link
Bookmarks
Synopsis of MIPS Measure 405: Appropriate Follow-Up Imaging for Incidental Abdominal Lesions
Matthew B. Morgan, MD, MS
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe

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 but ≤ 4.0 cm classified as likely 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 by unenhanced CT or washout protocol CT or MR with in- and opposed-phase sequences or other equivalent institutional imaging protocols

    Selected References

    1. MIPS Measure 405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions (for reference if using CQMS). Centers for Medicare and Medicaid Services (CMS). 2021.
    2. 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). 2021.
    Related Anatomy
    Loading...
    Related Differential Diagnoses
    Loading...
    References
    Tables

    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 but ≤ 4.0 cm classified as likely 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 by unenhanced CT or washout protocol CT or MR with in- and opposed-phase sequences or other equivalent institutional imaging protocols

      Selected References

      1. MIPS Measure 405: Appropriate Follow-up Imaging for Incidental Abdominal Lesions (for reference if using CQMS). Centers for Medicare and Medicaid Services (CMS). 2021.
      2. 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). 2021.