> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.
# [CMS130v13] Colorectal Cancer Screening
> Elation supports the automatic calculation of CMS130v13, Colorectal Cancer Screening.
This measure has been removed as an eCQM for Traditional MIPS reporting. This measure is still an applicable eCQM in other programs and is still available in Elation. It will not be eligible to be counted towards Traditional MIPS submissions via QRDA in the 2025 MIPS Performance Year. There are additional ways to report MIPS, please see our [MIPS (2025) Overview](/articles/MIPS-2025-Overview) article to better understand 2025 MIPS measure options.
## Measure Details
Percentage of adults 45-75 years of age who had appropriate screening for colorectal cancer
## Measure Parameters
**Numerator**: Patients with one or more screenings for colorectal cancer. Appropriate screenings are defined by any one of the following criteria:
* Fecal occult blood test (FOBT) during the measurement period
* Flexible sigmoidoscopy during the measurement period or the four years prior to the measurement period
* Colonoscopy during the measurement period or the nine years prior to the measurement period
* Stool DNA (sDNA) with FIT test during the measurement period or the two years prior to the measurement period
* CT Colonography during the measurement period or the four years prior to the measurement period
**Denominator**: Patients 46-75 years of age by the end of the measurement period with a visit during the measurement period.
**Exclusions/Exceptions:**
* Exclude patients who are in hospice care for any part of the measurement period.
* Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer.
* Exclude patients receiving palliative care during the measurement period.
* Exclude patients 66 and older by the end of the measurement period who are living long term in a nursing home any time on or before the end of the measurement period.
* Exclude patients 66 and older by the end of the measurement period with an indication of frailty for any part of the measurement period who also meet any of the following criteria advanced illness criteria:
* Advanced illness diagnosis during the measurement period or the year prior
* OR taking dementia medications for any part of the measurement period or the year prior
These are the exclusion document tags for this measure (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* EXCLUSION: HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE
* EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE
* EXCLUSION: COLECTOMY NO COL SCRN
**How to document frailty:**
To document frailty in Elation, both conditions below have to be met:
1. add a frailty diagnosis to the patient's Problem List
2. meet one of the following criteria:
3. record an advanced illness diagnosis in 2 outpatient encounters
4. record an advanced illness in 1 inpatient counter
5. record a dementia medication in the patient's chart
Attachments with frailty codes and advanced illness codes can be found in the [Attachments](#attachments) section of this article.
You can also document the use of a frailty device to claim the first part of the exclusion. To do so, please add a document tag that represents the frailty device to a visit note from the reporting year. The document tag should have the device code and description and can be created directly in the visit note or within your Document Tags Settings page in Elation. Attachments with device codes are also in the [Attachments](#attachments) section of this article.
## Elation Workflows
1. Documenting a screening from a visit note:
* Elation's Clinical Reminders Feature allows you to easily document screenings. When a patient is due for a Colorectal Cancer Screening, an alert will report at the top of the patient's visit note. Options for selecting the measure will appear after clicking address:
1. Documenting a screening from the patient chart:
2. For a patient in the denominator, scroll to the bottom of their clinical profile, where their Health Maintenance items appear.
3. Click on Colorectal Screening, indicate the date of the patient’s most recent Colorectal Screening (FOBT, Colonoscopy, Flexible sigmoidoscopy, FIT DNA, or CT Colonography), and click ***Save New***.
1. Tag a report in the patient’s record with one of the following document tags. This alone will meet the health maintenance requirement (**Reference**: [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)):
* COLONOSCOPY (RESULT: NEGATIVE)
* COLONOSCOPY (RESULT: POSITIVE)
* FIT DNA (RESULT: NEGATIVE)
* FIT DNA (RESULT: POSITIVE)
* FLEXIBLE SIGMOIDOSCOPY (RESULT: NEGATIVE)
* FLEXIBLE SIGMOIDOSCOPY (RESULT: POSITIVE)
* FOBT (RESULT: NEGATIVE)
* FOBT (RESULT: POSITIVE)
* CT COLONOGRAPHY (RESULT: NEGATIVE)
* CT COLONOGRAPHY (RESULT: POSITIVE)
## Measure Information
Colorectal cancer represents eight percent of all new cancer cases in the United States. In 2020, there were an estimated 147,950 new cases of colorectal cancer and an estimated 53,200 deaths attributed to it. According to the National Cancer Institute, about 4.2 percent of men and women will be diagnosed with colorectal cancer at some point during their lifetimes. For most adults, older age is the most important risk factor for colorectal cancer, although being male and black are also associated with higher incidence and mortality. Colorectal cancer is most frequently diagnosed among people 65 to 74 years old (National Cancer Institute, 2020).
Screening can be effective for finding precancerous lesions (polyps) that could later become malignant, and for detecting early cancers that can be more easily and effectively treated. Precancerous polyps usually take about 10 to 15 years to develop into colorectal cancer, and most can be found and removed before turning into cancer. The five-year relative survival rate for people whose colorectal cancer is found in the early stage before it has spread is about 90 percent (American Cancer Society, 2020).
[Reference: Measure Information from CMS](https://ecqi.healthit.gov/ecqm/ec/2025/cms0130v13)
## Frequently asked questions
While clinical guidelines recommend starting colorectal cancer screenings at age **45**, the official CMS technical specifications require the patient to be **46** by the end of the measurement period (December 31st).
**Why the difference?** CMS builds in a 1-year buffer to ensure eligibility for a full annual cycle so that providers are not penalized the moment a patient reaches the minimum age. This ensures the patient has been eligible long enough for a screening to have realistically occurred.
**Example:** If a patient is 45 for the entirety of 2026 and does not turn 46 until 2027, they will not appear in the 2026 CQM reports. They will automatically be included starting January 1st of the year they turn 46.
## Attachments
* [Advanced Illness Codes](/files/advanced-illness-codes-colorectal.xlsx)
* [Frailty Codes](/files/frailty-codes-colorectal.csv)
* [Frailty Descriptions](/files/frailty-descriptions-colorectal.xlsx)
## Related Articles
* [Clinical Quality Measures Reports Guide](/articles/elations-cqm-dashboards)
* [Clinical Reminders for Clinical Quality Measures](/articles/clinical-reminders-for-clinical-quality-measures)
* [Tag Reports and Notes with Document Tags](/articles/tag-reports-and-notes-with-document-tags)
* [Health Maintenance Documentation and Reminders](/articles/health-maintenance)
* [MIPS (2025) Overview](/articles/MIPS-2025-Overview)