CMS-10431 Oncology Cares Measures Paper Submission

(CMS-10431) PPS-exempt Cancer Hospital Quality Reporting (PCHQR) Program

Data Collection - Oncology Care Measures Paper Form (508)

PPS-exempt Cancer Hosptital Quality Reporitng (PCQR) Program

OMB: 0938-1175

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PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program

Clinical Process/Oncology Care Measures

Paper Submission for FY2020 and Subsequent Years


(NQF 0382) Oncology: Radiation Dose Limits to Normal Tissues

Q1 Q2 Q3 Q4

Shape1 Shape2

Patients who had documentation in medical record that radiation dose limits to normal tissues were established prior to the initiation of a course of 3D conformal radiation for a minimum of two tissues

NUMERATOR







Shape3

DENOMINATOR

Shape4

All patients, regardless of age, with a diagnosis of pancreatic, breast, rectal, or lung cancer receiving 3D conformal radiation therapy







(NQF 0383) Oncology: Plan of Care for Pain – Medical Oncology and Radiation Oncology

Shape5 Q1 Q2 Q3 Q4

NUMERATOR

Shape6

Patient visits that included a documented plan of care to address pain.

Documented plan of care may include: use of opioids, nonopioids analgesics, psychological support, patient and/or family education, referral to a pain clinic, or reassessment of pain at an appropriate time interval













Shape7 DENOMINATOR

Shape8

All selected surgical patients with a catheter in place postoperatively









(NQF 0384) Oncology: Pain Intensity Quantified- Medical Oncology and Radiation Oncology

Shape9 Q1 Q2 Q3 Q4

NUMERATOR

Shape10

Patient visits in which pain intensity is quantified.


Pain intensity should be quantified using a standard instrument, such as a 0-10 numerical rating scale, a categorical scale, or the pictorial scale











Shape11 DENOMINATOR

Shape12

All visits for patients, regardless of age, with a diagnosis of cancer currently receiving chemotherapy or radiation therapy










(NQF 0389) Prostate Cancer: Avoidance of Overuse Measure- Bone Scan for Staging Low-Risk Patients

Shape13 Q1 Q2 Q3 Q4

Shape14

Patients who did not have a bone scan performed any time since diagnosis of prostate surgery

NUMERATOR





Shape15

Shape16

All patients, regardless of age, with a diagnosis of prostate cancer, at low risk of recurrence, receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy, OR cryotherapy

DENOMINATOR












(NQF 0390) Prostate Cancer: Adjuvant Hormonal Therapy for High-Risk Patients

Q1 Q2 Q3 Q4

Shape18 Shape17

Patients who were prescribed adjuvant hormonal therapy (GnRH) [gonadotropin-releasing hormone] agonist or antagonist)

NUMERATOR





Shape19

Shape20

All patients, regardless of age, with a diagnosis of prostate cancer, at high risk of recurrence, receiving external beam radiotherapy to the prostate

DENOMINATOR











(*) indicates required for providers participating in the PPS-Exempt Cancer Hospital Quality Reporting Program.

* Facility Name:

* CEO Signature: * Date:

* CEO Email Address:

Complete and submit this form via email to: PCHQualityReporting@hcqis.org.

Following receipt of the request form, an email acknowledgement will be sent confirming the form has been received.



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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitlePCHQR Clinical Process/Oncology Care Measures
SubjectPCHQR Clinical Process/Oncology Care Measures
AuthorCMS
File Modified0000-00-00
File Created2021-01-22

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