Exploring CMS Quality Measure #405 for Small Incidental Abdominal Lesions.
J Am Coll Radiol. 2018 Sep;15(9):1243-1245. doi: 10.1016/j.jacr.2018.05.012. Epub 2018 Jun 20.
Dane B1, Rosenkrantz AB2.
Small incidental liver, renal, and adrenal lesions are frequently identified during routine abdominal imaging examinations, although they are generally unlikely to cause patient harm 1, 2. However, the detection of such lesions may lead to a potentially extensive chain of follow-up imaging examinations associated with cost and patient inconvenience, as well as possible exposure to radiation and intravenous contrast agents. Radiologists play a large role in determining the imaging follow-up performed for small incidental abdominal lesions through their provided recommendations at the time of initial detection. In the Merit-Based Incentive Payment System (MIPS), CMS has provided panels of quality measures relevant to each specialty . Physicians participating in MIPS select measures from these panels, and their scores in the selected measures impact subsequent Medicare payment adjustments. One measure that CMS has adopted for radiologists under MIPS is measure #405, relating to appropriate follow-up imaging recommendations for incidental abdominal lesions . Measure #405 is defined as the fraction of incidental liver lesions ≤ 0.5 cm, cystic renal lesions < 1 cm, and adrenal lesions ≤ 1 cm detected on ultrasound, CT, or MRI, for which radiologists recommend follow-up imaging . A rate of 0% indicates perfect performance. Lesions for which the report indicates a medical reason for recommending follow-up were excluded. In this study, we assessed the outcomes of lesions encompassed by CMS quality measure #405.