College of American Pathologists

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College of American Pathologists CAP Audio Conference on the CMS 2008 Physician Quality Reporting Initiative David Witte, MD PHD, FCAP College of American Pathologists

Overview Background on the development of pathology measures CMS Physicians Quality Reporting Initiative Q & A

Goals Understanding of Pathology Measures and Measures Development Process Basics of CMS’s Physician Quality Reporting Initiative (PQRI) Preparing for participation in PQRI in order to be eligible for bonus

Measures Development Process CAP pathology measures development process began in June 2006 Requirements: Developed through a consensus-based process by a multi-stakeholder organization; and Adopted or endorsed by a consensus organization

CAP/AMA Pathology Performance Measures The breast cancer resection pathology report includes the pT, pN, and histologic grade. The colorectal cancer resection pathology report includes includes the pT, pN, and histologic grade.

Measure #1: Breast Cancer Resection Pathology Reporting Numerator: Reports that include the pT category, the pN category and the histologic grade Denominator (Eligible Population): All breast cancer resection pathology reports (excluding biopsies) ICD-9 diagnosis codes: 174.0, 174.1, 174.2, 174.3, 174.4, 174.5, 174.6, 174.7, 174.8, 174.9, 175.0, 175.9 AND CPT service codes: 88307, 88309 Proposed CPT Category II Code: 3260 (-1P)

Measure #2: Colorectal Cancer Resection Pathology Reporting Numerator: Reports that include the pT category, the pN category and the histologic grade Denominator (Eligible Population): All colon and rectum cancer resection pathology reports (excluding biopsies) ICD-9 diagnosis codes: 153.0, 153.1, 153.2, 153.3, 153.4, 153.5, 153.6, 153.7, 153.8, 153.9, 154.0, 154.1, 154.8 AND CPT service codes: 88309 Proposed CPT Category II Code: 3260 (-1P)