MIPS #453 Percentage of Patients Who Died from Cancer Receiving Systemic Cancer-Directed Therapy in the Last 14 Days of Life

MIPS #453 Percentage of Patients Who Died from Cancer Receiving Systemic Cancer-Directed Therapy in the Last 14 Days of Life

2026 measure specification review pending.

Practice Insights coding changes completed for 2025

MEASURE DESCRIPTION

Percentage of patients who died from cancer receiving systemic cancer-directed therapy in the last 14 days of care.

This is an inverse measure; a lower percentage achieves a higher score.

Relevance to Value Based Care: Increased focus given to patients who receive unnecessary treatment at the end of life. These treatments have not been shown to improve outcomes at the end of life and can negatively impact the patient and caregiver experience. Studies show resource utilization costs are significantly higher at the end-of-life period.

Numerator

Patients who received systemic cancer-directed therapy in the last 14 days of life. Note: Hormonal therapies and steroids are not included in this systemic cancer directed therapy definition.

Denominator

Patients who died from cancer during the performance year.

Exclusion/Exceptions

None.

Required Fields in iKnowMed

Diagnosis of cancer (ICD-10 code), See specifications sheet for full list of codes included
- 2025 Updates:
  - Removed: C83.39, C86.0, C86.1, C86.2, C86.3, C86.4, C86.5, C86.6, C88.0, C88.2, C88.3, C88.4, C88.8, C88.9
  - Added: C83.390, C83.398, C86.00, C86.10, C86.20, C86.30, C86.40, C86.50, C86.60, C88.00, C88.20, C88.30, C88.40, C88.80, C88.90
2 or more E/M visits during the reporting period (99202, 99203, 99204, 99205, 99212, 99213, 99214, 99215)
- Established Clinician = 2 or more visits with patient in reporting year
- Telehealth visits are not included
- NOTE: If a detail report is run in Practice Insights for less than "year to date," patients may not populate the report as they may not have had 2 EM visits in the time frame used.
Date of death and patient status as deceased in demographics. If the cause of death is left blank in iKM death details, it will be assumed to be a cancer-related death and will be included in the denominator
Systemic Cancer-directed therapy includes: All traditional cytotoxic chemo (such as alkylating agents, antimetabolites, plant alkaloids and terpenoids, topoisomerase inhibitors, & antitumor antibiotics), Immunotherapy, Biologics (such as Herceptin, Rituxan), & Targeted agents
IV chemo administered or new prescription or refilled oral medication prescribed within 14 days prior to death will meet the numerator
Excluded therapies: growth factors, bisphosphonates, RANK ligand inhibitors, nausea medications or fluids if these are not given in association with “systemic cancer directed therapy”, hormonal, and steroids

Telehealth Included: No

Scoring: Up to 10 points

RESOURCES

MIPS 453 Workflow Steps

MIPS 453 Workflow PDF

2025 MIPS 453 Measure Specifications

Document Date of Death in iKM

2026 MIPS 453 Measure Specifications