MIPS # PIMSH1 Advance Care Planning in Metastatic Disease
To meet the MIPS #PIMSH1 Advance Care Planning in Metastatic Disease quality measure, the patient must have an E/M visit and one of the following must be documented within the 6 months following metastatic diagnosis:
Advance Directive/Living Will documented in the medical record.
Surrogate decision maker named and documented in the medical record.
Patient declines to name a surrogate decision maker.
Values Assessment documented in the ACP Care Plan.
Documentation of a non-billed significant conversation (less than 16 mins) documented in the ACP Care Plan.
Documentation the topic was introduced, and the patient did not wish to discuss or was unable to complete an advance directive.
Advance Care Planning discussion billed (CPT 99497 or 99498).
Exclusion:
Patient was enrolled in hospice during the reporting period.
To meet this measure, even if the patient has had previous ACP activity documented prior to metastatic diagnosis date, a new ACP activity must occur in the 6-month period following date of metastatic diagnosis.
MEASURE DESCRIPTION
Percentage of patients with metastatic (stage 4) cancer who have a documented Advance Care Planning discussion in the first 6 months after metastatic diagnosis to inform treatment decisions and end-of-life care.
Numerator
Patients who have had an advance care plan discussion with an advance care plan or surrogate decision maker documented in the medical record or documentation that an advance care plan was discussed but patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan within the first 6 months after their metastatic diagnosis.
Denominator
Total number of patients with stage 4 cancer within two years of the measurement period and had an E/M visit within the measurement period.
Exclusion/Exceptions
Hospice services received by patient any time during the measurement period
Scoring
Up to 10 points
RESOURCES
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