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2020 Measure Value Set Colorectal Cancer Screening

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2020 Measure Value Set Colorectal Cancer Screening PT ‐ 2020 Measure Value Set_Colorectal Cancer Screening Numerator Value Set Name Code Definition Code System FOBT Lab Test 82270 CPT FOBT Lab Test 82274 CPT Colorectal cancer screening; fecal occult blood test, immunoassay, 1‐3 FOBT Lab Test G0328 HCPCS simultaneous (G0328) FOBT Lab Test 12503‐9 Hemoglobin.gastrointestinal [Presence] in Stool ‐‐4th specimen LOINC FOBT Lab Test 12504‐7 Hemoglobin.gastrointestinal [Presence] in Stool ‐‐5th specimen LOINC FOBT Lab Test 14563‐1 Hemoglobin.gastrointestinal [Presence] in Stool ‐‐1st specimen LOINC FOBT Lab Test 14564‐9 Hemoglobin.gastrointestinal [Presence] in Stool ‐‐2nd specimen LOINC FOBT Lab Test 14565‐6 Hemoglobin.gastrointestinal [Presence] in Stool ‐‐3rd specimen LOINC FOBT Lab Test 2335‐8 Hemoglobin.gastrointestinal [Presence] in Stool LOINC FOBT Lab Test 27396‐1 Hemoglobin.gastrointestinal [Mass/mass] in Stool LOINC FOBT Lab Test 27401‐9 Hemoglobin.gastrointestinal [Presence] in Stool ‐‐6th specimen LOINC FOBT Lab Test 27925‐7 Hemoglobin.gastrointestinal [Presence] in Stool ‐‐7th specimen LOINC FOBT Lab Test 27926‐5 Hemoglobin.gastrointestinal [Presence] in Stool ‐‐8th specimen LOINC FOBT Lab Test 29771‐3 Hemoglobin.gastrointestinal.lower [Presence] in Stool by Immunoassay LOINC Hemoglobin.gastrointestinal.lower [Presence] in Stool by Immunoassay FOBT Lab Test 56490‐6 LOINC ‐‐2nd specimen Hemoglobin.gastrointestinal.lower [Presence] in Stool by Immunoassay FOBT Lab Test 56491‐4 LOINC ‐‐3rd specimen Hemoglobin.gastrointestinal.lower [Presence] in Stool by Immunoassay FOBT Lab Test 57905‐2 LOINC ‐‐1st specimen Hemoglobin.gastrointestinal.lower [Mass/volume] in Stool by FOBT Lab Test 58453‐2 LOINC Immunoassay Page 1 of 186 November 2019 PT ‐ 2020 Measure Value Set_Colorectal Cancer Screening Numerator Value Set Name Code Definition Code System FOBT Lab Test 80372‐6 Hemoglobin.gastrointestinal [Presence] in Stool by Rapid immunoassay LOINC FOBT Lab Test 104435004 Screening for occult blood in feces (procedure) SNOMED CT US Edition Measurement of occult blood in stool specimen using immunoassay FOBT Lab Test 441579003 SNOMED CT US Edition (procedure) Measurement of occult blood in two separate stool specimens FOBT Lab Test 442067009 SNOMED CT US Edition (procedure) Measurement of occult blood in three separate stool specimens FOBT Lab Test 442516004 SNOMED CT US Edition (procedure) FOBT Lab Test 442554004 Guaiac test for occult blood in feces specimen (procedure) SNOMED CT US Edition FOBT Lab Test 442563002 Measurement of occult blood in single stool specimen (procedure) SNOMED CT US Edition FOBT Test Result or 59614000 Occult blood in stools (finding) SNOMED CT US Edition Finding FOBT Test Result or 167667006 Fecal occult blood: negative (finding) SNOMED CT US Edition Finding FOBT Test Result or 389076003 Fecal occult blood: trace (finding) SNOMED CT US Edition Finding Flexible Sigmoidoscopy 45330 CPT Flexible Sigmoidoscopy 45331 CPT Flexible Sigmoidoscopy 45332 CPT Flexible Sigmoidoscopy 45333 CPT Flexible Sigmoidoscopy 45334 CPT Flexible Sigmoidoscopy 45335 CPT Flexible Sigmoidoscopy 45337 CPT Page 2 of 186 November 2019 PT ‐ 2020 Measure Value Set_Colorectal Cancer Screening Numerator Value Set Name Code Definition Code System Flexible Sigmoidoscopy 45338 CPT Flexible Sigmoidoscopy 45339 CPT Flexible Sigmoidoscopy 45340 CPT Flexible Sigmoidoscopy 45341 CPT Flexible Sigmoidoscopy 45342 CPT Flexible Sigmoidoscopy 45345 CPT Flexible Sigmoidoscopy 45346 CPT Flexible Sigmoidoscopy 45347 CPT Flexible Sigmoidoscopy 45349 CPT Flexible Sigmoidoscopy 45350 CPT Flexible Sigmoidoscopy G0104 Colorectal cancer screening; flexible sigmoidoscopy (G0104) HCPCS Flexible Sigmoidoscopy 44441009 Flexible fiberoptic sigmoidoscopy (procedure) SNOMED CT US Edition Flexible Sigmoidoscopy 396226005 Flexible fiberoptic sigmoidoscopy with biopsy (procedure) SNOMED CT US Edition Diagnostic endoscopic examination of lower bowel and sampling for Flexible Sigmoidoscopy 425634007 SNOMED CT US Edition bacterial overgrowth using fiberoptic sigmoidoscope (procedure) History of Flexible 841000119107 History of flexible sigmoidoscopy (situation) SNOMED CT US Edition Sigmoidoscopy Page 3 of 186 November 2019 PT ‐ 2020 Measure Value Set_Colorectal Cancer Screening Numerator Value Set Name Code Definition Code System Colonoscopy 44388 CPT Colonoscopy 44389 CPT Colonoscopy 44390 CPT Colonoscopy 44391 CPT Colonoscopy 44392 CPT Colonoscopy 44393 CPT Colonoscopy 44394 CPT Colonoscopy 44397 CPT Colonoscopy 44401 CPT Colonoscopy 44402 CPT Colonoscopy 44403 CPT Colonoscopy 44404 CPT Colonoscopy 44405 CPT Colonoscopy 44406 CPT Colonoscopy 44407 CPT Colonoscopy 44408 CPT Colonoscopy 45355 CPT Colonoscopy 45378 CPT Colonoscopy 45379 CPT Colonoscopy 45380 CPT Colonoscopy 45381 CPT Colonoscopy 45382 CPT Colonoscopy 45383 CPT Colonoscopy 45384 CPT Colonoscopy 45385 CPT Colonoscopy 45386 CPT Colonoscopy 45387 CPT Colonoscopy 45388 CPT Colonoscopy 45389 CPT Colonoscopy 45390 CPT Colonoscopy 45391 CPT Colonoscopy 45392 CPT Page 4 of 186 November 2019 PT ‐ 2020 Measure Value Set_Colorectal Cancer Screening Numerator Value Set Name Code Definition Code System Colonoscopy 45393 CPT Colonoscopy 45398 CPT Colorectal cancer screening; colonoscopy on individual at high risk Colonoscopy G0105 HCPCS (G0105) Colorectal cancer screening; colonoscopy on individual not meeting Colonoscopy G0121 HCPCS criteria for high risk (G0121) Colonoscopy 8180007 Fiberoptic colonoscopy through colostomy (procedure) SNOMED CT US Edition Colonoscopy 12350003 Colonoscopy with rigid sigmoidoscope through colotomy (procedure) SNOMED CT US Edition Colonoscopy 25732003 Fiberoptic colonoscopy with biopsy (procedure) SNOMED CT US Edition Colonoscopy 34264006 Intraoperative colonoscopy (procedure) SNOMED CT US Edition Colonoscopy 73761001 Colonoscopy (procedure) SNOMED CT US Edition Colonoscopy 174158000 Open colonoscopy (procedure) SNOMED CT US Edition Colonoscopy 235150006 Total colonoscopy (procedure) SNOMED CT US Edition Colonoscopy 235151005 Limited colonoscopy (procedure) SNOMED CT US Edition Colonoscopy 310634005 Check colonoscopy (procedure) SNOMED CT US Edition Colonoscopy 367535003 Fiberoptic colonoscopy (procedure) SNOMED CT US Edition Diagnostic endoscopic examination of ileoanal pouch and biopsy of Colonoscopy 425672002 SNOMED CT US Edition ileoanal pouch using colonoscope (procedure) Diagnostic endoscopic examination of enteric pouch using colonoscope Colonoscopy 425937002 SNOMED CT US Edition (procedure) Diagnostic endoscopic examination of colonic pouch and biopsy of Colonoscopy 427459009 SNOMED CT US Edition colonic pouch using colonoscope (procedure) Colonoscopy through colostomy with endoscopic biopsy of colon Colonoscopy 443998000 SNOMED CT US Edition (procedure) Colonoscopy 444783004 Screening colonoscopy (procedure) SNOMED CT US Edition Colonoscopy 446521004 Colonoscopy and excision of mucosa of colon (procedure) SNOMED CT US Edition Page 5 of 186 November 2019 PT ‐ 2020 Measure Value Set_Colorectal Cancer Screening Numerator Value Set Name Code Definition Code System Colonoscopy 446745002 Colonoscopy and biopsy of colon (procedure) SNOMED CT US Edition Colonoscopy 447021001 Colonoscopy and tattooing (procedure) SNOMED CT US Edition Colonoscopy 709421007 Colonoscopy and dilatation of stricture of colon (procedure) SNOMED CT US Edition Colonoscopy 710293001 Colonoscopy using fluoroscopic guidance (procedure) SNOMED CT US Edition Colonoscopy 711307001 Colonoscopy using X‐ray guidance (procedure) SNOMED CT US Edition Endoscopic submucosal dissection of rectum using colonoscope Colonoscopy 713154003 SNOMED CT US Edition (procedure) CT Colonography 74261 CPT CT Colonography 74262 CPT CT Colonography 74263 CPT CT Colonography 60515‐4CT Colon and Rectum W air contrast PR LOINC CT Colonography 72531‐7CT Colon and Rectum W contrast IV and W air contrast PR LOINC CT Colon and Rectum for screening WO contrast IV and W air contrast CT Colonography 79069‐1 LOINC PR CT Colonography 79071‐7CT Colon and Rectum WO contrast IV and W air contrast PR LOINC CT Colonography 79101‐2CT Colon and Rectum for screening W air contrast PR LOINC CT Colonography 82688‐3CT Colon and Rectum WO and W contrast IV and W air contrast PR LOINC CT Colonography 418714002 Virtual computed tomography colonoscopy (procedure) SNOMED CT US Edition History of Colonoscopy 851000119109 History of colonoscopy (situation) SNOMED CT US Edition FIT DNA Lab Test 81528 CPT Colorectal cancer screening; stool‐based dna and fecal occult FIT DNA Lab Test G0464 HCPCS hemoglobin (e.g., kras, ndrg4 and bmp3) (G0464) Noninvasive colorectal cancer DNA and occult blood screening FIT DNA Lab Test 77353‐1 LOINC [Interpretation] in Stool Narrative Noninvasive colorectal cancer DNA and occult blood screening FIT DNA Lab Test 77354‐9 LOINC [Presence] in Stool FIT DNA Test Result or 708699002 Stool DNA‐based colorectal cancer screening positive (finding) SNOMED CT US Edition Finding Page 6 of 186 November 2019 PT ‐ 2020 Measure Value Set_Colorectal Cancer Screening Exclusion Value Set Name Code Definition Code System Advanced Illness A81.00 [A81.00] Creutzfeldt‐Jakob disease, unspecified ICD10CM Advanced Illness A81.01 [A81.01] Variant Creutzfeldt‐Jakob disease ICD10CM Advanced Illness A81.09 [A81.09] Other Creutzfeldt‐Jakob disease ICD10CM Advanced Illness C25.0 [C25.0] Malignant neoplasm of head of pancreas ICD10CM Advanced Illness C25.1 [C25.1] Malignant neoplasm of body of pancreas ICD10CM Advanced Illness C25.2 [C25.2] Malignant neoplasm of tail of pancreas ICD10CM Advanced Illness C25.3 [C25.3] Malignant
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