CMS129v14: Prostate Cancer: Avoidance of Overuse of Bone Scan for Staging Low Risk Prostate Cancer Patients

Percentage of patients, with a diagnosis of prostate cancer at low (or very low) risk of recurrence receiving interstitial prostate brachytherapy, OR external beam radiotherapy to the prostate, OR radical prostatectomy who did not have a bone scan performed at any time since diagnosis of prostate cancer

Numerator

Patients who did not have a bone scan performed after diagnosis of prostate cancer and before the end of the measurement period.

Denominator

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

 

To add a patient in the denominator, the patient needs to have 2 encounters:

  • On the first encounter:
    • The patient must have a diagnosis of Prostate Cancer in their problem list
    • One of the following staging added to the Assessment or Plan of the encounter:
      • Most Recent Prostate Cancer Staging Tumor Size: T1a
      • Most Recent Prostate Cancer Staging Tumor Size: T1b
      • Most Recent Prostate Cancer Staging Tumor Size: T1c
      • Most Recent Prostate Cancer Staging Tumor Size: T2a
    • In Tracked Data, Add the PSA and the Gleason scores.
      • From the patient’s chart, select “Summary Sheet” tab at the top of the chart
      • The “Tracked Data” section will be on the right of the page. Click “Add/Edit”
      • Enter “PSA” into the Item
      • Enter the Value (Note: PSA score must be under 10)
      • Enter the date collected
      • Select “Move Data To Grid” and then click “Ok”

THEN

      • Enter “Gleason” into the Item
      • Enter the Value (Note: Gleason score must be 6 or under)
      • Enter the date collected
      • Select “Move Data To Grid” and then click “Ok”
      • Select “Save and Close”

NOTE: PSA must be dated before the tumor size and Gleason scores must be dated before the first prostate cancer treatment

    • PSA/Gleason score electronically imported from a lab interface.
  • On the following encounter:
    • In the Plan or Assessment field, the following phrase is added:
      • First prostate cancer treatment

Exclusions:

Documentation of reason(s) for performing a bone scan (including documented pain, salvage therapy, other medical reasons:

  • Diagnosis of pain related to cancer added to the patient’s problem list
  • In the Plan or Assessment fields, add the following phrases:
    • Bone scan ordered for other reasons
    • Bone Scan ordered for medical reasons
    • Salvage cystoprostatectomy
  • CPT code of salvage therapy (51597, 55860, 55862, 55865) included on super bill in Amazing Charts