Percentage of final reports for imaging studies for patients aged 18+ years with 1 or more of following noted incidentally with specific recommendation for no follow‐up imaging recommended based on radiological findings
Cystic renal lesion that is simple appearing (Bosniak I or II)
Adrenal lesion ≤ 1.0 cm
Adrenal lesion > 1.0 cm but ≤ 4.0 cm classified as likely benign or diagnostic benign by unenhanced CT or washout protocol CT or MR with in- and opposed-phase sequences or other equivalent institutional imaging protocols
Simple-appearing criteria: Incidental renal mass on non-contrast-enhanced abdominal CT that does not contain fat, is homogenous in appearance, -10-20 HU or ≥ 70 HU (ACR, 2017); incidental renal mass on contrast-enhanced abdominal CT that does not contain fat, is homogenous in appearance, -10-20 HU (ACR, 2017)
Rationale
Incidental renal and adrenal lesions are commonly found during imaging studies, with most findings being benign. Given low rate of malignancy, unnecessary follow-up procedures are costly and present significant burden to patients. To avoid excessive testing and costs, follow-up is not recommended for these small lesions.
Instructions
This measure is to be submitted each time patient undergoes imaging study with incidental abdominal lesion finding during performance period. There is no diagnosis associated with this measure. It is anticipated that Merit-Based Incentive Payment System (MIPS)-eligible clinicians who provide professional component of diagnostic imaging studies will submit this measure.
Numerator
Final reports for imaging studies that include description of incidental cystic renal lesion or adrenal lesion stating follow-up imaging is not recommended
Denominator
All final reports for imaging studies for patients aged 18+ years with 1 or more of following incidentally noted
Cystic renal lesion that is simple appearing (Bosniak I or II) OR
Adrenal lesion ≤ 1.0 cm OR
Adrenal lesion > 1.0 cm but ≤ 4.0 cm classified as likely benign or diagnostic benign by unenhanced CT or washout protocol CT or MR with in- and opposed-phase sequences or other equivalent institutional imaging protocols
Selected References
MIPS Measure 405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions (for reference if using CQMS). Centers for Medicare and Medicaid Services (CMS). 2023
MIPS Measure 405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions (for reference if using Medicare Part B claims). Centers for Medicare and Medicaid Services (CMS). 2023
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References
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Tables
KEY FACTS
Terminology
TERMINOLOGY
Description
Percentage of final reports for imaging studies for patients aged 18+ years with 1 or more of following noted incidentally with specific recommendation for no follow‐up imaging recommended based on radiological findings
Cystic renal lesion that is simple appearing (Bosniak I or II)
Adrenal lesion ≤ 1.0 cm
Adrenal lesion > 1.0 cm but ≤ 4.0 cm classified as likely benign or diagnostic benign by unenhanced CT or washout protocol CT or MR with in- and opposed-phase sequences or other equivalent institutional imaging protocols
Simple-appearing criteria: Incidental renal mass on non-contrast-enhanced abdominal CT that does not contain fat, is homogenous in appearance, -10-20 HU or ≥ 70 HU (ACR, 2017); incidental renal mass on contrast-enhanced abdominal CT that does not contain fat, is homogenous in appearance, -10-20 HU (ACR, 2017)
Rationale
Incidental renal and adrenal lesions are commonly found during imaging studies, with most findings being benign. Given low rate of malignancy, unnecessary follow-up procedures are costly and present significant burden to patients. To avoid excessive testing and costs, follow-up is not recommended for these small lesions.
Instructions
This measure is to be submitted each time patient undergoes imaging study with incidental abdominal lesion finding during performance period. There is no diagnosis associated with this measure. It is anticipated that Merit-Based Incentive Payment System (MIPS)-eligible clinicians who provide professional component of diagnostic imaging studies will submit this measure.
Numerator
Final reports for imaging studies that include description of incidental cystic renal lesion or adrenal lesion stating follow-up imaging is not recommended
Denominator
All final reports for imaging studies for patients aged 18+ years with 1 or more of following incidentally noted
Cystic renal lesion that is simple appearing (Bosniak I or II) OR
Adrenal lesion ≤ 1.0 cm OR
Adrenal lesion > 1.0 cm but ≤ 4.0 cm classified as likely benign or diagnostic benign by unenhanced CT or washout protocol CT or MR with in- and opposed-phase sequences or other equivalent institutional imaging protocols
Selected References
MIPS Measure 405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions (for reference if using CQMS). Centers for Medicare and Medicaid Services (CMS). 2023
MIPS Measure 405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions (for reference if using Medicare Part B claims). Centers for Medicare and Medicaid Services (CMS). 2023
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