|High Priority Measure?
|Medicare Part B Claims, MIPS CQM
Percentage of final reports for all patients, regardless of age, undergoing bone scintigraphy that include physician documentation of correlation with existing relevant imaging studies (e.g., x-ray, MRI, CT, etc.) that were performed
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This measure is to be submitted each time bone scintigraphy is performed during the performance period. There is no diagnosis associated with this measure. It is anticipated that Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the professional component of the bone scintigraphy study will submit this measure.
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.
All final reports for patients, regardless of age, undergoing bone planar and whole body scintigraphy
Denominator Criteria (Eligible Cases):
Patient encounter during the performance period (CPT): 78300, 78305, 78306, 78315
Telehealth Modifier: GQ, GT, 95, POS 02
Final reports that include physician documentation of correlation with existing relevant imaging studies (e.g., x-ray, MRI, CT, etc.)
Relevant Imaging Studies – Relevant imaging studies are defined as studies that correspond to the same anatomical region in question.
Final report for bone scintigraphy study includes correlation with existing relevant imaging studies (e.g., x-ray, MRI, CT) corresponding to the same anatomical region in question (3570F)
Documentation of system reason(s) for not documenting correlation with existing relevant imaging studies in final report (e.g., no existing relevant imaging study available, patient did not have a previous relevant imaging study) (3570F with 3P)
Note: Correlative studies are considered to be unavailable if relevant studies (reports and/or actual examination material) from other imaging modalities exist but could not be obtained after reasonable efforts to retrieve the studies are made by the interpreting physician prior to the finalization of the bone scintigraphy report.
Performance Not Met:
Bone scintigraphy report not correlated in the final report with existing relevant imaging studies, reason not otherwise specified (3570F with 8P)