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2020 Pathology Quality Measures

2020 Pathology Quality Measures

The Pathologists Quality Registry offers 30 quality measures. Seven are Merit-based Incentive Payment System (MIPS) clinical quality measures (CQMs). The remaining 23 are specific pathology measures, all developed by the CAP and approved by the CMS as qualified clinical data registry (QCDR) measures—exclusively available in the Pathologists Quality Registry. To better understand how to review and interpret measure specifications, the CMS has developed the 2020 Quality Payment Program Measure Specification and Measure Flow Guide for MIPS Clinical Quality Measures.

Important 2020 Updates

Beginning January 1, 2020, this measure can no longer be reported on for MIPS. The CMS removed the following QCDR measure from the Pathologists Quality Registry:

CAP14: Appropriate Formalin Fixation Time (6 – 72 hours) of Breast Cancer Specimens to Ensure Accurate Ancillary Testing Results

For quality measure CAP29: Turnaround Time (TAT)—Lactate (formerly CAP8: Turnaround Time (TAT)—Lactate), specifications were updated

TAT required to meet the measure reduced from 3 hours to 1 hour

For QPP 440: Skin Cancer: Biopsy Reporting Time - Pathologist to Clinician, specifications were updated

Denominator expanded to include Melanoma, including Melanoma in-situ

Pathology Specific QPP Measures

These measures can be reported to the CMS using the Pathologists Quality Registry, through billing/claims, and other registries.

QPP 249: Barrett Esophagus Pathology Reporting Registry and Claims Specifications

QPP 250: Radical Prostatectomy Pathology Reporting Registry and Claims Specifications

QPP 395: Lung Cancer Reporting (biopsy/cytology specimens)* Registry and Claims Specifications

QPP 396: Lung Cancer Reporting (resection specimens)* Registry and Claims Specifications

QPP 397: Melanoma Reporting* Registry and Claims Specifications

These measures can be reported to the CMS using the Pathologists Quality Registry and other registries.

QPP 265: Biopsy Follow-Up* Registry Specifications (American Academy of Dermatology measure)

QPP 440: Skin Cancer: Biopsy Reporting Time - Pathologist to Clinician* Registry Specifications (American Academy of Dermatology measure)

Pathologists Quality Registry QCDR Measures

These measures can be reported to the CMS only with the Pathologists Quality Registry.

CAP9: Turnaround Time (TAT) – Troponin*

CAP10: Blood Laboratory Samples for Potassium Determination with Hemolysis Drawn in the Emergency Department**

CAP11: Accurate Human Epidermal Growth Factor Receptor 2 (HER2) Tumor Evaluation and Repeat Evaluation in Patients with Breast Carcinoma*

CAP12: Accurate Human Epidermal Growth Factor Receptor 2 (HER2) Tumor Evaluation and Repeat Evaluation in Patients with Gastroesophageal Adenocarcinoma*

CAP13: Anaplastic Lymphoma Kinase (ALK) Biomarker Testing to Inform Clinical Management and Treatment Decisions in Patients with Non-small Cell Lung Cancer*

CAP15: BRAF Biomarker Testing to Inform Clinical Management and Treatment Decisions in Patients with Metastatic Colorectal Adenocarcinoma*

CAP16: Epidermal Growth Factor Receptor (EGFR) Biomarker Testing to Inform Clinical Management and Treatment Decisions in Patients with Non-small Cell Lung Cancer*

CAP17: FMS-like Tyrosine 3-Internal Tandem Duplication (FLT3-ITD) Biomarker Testing to Inform Clinical Management and Treatment Decisions in Patients with Acute Myeloid Leukemia*

CAP18: Mismatch Repair (MMR) or Microsatellite Instability (MSI) Biomarker Testing to Inform Clinical Management and Treatment Decisions in Patients with Primary or Metastatic Colorectal Carcinoma*

CAP19: ROS 1 Biomarker Testing to Inform Clinical Management and Treatment Decisions in Patients with Non-small Cell Lung Cancer*

CAP20: High Risk HPV Testing and p16 Scoring in Surgical Specimens for Patients with Oropharyngeal Squamous Cell Carcinoma (OPSCC)*

CAP21: High Risk HPV Testing in Cytopathology Specimens for Patients with Oropharyngeal Squamous Cell Carcinoma (OPSCC)*

CAP22: Turnaround Time (TAT) – Biopsies*

CAP23: Cancer Protocol Elements and Turnaround Time for Carcinoma and Carcinosarcoma of the Endometrium*

CAP24: Cancer Protocol Elements and Turnaround Time for Carcinoma of the Intrahepatic Bile Ducts*

CAP25: Cancer Protocol Elements and Turnaround Time for Carcinoma of the Pancreas*

CAP26: Cancer Protocol Elements and Turnaround Time for Hepatocellular Carcinoma*

CAP27: Cancer Protocol Elements and Turnaround Time for Invasive Carcinoma of Renal Tubular Origin*

CAP28: Helicobacter pylori Status and Turnaround Time*

CAP29: Turnaround Time (TAT) – Lactate*

^ǂ CAP30: Urinary Bladder Biopsy Diagnostic Requirements For Appropriate Patient Management*

^ǂ CAP31: Endometrial Carcinoma Testing for MMR, MSI, or Both*

^ǂ CAP32: Prostate Cancer Gleason Pattern, Score, and Grade Group*

* = high-priority measure

** = outcome measure

ǂ = new measure for 2020

The CMS recommends that eligible professionals check with the QPP HelpDesk for more information on measures and the QPP.
Professionals may contact the QPP Help Desk.
7:00 AM–7:00 PM CT Monday - Friday
Email: QPP@cms.hhs.gov
Phone: 866-288-8292

Claims-based Reporting Information

The CAP developed an instruction sheet on claims-based reporting to assist with submitting data on quality measures for MIPS through claims. The corresponding document provides the CPT II and quality data codes (QDC) and descriptors of the for 2020 QPP measures.

For the 2020 Reporting Period

Beginning in 2020, pathologists in a group of 16 or more clinicians cannot submit quality measures using claims regardless of whether participating as an individual or a group.

Find out more about the Pathologists Quality Registry