chemotherapy Administration’ or ‘Radiation Treatment Management’ procedure, navigate to Patient > Provider Note > Orders > Procedures. Click ‘Add’ and search for the procedure. Add the procedure details and click ‘Save & Accept’ or ‘Sign & Accept’.

For Numerator:

To document the pain assessment, use the workflow Patient > Provider Note > Evaluations. Click ‘Add’ and search for a relevant pain assessment. From the ‘Status’ dropdown, select ‘Performed’, and add the result in the ‘Result’ field. Then click ‘Save & Accept’ or ‘Sign & Accept’.