URSA-QUALITY-BCS-E: Breast Cancer Screening ECDS (BCS-E)

Measure Description

Among patients aged 50-74 years as of the end of the measurement period who were recommended for routine breast cancer screening, the percentage with a qualifying mammogram to screen for breast cancer. Unadjusted Certified Measure 6d5d857c-4d1a-40de-8063-0f3ab187c9ce

Metadata

• Measure Type: Rate Measure
• Temporal Structure: Entity
• Component Class: Long-Form
• Denominator Case Field: Patient ID, Output NCQA Payer Type Code
• Target Direction: Up

Denominator Description

Patients 50-74 years of age who were recommended for routine breast cancer screening.

Numerator Description

Qualifying denominator patients with one or more mammograms in the 27 months prior to the snapshot date.

Published Fields

• [No Field Group]

  • Measure ID
  • Measure Name
  • Ursa Serial ID

• Data Model Keys

  • Patient ID
  • Primary Plan Attributee Provider ID
  • Primary Payor ID
  • Primary Plan ID

• Date Fields

  • Current Continuous Primary Payor Membership Episode Start Date
  • Current Continuous Primary Payor Membership Episode End Date
  • Segment Start Date -- The start date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Segment End Date -- The end date of the reporting segment. (See also [URSA-CORE] Reporting Segment)
  • Snapshot Date -- The date, evaluated at 00:00:00 AM, giving the moment the state of the world will be set to for the purposes of an analysis. The snapshot date does not represent the freshness of the data, or the date in real time at which an analysis was executed.

• Patient Fields

  • Patient Operational ID
  • Patient Date of Birth
  • Patient Age Integer
  • Is Patient Sex Female
  • Is Patient Sex Male
  • Patient State Abbreviation
  • Patient ZIP Code 5-Digit
  • Patient Date of Death

• Insurance Fields

  • Primary Payor Description
  • Primary Plan Description
  • Primary Plan Financial Class Description

• Denominator Fields

  • Is Patient Sex Female for BCS
  • Is Continuous Membership Criterion Met
  • Is Eligible Population
  • Is Any Required Exclusion
  • Is Required Exclusion for Hospice
  • Is Required Exclusion for Patient Death
  • Is Required Exclusion for Bilateral Mastectomy
  • Is Required Exclusion for Gender Affirming Chest Surgery with Gender Dysphoria
  • Is Required Exclusion for Medicare Age 66+ with I-SNP or LTI
  • Is Required Exclusion for Age 66+ with Frailty and Advanced Illness
  • Is Required Exclusion for Palliative Care
  • Denominator Excluded Reasons Description

• Numerator Fields

  • Is Numerator Qualifying Using Standard End-of-Year Timing
  • Numerator Component Contribution Using Standard End-of-Year Timing
  • Numerator Document ID
  • Numerator Source ID
  • Numerator Document Effective Date
  • Numerator HCPCS Code
  • Numerator HCPCS Description
  • Numerator Document Type Description
  • Is Numerator Source Claim
  • Is Numerator Source Bill
  • Is Numerator Source EMR

• NCQA Cert Fields

  • Is NCQA Numerator Criteria Met
  • Output NCQA Payer Type Code
  • NCQA Race Code
  • NCQA Ethnicity Code
  • Patient Age Integer Unbounded by Death

• Provider Fields

  • Primary Plan Attributee Provider Description

• Metadata Fields

  • Table Last Updated Datetime
  • Is Parameter Set to Override Continuous Enrollment Criteria
  • Is Parameter Set to Override Payor Criteria

• Measure Fields

  • Denominator
  • Numerator