2021 MIPS Measure #249: Barrett’s Esophagus

Measure Description

Percentage of esophageal biopsy reports that document the presence of Barrett’s mucosa that also include a statement about dysplasia

Instructions

This measure is to be submitted each time a patient’s surgical pathology report demonstrates Barrett’s Esophagus; however, only one quality-data code (QDC) per date of service for a patient is required. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

Measure Submission Type:

Measure data may be submitted by individual MIPS eligible clinicians, groups, or third party intermediaries. The listed denominator criteria are used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions as allowed by the measure. The quality-data codes listed do not need to be submitted by MIPS eligible clinicians, groups, or third party intermediaries that utilize this modality for submissions; however, these codes may be submitted for those third party intermediaries that utilize Medicare Part B claims data. For more information regarding Application Programming Interface (API), please refer to the Quality Payment Program (QPP) website.

Denominator

All surgical pathology biopsy reports for Barrett’s Esophagus

Denominator Criteria (Eligible Cases):

Diagnosis for Barrett’s esophagus (ICD-10-CM): K22.70, K22.710, K22.711, K22.719

AND

Patient procedure during the performance period (CPT): 88305

AND NOT

DENOMINATOR EXCLUSION:

Specimen site other than anatomic location of esophagus: G8797

Numerator

Esophageal biopsy report documents the presence of Barrett’s mucosa and includes a statement about dysplasia Numerator Options:

Performance Met:

Esophageal biopsy reports with the histological finding of Barrett’s mucosa that contains a statement about dysplasia (present, absent, or indefinite and if present, contains appropriate grading) (3126F)

OR

Denominator Exception:

Documentation of medical reason(s) for not submitting the histological finding of Barrett’s mucosa (e.g., malignant neoplasm or absence of intestinal metaplasia) (3126F with 1P)

OR

Performance Not Met: Pathology report with the histological finding of Barrett’s mucosa that does not contain a statement about dysplasia (present, absent, or indefinite, and if present, contains appropriate grading), reason not otherwise specified (3126F with 8P)