azara proprietary & confidential cervical cancer screening 2014 measure changes improving...

Azara Proprietary & Confidential

Cervical Cancer Screening 2014 Measure Changes

Improving Patient Outcomes through Data

0032 Cervical Cancer Screening CMS124 2

• Measure Update • Measure Title & Steward #• Measure Description• Measure Comparison MU 2011 vs MU 2014• What did the old measure include• What changes are applied to the new

measure• What are current considerations due to

measure update

Azara CQM’s


LOINCAdditional LOINC codes e.g., 18500-9, Cytopathology stain thin prep were added The additional LOINC codes will help to improve performance rates provided the clinic captures the appropriate codes in their lab requisitions, EMR, etc.

SNOMEDSNOMED codes for Sampling of cervix for Papanicolaou smear e.g., 439958008 were removed

from criteria of patients that meet the numerator

Potential reduction in performance rate if deleted

codes were exclusively used to document screening

Population CriteriaRevisions/ additions to “visit types” for patients who will meet the initial denominator criteria were made.Look-back period for encounter shortened from 2 years to 1 year.Look-back period for Pap test unchanged, though worded differently.

MU 2014 Measure Update Change Summary

ICD 9 and 10 codes Diagnosis

Some ICD 9 & 10 Dx codes for pap smear were removed as indicators for

patients that meet the numerator criteria

Changes may cause a potential reduction in performance rate if

deleted codes are exclusively used to document screening

Several Hysterectomy codes were also deleted. This further clarifies the need

for a patient to have “no residual cervix” in order for them to be

excluded from the initial population/ denominator criteria

CPT Codes & HCPCSVisit codes for patient encounters performed as a group visit e.g. 99411, 99412 or non-physician presence visit e.g., 99211 were removed as encounter types.Some Pap test Cytopathology codes e.g., 88141, 88142 were removed as indicators for patients meeting the numerator criteria. (see excel for detail).Potential reduction in performance rate if deleted codes were exclusively used to document screening.HCPCS Codes related to Medicare Cytopathology were removed, e. g., G0123 correlates to the CPT 88142 which was also removed as an indicator for patients meeting the numeratorPotential reduction in performance rate if deleted codes were exclusively used to document screening

What’s New with MU 2014

Cervical Cancer Screening


Cervical Cancer Screening Measure MU 2014

Percentage of women 21-64 years of age, who received one or more Pap tests to screen for cervical cancer.

National Quality Strategy (NQS) Domain – Clinical Process/Effectiveness

• Women with one or more Pap tests during the measurement period or the two years prior to the measurement period

Numerator

• Women 23-64 years of age with a visit during the measurement periodDenominator


Explanation and Impact of ChangesPopulation Criteria

Look-back period for encounter shortened from 2 years to 1 year, so population eligible for the denominator will be smaller.

Look-back period for Pap unchanged [measurement period or the two years prior to the measurement period], although worded differently in 2014 specs.


Explanation and Impact of ChangesPopulation Criteria

Revisions/ additions to the visit types for patients that will fall into the initial population/ denominator.

2011 Criteria • Encounter Types :OB/GYN or Outpatient• Pap laboratory test result had a 3 year look back

2014 Criteria • Encounter Types Performed: • Office Visit, • Face-to-Face Interaction, • Preventive Care Services, • Established Office Visit, 18 and Up, • Preventive Care Services-Initial Office Visit,

18 and Up, • Home Healthcare Services

See excel for population criteria


Explanation and Impact of Changes

CPT Codes RemovedEncounter outpatient- 99211, 99217, 99218, 99219, 99220, 99241, 99242, 99243, 99244, 99245 99384, 99394, 99245, 99401, 99402, 99403, 99404, 99411, 99412, 99420, 99429, 99455, 99456PAP Test - 88141, 88142, 88143, 88147, 88148, 88150, 88152, 88153, 88154, 88155, 88164, 88165, 88166, 88167, 88174, 88175 CPT Codes Added Hysterectomy with No Residual Cervix-57540,57545, 57550, 57555, 57556, 58548

CPT CODES Visit codes for patient encounters performed as a group visit e.g. 99411, 99412 or non-physician

presence visit e.g., 99211 were removed as encounter types Some Pap test Cytopathology codes e.g., 88141, 88142 were removed as indicators for patients

meeting the numerator criteria. (see excel for detail) Potential reduction in performance rate if deleted codes were exclusively used to document

screening



HCPCS Codes related to Medicare Cytopathology were removed, e. g., G0123 correlates to the CPT 88142 which was also removed as an indicator for patients meeting the numerator

Potential reduction in performance rate if deleted codes were exclusively used to document screening

Health Care Common Procedure Codes (HCPCS)

HCPCS Codes Removed Pap Test- G0123, G0124, G0141, G0143, G0144, G0145, G0147, G0148, P3000, P3001, Q0091HCPCS Codes AddedNONE


Explanation and Impact of ChangesICD 10/ ICD 9 CODES Some ICD 9 & 10 Dx codes for pap smear were removed (see excel for detail) as indicators for

patients that meet the numerator criteria. These changes may cause a potential reduction in performance rate if deleted codes are exclusively used to document screening

Several Hysterectomy codes were also deleted (see excel for detail). This further clarifies the need for a patient to have “no residual cervix” in order for them to be excluded from the initial population/ denominator criteria

ICD-9-CM RemovedEncounter ob/gyn- V24, V25 , V26, V27, V28, V45.5, V61.5, V61.6, V61.7, V69.2, V72.3, V72.4 Encounter outpatient- V70.0 V70.3 V70.5 V70.6 V70.8 V70.9 Hysterectomy - 68.15 68.4 68.41 68.49 68.5 68.51 68.59 68.6 68.61 68.69 68.7 68.71 68.79 68.8 V67.01 V76.47 V88.01 V88.03 Pap test - 91.46, V72.32

ICD-9-CM AddedNONE

ICD-10-CM RemovedHysterectomy- N81.81 Z12.72 Z90.71 Z90.710 Z90.7112 Pap test -Z12.4

ICD-10-CM AddedNONE



SNOMED- CT Codes Removed Hysterectomy 236886002, 79095000

Pap test - 439958008, 440615002, 440623000

SNOMED-CT Codes AddedFact To Face Interaction 12843005, 18170008, 185349003, 185463005, 185465003, 19681004, 207195004, 27042700,3 270430005, 308335008, 390906007, 406547006, 439708006, 4525004, 87790002, 90526000

Hysterectomy with No Residual Cervix (that will exclude patients from the denominator)112918004, 112918004 24293001 265056007 27185000 287924009 30160001 309880009 359971002 359974005 359977003 359983000 413145007 41566006 43791001 441820006 446446002 446679008 447771005 448539002 54490004 63516002 75835007 77902002

Systematized Nomenclature of Medicine Codes(SNOMED-CT)

SNOMED codes for Sampling of cervix for Papanicolaou smear e.g., 439958008 were removed from criteria of patients that meet the numerator

Potential reduction in performance rate if deleted codes were exclusively used to document screening



Additional LOINC codes e.g., 18500-9, Cytopathology stain thin prep were added The additional LOINC codes will help to improve performance rates provided the clinic

captures the appropriate codes in their lab requisitions, EMR, etc.

LOINC CODES

LOINC Codes Added Pap Test- 18500-9, 19762-4, 19764-0, 19765-7, 19766-5, 19774-9, 33717-0, 47527-7, 47528-5

azara proprietary & confidential cervical cancer screening 2014 measure changes improving...

Documents