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Pathology Quality Measures

In 2018, the Pathologists Quality Registry offered 17 quality reporting measures all developed by the CAP. Eight were Quality Payment Program (QPP) measures to be reported through a registry or billing claims. The remaining nine were specific pathology measures approved by the CMS as qualified clinical data registry (QCDR) measures—exclusively available in the Pathologists Quality Registry.

Through the development of quality measures by the CAP, pathologists improve the quality of their care, avoid Medicare payment penalties, and earn bonuses when reported correctly. In Medicare’s Merit-based Incentive Payment System (MIPS) the Quality category, which utilizes measures, comprises almost the entire MIPS composite score for a pathologist. It is also the category with the most complex scoring calculation, and has the most potential for bonus points. The measures below were applicable to the 2018 MIPS performance year. Go to the 2019 Pathology Quality Measures page to access measures for the current MIPS performance year.

Pathologists Quality Registry QPP Measures

These measures can be reported to the CMS using the Pathologists Quality Registry, through billing/claims, and other registries.

QPP 99: Breast Cancer Resection Pathology Reporting Registry and Claims Specifications
QPP 100: Colorectal Cancer Resection Pathology Reporting Registry and Claims Specifications
QPP 249: Barrett Esophagus Pathology Reporting Registry and Claims Specifications
QPP 250: Radical Prostatectomy Pathology Reporting Registry and Claims Specifications
QPP 251: Evaluation of HER2 for Breast Cancer Patients Registry and Claims Specifications
QPP 395: Lung Cancer Reporting (biopsy/cytology specimens)** Registry and Claims Specifications 
QPP 396: Lung Cancer Reporting (resection specimens)** Registry and Claims Specifications 
QPP 397: Melanoma Reporting** Registry and Claims Specifications 

Pathologists Quality Registry QCDR Measures

Resources

CAP Advocacy

The CAP advocates on behalf of pathologists regarding their options for quality reporting. While the CAP has created eight quality measures included in the current CMS quality program for pathologists, other measures in the current MIPS program may apply. In 2018, most specialties must report on a minimum of six measures.

The CMS recommends that eligible professionals check with the QualityNet HelpDesk for more information on which measures apply to you.

Professionals may contact the Qualitynet Help Desk.
7:00 AM–7:00 PM CT Monday - Friday
email: qnetsupport@hcqis.org
Phone: 866-288-8912

Claims-Based Instruction Sheet

The CAP developed a Claims-Based Instruction Sheet to help you submit data on quality measures for MIPS through claims. The corresponding 2018 QPP Reporting Codes can help on which codes to report.

Related Resources

Centers for Medicaid and Medicare Services (CMS)