Measure 509
Melanoma: Tracking and Evaluation of Recurrence
DESCRIPTION:
Percentage of patients who had an excisional surgery for melanoma or melanoma in situ with initial American Joint Committee on Cancer (AJCC) staging of 0, I, or II, in the past 5 years in which the operating provider examines and/or diagnoses the patient for recurrence of melanoma.
| MEASURE ID: | 509 |
|---|---|
| Type: | Process |
CMS Derm Specialty Set: | Yes |
| High priority: | Yes |
| Topped out: | No |
| Telehealth Eligible: | No |
| Reporting methods: | Registry/QCDR |
| Maximum points: | 10 |
MEASURE PURPOSE:
This measure aims to monitor melanoma cases by regular examination of patients and early detection of recurrent melanoma and to drive communication about the recurrence status of melanoma patients between the excising provider and the provider who is following the patient longitudinally.
Measure 503 FAQs
Q. Is this measure reportable via claims?
A. No.
Q. Are patient encounters conducted via telehealth allowable?
A. No. Telehealth encounters are not allowable.
Q. Is this an inverse measure?
A. The measure is both. Criteria 1 is not inverse. The higher the score indicates higher quality. Criteria 2 is inverse where a lower score indicates higher quality.
Q. What is the numerator?
A. There are two criteria for this measure.
Criteria 1: Documentation by the provider who performed the surgery that an exam for recurrence of melanoma was performed on the patient within the performance period.
Criteria 2: All patients that were diagnosed with a recurrent melanoma in the current performance year.
Q. What is the denominator?
A. All patients that the clinician has performed a type of excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial AJCC staging of 0, I, or II.
Q. Are there any exclusions or exceptions for this measure?
A. Yes. The following are the exclusions for the measure:
Documentation that the patient is deceased.
Documentation of patient refusal of examination.
Documentation that the patient was lost to follow-up (documentation must include information that the provider was unable to reach the patient by phone, mail or secure electronic mail – at least one method must be documented).
Q. What is considered a recurrent melanoma?
A. For purposes of this measure, recurrence is local recurrence of where the anatomical location(s) of the excised lesion or Mohs surgery occurred for ALL qualifying excisions identified in the denominator. Other locations should not be counted for this measure.
Q. What is considered lost to follow-up?
A. For purposes of this measure, in addition to those patients that the clinician is unable to locate for follow-up after documentation of attempt, lost to follow-up includes documentation of patients who relocated outside of the geographic area, transferred to a new clinician, or who had changes in insurance and are unable to follow-up.
Calculation
The numerator:
Criteria 1: Documentation by the provider who performed the surgery that an exam for recurrence of melanoma was performed on the patient within the reporting period.
Criteria 2: All patients that were diagnosed with a recurrent melanoma in the current reporting year.
The denominator: All patients that the provider has performed a type of excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial AJCC staging of 0, I, or II.
Measure calculation example
Dr. Park performed 100 excisional surgeries for melanoma or melanoma in situ in the past 5 years with an initial AJCC staging of 0, I, or II. This is the denominator.
During the measurement period, she examined 79 patients for recurrence of melanoma. This is the numerator. Quality of patient care = 79/100. Dr. Park has a score of 79% for criteria 1.
During the measurement period, 2 of the patients had a recurrence of melanoma. Quality of patient care = 2/100. Dr. Park has a score of 2% for criteria 2.
Overall performance rate is determined using a specific performance rate. For Measure 509, it is the first performance rate. Dr. Park has a score of 79% for this measure. This translates to 7-10 points when reporting by registry.
Important note
CMS has not set benchmarks for this measure. As a new MIPS measure, it is subject to 7-point scoring floor if data completeness is met.
