Prostate Cancer: Combination Androgen Deprivation Therapy for High Risk or Very High Risk Prostate Cancer
MEASURE DESCRIPTION
Percentage of patients, regardless of age, with a diagnosis of prostate cancer at high or very high risk of recurrence receiving external beam radiotherapy to the prostate who were prescribed androgen deprivation therapy in combination with external beam radiotherapy to the prostate.
Relevance to Value Based Care
Hormonal therapy following radiation is an established standard of care for high-risk prostate patients. Studies have shown that men who receive hormonal therapy following radiation can live longer and have a lower risk of recurrence than radiation alone. A cost-analysis found the use of adjuvant hormonal therapy and radiation therapy is cost-effective and adds quality-adjusted life years for patients.
Numerator
Patients who were prescribed androgen deprivation therapy in combination with external beam radiotherapy to the prostate
Denominator
All patients, regardless of age, with a diagnosis of prostate cancer at high or very high risk of recurrence receiving external beam radiotherapy to the prostate.
Exclusion/Exceptions
Documentation of medical reason or patient reason why treatment not prescribed/administered
Diagnosis for metastatic cancer
Scoring
CMS has removed the benchmark for this measure for 2024. Reporting this measure will earn 0 points, unless CMS develops benchmarks after submission.
RESOURCES
ADT for High Risk Prostate Cancer Workflow
1. Under the Problems tab click ADD PROBLEM.
2. Type the name of the diagnosis in the Problem field and select.
NOTE: Must be C61 for inclusion in the measure.
Add the date of diagnosis.
Click NEXT.
Add the PSA results.
ADT for High Risk Prostate Cancer Workflow
Add the Tumor type.
Add the Node type.
Add the Metastasis level.
ADT for High Risk Prostate Cancer Workflow
Add the Gleason score.
To enter the hormonal therapy as a regimen, click on the Orders tab.
Click Regimes.
Using the drop-down arrow, select Prostate Cancer.
Click SEARCH FOR REGIMES.
ADT for High Risk Prostate Cancer Workflow
14. Chose the hormonal therapy regimen.
15. Click Show Options.
16. Click Select.
ADT for High Risk Prostate Cancer Workflow
17. Complete details and click OK.
18. The hormonal therapy regimen can be viewed in the flowsheet.
19. If the hormone therapy is ordered and given by another provider, enter the treatment document as offsite. To add the off site documentation, select the C1D1 heading for the hormone treatment.
20. Click Approve treatment - administered off site.
21. Click CLOSE.
ADT for High Risk Prostate Cancer Workflow
22. The hormone regimen in the flowsheet will show the treatment was given off site.
23. To add the radiation On Treatment Visit code, click on the user Dashboard.
24. Click EDIT to add the weekly On Treatment Visit Billing Code.
25. Select the name of the Rendering Provider.
26. Click the drop down list to add the Seen By provider.
27. Click 77427 (or 77435) to add the radiation On Treatment Visit code.
28. Click CLOSE.
ADT for High Risk Prostate Cancer Workflow
29. To document an exception for a medical or patient reason, click on the Care Plan tab to create a Clinical Quality Exception care plan.
30. Click ADD CAREPLAN.
31. Select Clinical Quality Exceptions from the drop-down list.
32. Click SAVE.
33. Use the calendar widget to enter the Date of Service or click TODAY.
34. Click the arrow to unzip the Prostate Cancer / Adjuvant Hormonal Therapy exception reasons.
35. Use the calendar widget to enter the Decision Date or click TODAY.
ADT for High Risk Prostate Cancer Workflow
36. If the exception is for a medical reason, click the check box for Documentation of medication reason(s) for not prescribing.
37. If the exception is for a patient reason, click the check box under Patient Reasons.
38. Click SAVE.