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Synopsis of MIPS Measure 406: Appropriate Follow-Up Imaging for Incidental Thyroid Nodules in Patients
Matthew B. Morgan, MD, MS
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KEY FACTS

  • Terminology

    TERMINOLOGY

    • Description

      • Percentage of final reports for CT, CTA, MR, or MRA studies of chest or neck for patients aged 18+ years with no known thyroid disease with thyroid nodule < 1.0 cm noted incidentally with follow-up imaging recommended
    • Rationale

      • Thyroid nodules are common, with estimates of prevalence as high as 50%. Desser and Kamaya found that majority of incidentally noted thyroid nodules were benign with ~ 5% being malignant. Due to common nature of small thyroid nodules combined with low malignancy, nonpalpable nodules detected on US or other anatomic imaging studies are termed incidentally discovered nodules or ''incidentalomas.'' Nonpalpable nodules have same risk of malignancy as palpable nodules with same size. Generally, only nodules > 1 cm should be evaluated because they have greater potential to be clinically significant cancers (ATA, 2009).
    • Instructions

      • This measure is to be submitted each time patient undergoes CT or MR with incidental thyroid nodule 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 for CT or MR will submit this measure.
    • Numerator

      • Final reports for CT, CTA, MR, or MRA of chest or neck with follow-up imaging recommended for reports with incidentally detected thyroid nodule < 1.0 cm noted
    • Denominator

      • All final reports for CT, CTA, MR, or MRA studies of chest or neck for patients aged 18+ years with incidentally detected thyroid nodule < 1.0 cm noted

    Selected References

    1. MIPS Measure 406: Appropriate Follow-Up Imaging for Incidental Thyroid Nodules in Patients (for reference if using CQMS). Centers for Medicare and Medicaid Services (CMS). 2021.
    2. MIPS Measure 406: Appropriate Follow-Up Imaging for Incidental Thyroid Nodules in Patients (for reference if using Medicare Part B claims). Centers for Medicare and Medicaid Services (CMS). 2021.
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    Tables

    Tables

    KEY FACTS

    • Terminology

      TERMINOLOGY

      • Description

        • Percentage of final reports for CT, CTA, MR, or MRA studies of chest or neck for patients aged 18+ years with no known thyroid disease with thyroid nodule < 1.0 cm noted incidentally with follow-up imaging recommended
      • Rationale

        • Thyroid nodules are common, with estimates of prevalence as high as 50%. Desser and Kamaya found that majority of incidentally noted thyroid nodules were benign with ~ 5% being malignant. Due to common nature of small thyroid nodules combined with low malignancy, nonpalpable nodules detected on US or other anatomic imaging studies are termed incidentally discovered nodules or ''incidentalomas.'' Nonpalpable nodules have same risk of malignancy as palpable nodules with same size. Generally, only nodules > 1 cm should be evaluated because they have greater potential to be clinically significant cancers (ATA, 2009).
      • Instructions

        • This measure is to be submitted each time patient undergoes CT or MR with incidental thyroid nodule 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 for CT or MR will submit this measure.
      • Numerator

        • Final reports for CT, CTA, MR, or MRA of chest or neck with follow-up imaging recommended for reports with incidentally detected thyroid nodule < 1.0 cm noted
      • Denominator

        • All final reports for CT, CTA, MR, or MRA studies of chest or neck for patients aged 18+ years with incidentally detected thyroid nodule < 1.0 cm noted

      Selected References

      1. MIPS Measure 406: Appropriate Follow-Up Imaging for Incidental Thyroid Nodules in Patients (for reference if using CQMS). Centers for Medicare and Medicaid Services (CMS). 2021.
      2. MIPS Measure 406: Appropriate Follow-Up Imaging for Incidental Thyroid Nodules in Patients (for reference if using Medicare Part B claims). Centers for Medicare and Medicaid Services (CMS). 2021.