Sigmoidoscopy every 10 years with annual FIT.įor individuals from 76–85 years of age, the Task Force recommends that the decision to screen should be personalized-based on overall health status and prior screening history (USPSTF, 2016).Multitarget stool DNA test every 1 or 3 years (interval based on manufacturer).Annual fecal immunochemical test (FIT).The USPSTF (2016) recommends the following screening regimens for individuals 50-75 years of age with average risk: The population of individuals aged 86 years and older is projected to double by 2050, hence, the clinical and economic effects of inappropriate performance of colorectal cancer screening in this age group can be expected to increase in the coming decade (Goodwin, 2011). Individuals aged 86 and older have an average life expectancy of less than 5 years and are at increased risk for colonoscopy-related complications. The benefit of colorectal cancer screening for an individual patient is dependent on that patient’s life expectancy and probability of harm from colonoscopy. Performance Not Met: Patients between 50 and 85 years of age who received a screening colonoscopy during the performance period. Performance Not Met: Patients greater than or equal to 86 years of age who received a colonoscopy for an assessment of signs/symptoms of GI tract illness, and/or because the patient meets high risk criteria, and/or to follow-up on previously diagnosed advanced lesions (G9661) Performance Not Met: Documentation of medical reason(s) for a colonoscopy performed on a patient greater than or equal to 86 years of age (e.g., iron deficiency anemia, lower gastrointestinal bleeding, Crohn’s Disease (i.e., regional enteritis), familial history of adenomatous polyposis, Lynch Syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits) (G9660) Performance Met: Patients greater than or equal to 86 years of age who underwent a screening colonoscopy and did not have a history of colorectal cancer or other valid medical reason for the colonoscopy, including: iron deficiency anemia, lower gastrointestinal bleeding, Crohn’s Disease (i.e., regional enteritis), familial adenomatous polyposis, Lynch Syndrome (i.e., hereditary non-polyposis colorectal cancer), inflammatory bowel disease, ulcerative colitis, abnormal finding of gastrointestinal tract, or changes in bowel habits (G9659) For inverse measures, a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control. Submitting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. INVERSE MEASURE - A lower calculated performance rate for this measure indicates better clinical care or control. Screening colonoscopies performed in patients greater than or equal to 86 years of age Numerator Instructions: For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.Īll screening colonoscopy examinations performed on patients greater than or equal to 50 years of age during the encounter period Denominator Criteria (Eligible Cases):Īll patients greater than or equal to 50 years of age on date of encounter receiving a colonoscopy for screening purposes only The quality data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this modality for submissions however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The listed denominator criteria are used to identify the intended patient population. Measure data may be submitted by individual MIPS eligible clinicians, groups, or third party intermediaries. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding. There is no diagnosis associated with this measure. This measure is to be submitted each time a colonoscopy is performed for all patients during the performance period. The percentage of screening colonoscopies performed in patients greater than or equal to 86 years of age from January 1 to December 31.
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