QCDR measure AAD 17
Continuation of Anticoagulation Therapy in the Office-based Setting for Closures and Reconstruction After Skin Cancer Resection Procedures
DESCRIPTION:
Percentage of procedures in patients aged 18 and older with a diagnosis of skin cancer, on prescribed anticoagulation therapy, who had intermediate layer and/or complex linear closures OR reconstruction after skin cancer resection performed in the office-based setting where anticoagulant therapy was continued prior to surgery.
This measure is stratified by intermediate layer or complex linear closure or reconstructive procedures.
| MEASURE ID: | AAD17 |
|---|---|
| Type: | Process |
CMS Derm Specialty Set: | N/A |
| High priority: | Yes |
| Topped out: | Yes |
| Telehealth Eligible: | No |
| Reporting methods: | Registry/QCDR |
| Maximum points: | 10 |
MEASURE PURPOSE:
This measure encourages continued use of anticoagulation therapy prior to intermediate layer and/or complex linear closures and/or reconstruction after skin cancer resection procedures in an office-based setting as studies have shown cases of increased bleeding post-operatively did not result in serious consequences; whereas medication cessation has been associated with serious adverse events.
AAD17 FAQs
QQ. Is this measure reportable via claims?
A. No. This measure can only be reported via a registry, such as DataDerm.
Q. Are patient encounters conducted via telehealth allowable?
A. No. Telehealth encounters are not allowable.
Q. What is the numerator?
A. The numerator are patients for whom anticoagulant therapy was continued prior to surgery.
Q. What is the denominator?
A. The denominator is all patients aged 18 and older on prescribed anticoagulation therapy in the office-based setting who underwent:
Intermediate layer or complex linear closures; or
Reconstruction after skin cancer resection; or
Intermediate layer and complex linear closures AND reconstruction after skin cancer resection.
Q. Are there any exceptions for this measure?
A. Yes. Medical reason exceptions include:
Consultation with managing physician which resulted in medication modification.
Patients who are taking aspirin (ASA) without a prescriber’s recommendation/prescription
Patients who are taking warfarin, with a supratherapeutic INR.
Q. As a dermatologist (non-Mohs surgeon) will I be eligible to report AAD17 for MIPS for skin cancer excisions I perform in the office?
A. Yes, dermatologists that are non-Mohs surgeons could report these measures, but it will depend on your patient population and the types of procedures you perform. Measure AAD17 is related to intermediate layer, complex linear, and reconstruction after skin cancer resection procedures, not the malignant excision (11600, etc.) type procedures.
Calculation
The numerator: Patients for whom anticoagulant therapy was continued prior to surgery
The denominator: All procedures in patients aged 18 and older with a diagnosis of skin cancer, on prescribed anticoagulation therapy who underwent:
- Strata 1 - Intermediate layer or complex linear closures after skin cancer resection
- Strata 2 - Reconstruction after skin cancer resection
- Strata 3 - Intermediate layer and complex linear closures AND reconstruction after skin cancer resection in the office-based setting (Weighted average of Strata 1 AND 2)
Measure calculation example
Dr. Long saw 121 adult patients who were on prescribed anticoagulant therapy and underwent reconstruction after skin cancer resection in an office-based setting. This is the denominator.
Of the 121 patients, all but 2 continued their anticoagulant therapy prior to surgery. This is the numerator.
Quality of patient care = 119/121. Dr. Long has a score of 98.3% for this measure. This translates to 1 to 1.9 points.
Important note
Physicians who achieve a 99.99% score receive 1.9 points. They must score a perfect 100% to earn the maximum of 10 points available. Clinicians score 3 points even if they report on only one patient. This is applicable only to small practices with 15 providers or fewer.
Quality measure score benchmark
CMS will award points based on a comparison of your performance rate to CMS benchmarks listed below. Reach the performance rate listed to achieve the corresponding points per measure. Points achieved for the Quality category will account for 30% of the overall MIPS score.
| Decile 1 | Decile 2 | Decile 3 | Decile 4 | Decile 5 | Decile 6 | Decile 7 | Decile 8 | Decile 9 | Decile 10 |
|---|---|---|---|---|---|---|---|---|---|---|
Performance rate |
39.02 - 99.99 |
100 |
||||||||
Points |
1 - 1.9 |
2 - 2.9 |
3 - 3.9 |
4 - 4.9 |
5 - 5.9 |
6 - 6.9 |
7 - 7.9 |
8 - 8.9 |
9 - 9.9 |
10 |
