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

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

3. 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

4. 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

5. 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.

6. 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: (-1P)

7. 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: (-1P)