Metric 12

Use of Minimally Invasive Lung Surgery for Lung Cancer

Metric Category: Appropriateness

About the Metric

Definition

The percentage of all lung resection procedures performed for lung cancers that were minimally invasive lung resections.

Background

Minimally invasive surgery is a safe and effective option for the resection of non-small cell lung cancer. Minimally invasive techniques may allow for surgical resection in high risk patients for whom an open resection may be prohibitive. Minimally invasive lobectomies, performed through a video assisted thoracoscopic surgical approach, are associated with similar long-term survival, fewer postoperative complications, and shorter length of stay compared to open resection. MIS may also be associated with lower costs.

Metric Ratings

Evidence
5/5
Expert Consensus
5/5
Clinician Buy-in
4/5
Economic Impact
3.5/5
Reduction in Avoidable Harm
4.5/5
Applicability to Medicare Data
5/5
Applicability to Medicaid
4/5

Applicable to EHR Data?

Requires Pharmacy Data?

How It Works

Numerator

The number of procedures from the denominator that were minimally invasive lung
resection procedures (CPT codes: 32663, 32666, 32667, 32668, 32669).

Denominator

The number of all lung resection procedures (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669) performed for lung cancers (ICD-10-CM codes: C34.1, C34.2, C34.3, C34.8, C34.9) by a given physician during the study period.

Inclusion Criteria

All patients who underwent a lung resection procedure for lung cancer.

Exclusion Criteria

1. Patients who underwent a pneumonectomy or bilobectomy (CPT code: 32670, 32671, 32482, 32488) on the day of the lung resection procedure.

 

2. Patients who had any history of lung resection (CPT codes: 32440, 32442, 32445, 32480, 32484, 32486, 32505, 32506, 32507, 32608, 32663, 32666, 32667, 32668, 32669, 32670, 32671, 32482, 32488) prior to the study period.

Attribution

None.

GAM™ Thresholds

Minimal number of patients required in the denominator Clinical threshold of what constitutes an outlier
11 <44%