Measure ID: MIPS 320|Colorectal Cancer|2026 Performance Year

Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients

Percentage of patients aged 45 to 75 years of age receiving a screening colonoscopy without biopsy or polypectomy who had a recommended follow-up interval of 10 years for repeat colonoscopy documented in their colonoscopy report.

Process – High PriorityColorectal CancerPreventive Care

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

Patients aged 45 to 75 on date of encounter
ANDPatient undergoing screening for malignant neoplasm of colon
ANDPatient procedure during the performance period
WITHOUTModifiers: 52, 53, 73, or 74
ORDenominator Exception: Documentation of medical reason(s) for not recommending a 10- year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is ≥ 66 years old, or life expectancy < 10 years, other medical reasons) (M1378)
ORPerformance Not Met: A 10-year follow-up interval for colonoscopy not recommended, reason not otherwise specified (M1379)

Denominator Exclusions

None

Numerator

Patients who had recommended follow-up interval of 10 years for repeat colonoscopy documented in their colonoscopy report. _NUMERATOR NOTE:_ To meet the numerator, patients with a negative screening colonoscopy should have documentation that they received counseling or instruction to have a follow-up or repeat colonoscopy in 10 years. A 6 month period before or after 10 years is considered within the recommended follow-up interval.

Submission Codes (QDCs)

✓ Performance Met
M1377Recommended follow-up interval for repeat colonoscopy of 10 years documented in colonoscopy report and communicated with patient
✗ Performance Not Met
M1379A 10-year follow-up interval for colonoscopy not recommended, reason not otherwise specified

Denominator Exceptions

M1378Denominator Exception: Documentation of medical reason(s) for not recommending a 10- year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is ≥ 66 years old, or life expectancy < 10 years, other medical reasons)

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VBCA Insights

💡Why This Measure Matters

When a colonoscopy is normal with no polyps removed, the patient is at very low colorectal cancer risk and doesn't need another colonoscopy for 10 years. This measure ensures you're documenting that 10-year interval recommendation. Too-frequent colonoscopies waste resources, expose patients to unnecessary procedural risk, and drain endoscopy capacity from people who actually need screening. Be clear and specific: a normal scope means 10 years of reassurance.

📖Clinical Rationale

In the average-risk population, colorectal cancer screening using colonoscopy is recommended in all current guidelines at 10- year intervals. Inappropriate interval recommendations can result in overuse of resources and can lead to significant patient harm and unnecessary healthcare expenditures. Performing colonoscopy too often not only increases patients’ exposure to procedural harm, but also drains resources that could be more effectively used to adequately screen those in need of more urgent colonoscopy.

Variations in the recommended time interval between colonoscopies exist for patients with normal colonoscopy findings. In a 2006 study of 1282 colonoscopy reports, recommendations were consistent with contemporaneous guidelines in only 39.2% of cases and with current guidelines in 36.7% of cases. Further, the adjusted mean number of years in which repeat colonoscopy was recommended was 7.

8 years following normal colonoscopy.

📝Clinical Recommendations

At present, colonoscopy every 10 years is an acceptable option for colorectal cancer (CRC) screening in average-risk adults beginning at age 45 years. (USPSTF 2021, USMSTF 2021). The US Preventive Services Task Force (USPSTF) recommends CRC screening using stool-based tests (fecal occult blood test, fecal immunochemical test [FIT], FIT-DNA), sigmoidoscopy, CT colonography, or colonoscopy in adults, beginning at age 45 years and continuing until the age of 75 years (USPSTF Grade B recommendation for age 45-49; USPSTF Grade A recommendation for age 50-75).

The risks and benefits of these screening methods vary (USPSTF, 2021). The decision to screen for colorectal cancer in adults 76 to 85 years of age should be an individual one, taking into account the patient’s overall health, prior screening history, and preferences (Grade C recommendation) (USPSTF, 2021).

📋Implementation Notes

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this patient-process measure is submitted a minimum of once per patient for the performance period. The most advantageous quality data code will be used if the measure is submitted more than once. Patients who have a coded colonoscopy procedure that has a modifier 52, 53, 73, or 74 will not qualify for inclusion into the measure.

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© 2025 American Medical Association, American Gastroenterological Association, American Society for Gastrointestinal