2026 MIPS Measure #396: Lung Cancer Reporting (Resection Specimens)

Pathology reports based on lung resection specimens with a diagnosis of primary lung carcinoma that include the pT category, pN category and for non-small cell lung cancer (NSCLC), histologic type.

This measure is to be submitted each time a patient’s lung pathology report addresses specimens with a diagnosis of non-small cell lung cancer; however, only one quality data code (QDC) per date of service for a patient is required. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

Pathology reports for lung resection specimens for primary lung carcinoma

Patients ?18 years of age on date of service

AND

Diagnosis for lung cancer (ICD-10-CM): C34.00, C34.01, C34.02, C34.10, C34.11, C34.12, C34.2, C34.30, C34.31, C34.32, C34.80, C34.81, C34.82, C34.90, C34.91, C34.92

AND

Patient procedure during performance period (CPT): 88309

AND NOT

DENOMINATOR EXCLUSION:

Specimen site other than anatomic location of lung, OR classified as NSCLC-NOS: G9424

Pathology reports based on lung resection specimens with a diagnosis of primary lung carcinoma that include the pT category, pN category and for non-small cell lung cancer, histologic type (e.g., squamous cell carcinoma, adenocarcinoma and NOT NSCLC-NOS (non-small cell lung cancer, not otherwise specified))

Performance Met: Primary lung carcinoma resection report documents pT category, pN category and for Non-small Cell Lung Cancer, Histologic Type (e.g. Squamous Cell Carcinoma, Adenocarcinoma and NOT NSCLC-NOS) (G9422)

OR

Denominator Exception: Documentation of medical reason for not including pT category, pN category and histologic type [For patient with appropriate exclusion criteria (e.g. metastatic disease, benign tumors, malignant tumors other than carcinomas, inadequate surgical specimens)] (G9423)

OR

Performance Not Met: Primary lung carcinoma resection report does not document pT category, pN category and for Nonsmall Cell Lung Cancer, Histologic Type (e.g. Squamous Cell Carcinoma, Adenocarcinoma) (G9425)

The TNM staging revisions (AJCC 7th edition) became effective for all new cases diagnosed after January 1, 2010. The new staging system is applicable to both NSCLC and, for the first time, small cell lung cancer (SCLC). There are significant changes in staging, particularly in T3 for NSCLC. These updates were maintained in the AJCC 8th edition (2018). Recent evidence suggests that significant variability still exists among clinicians with respect to staging practices (Turner, SR 2018)