> ## 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.
# [CMS130v14] Colorectal Cancer Screening
> Elation supports the automatic calculation of CMS130v14, Colorectal Cancer Screening.
This measure has been removed **as an eCQM for Traditional MIPS reporting** .
It remains an applicable eCQM for other programs and will continue to be available in Elation. However, it will **not** be eligible to count toward Traditional MIPS submissions via QRDA for the 2026 MIPS Performance Year. For a list of 2026 MIPS eligible eCQMs, see our [MIPS (2026) Overview](/articles/MIPS-2026-Overview) article.
## 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
## Elation Workflows
### Documenting measure requirements using a Clinical Reminder in a visit note
| **1** | Click **Address** in the **Colorectal Cancer Screening is due** reminder at the top of the visit note draft. This reminder will automatically appear if ALL of the following denominator requirements are met: |
| ------ | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2a** | To immediately meet the numerator requirements by documenting a Cologuard, FIT, FIT-DNA or FOBT test result for the patient Click **Enter FOBT or Fit DNA result**. • Record the details of a Pap Smear or HPV Test: • Click **Sign** or **Sign & Export to Note** to save the results. |
| **2b** | To immediately meet the numerator requirements by linking a test result: Click **Document existing screening results**. • Record the details of a test: • Click **Save New**. |
| **2c** | To move closer to meeting the numerator requirements: Click **Order FOBT or FIT DNA** to create a lab order for the patient. • Click **Refer for colonoscopy** to create a referral for the patient. • Click **Refer for CT colonography** to create an imaging order for the patient. • Click **Refer for flexible sigmoidoscopy** to create a referral for the patient. • Click **Send office message to follow-up on open order** to have staff follow up on an outstanding lab order. Once the test is completed and you have the results, return to **Step 2a or 2b**. |
| **2d** | To exclude the patient due to total colectomy, click **Document exclusion: patient had a total colectomy.** This will append the **EXCLUSION: COLECTOMY NO COL SCRN** document tag to the visit note to exclude the patient from the measure. [Click here for instructions on how to document other exclusions/exceptions](#document_exclusion_or_exception). |
Clicking **Dismiss** will dismiss the reminder and the reminder will not appear again until a new visit note draft is opened.
### Documenting measure requirements using the Health Maintenance section
| **1** | Click on **Colorectal Cancer Screening** in the **Health Maintenance** section of the **Clinical Profile** . |
| ----- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ |
| **2** | Enter the date of the test in the **Date** field. |
| **3** | Select the **appropriate** document tag in the **Type** field: **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)** |
| **4** | Click **+ Link a report to this item** to link the test results in the patient's chart to the record. |
| **5** | Click **Save New**. |
### Documenting measure requirements from the test results
| **1** | Open the test results in the patient's chart. |
| ----- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **2** | Click **Actions** -> **Edit Details** . |
| **3** | Go to the **Tags** field and select the appropriate document tag below: **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)** |
| **4** | Click **Save** . |
### Documenting exclusions/exceptions
| **Exclusion/Exception** | **Step(s)** |
| ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| Patients whose hospice care overlaps the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the appropriate document tag from this list: **EXCLUSION: HOSPICE CARE** • **EXCLUSION: IP DISCHARGE STATUS TO HEALTH CARE FACILITY FOR HOSPICE CARE** • **EXCLUSION: IP DISCHARGE STATUS TO HOME FOR HOSPICE CARE** |
| Exclude patients with a diagnosis or past history of total colectomy or colorectal cancer. | Add a diagnosis of total colectomy or colorectal cancer in the patient’s [Problem List](/articles/managing-your-problem-list) or visit note with a start date prior to December 31, 2026. Alternatively for total colectomy, you can add click **+ Tag** at the bottom of the visit note draft and add the document tag - **EXCLUSION: COLECTOMY NO COL SCRN** |
| Patients receiving palliative care for any part of the measurement period. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: PALLIATIVE CARE** |
| 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. | Click **+ Tag** at the bottom of the visit note draft and add the following document tag - **EXCLUSION: Living Long Term in a Nursing Home** . |
| 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 | See below. |
**Documenting frailty**
To document frailty in Elation using
1. Frailty diagnosis, advanced illness codes and/or medications
2. Add a frailty diagnosis to the Problem List. You must select from one of the frailty codes listed [here](/files/frailty-codes-2026.csv).
3. Record one of the following:
4. an advanced illness diagnosis in 2 outpatient encounters using one of the codes listed [here](/files/advanced-illness-codes-2026.xlsx).
5. an advanced illness in 1 inpatient counter using one of the codes listed [here](/files/advanced-illness-codes-2026.xlsx).
6. a dementia medication in the patient's chart.
7. A frailty device code
8. Click **+ Tag** at the bottom of the visit note draft.
9. Create/add the appropriate document tag for the relevant frailty device from [this list of frailty device codes](/files/frailty-descriptions-2026.xlsx).
10. If you are creating the document tag for the first time for a frailty device, make sure the document tag has the device's HCPCS code listed.
## 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/2026/cms0130v14)
## 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)