Run Chart Audit for Breast Cancer Screening Measure (Ages 50-74) — Free

Audit Setup and Patient Eligibility

Patient is female and age 50 to 74 at the end of the measurement period critical (required)

Verify the patient meets the age and sex criteria for the breast cancer screening measure.

Yes No N/A

Measurement period end date documented

Record the end date used to calculate the 27-month lookback window.

27-month lookback window calculated correctly critical (required)

Confirm the audit uses the correct 27-month period prior to the measurement period end date.

Yes No N/A

Patient is included in the audit population

Confirm the chart belongs in the denominator for this measure after applying eligibility criteria.

Yes No N/A

Relevant chart sources reviewed

Identify which record sources were reviewed for mammography evidence.

Note (optional)

Mammography Evidence Verification

Mammogram documented within 27 months before measurement period end critical (required)

Verify a screening or qualifying mammogram is documented within the required lookback period.

Yes No N/A

Mammogram date recorded

Enter the date of the qualifying mammogram.

Mammogram result documented

Capture the documented result if available; result is not required for measure compliance but supports documentation quality.

Note (optional)

Evidence source is clearly attributable to a mammography exam

Confirm the documentation clearly identifies the study as a mammogram rather than another breast imaging test.

Yes No N/A

Outside mammogram record includes patient identifiers and exam date

If the evidence is from an external source, confirm the record includes enough detail to support chart abstraction.

Yes No N/A

Duplicate or conflicting mammogram entries reconciled

Resolve conflicting dates or duplicate entries so the final determination is based on the best available evidence.

Yes No N/A

Exceptions, Refusals, and Exclusions

Documented refusal of mammography reviewed

Check whether the patient refused screening and whether the refusal is documented in the chart.

Yes No N/A

Medical exclusion or contraindication documented

Verify whether a documented exclusion applies, such as a clinical reason preventing screening.

Yes No N/A

Exclusion reason specified

Describe the documented exclusion, contraindication, or other exception if present.

Follow-up plan documented for overdue screening

Confirm there is a plan for outreach, ordering, or follow-up when the patient is overdue.

Yes No N/A

Patient outreach or reminder documented

Verify whether the chart shows outreach efforts for patients without qualifying mammography evidence.

Yes No N/A

Documentation Quality and Final Determination

Chart documentation supports measure abstraction critical (required)

Confirm the chart contains sufficient, legible documentation to support the final audit decision.

Yes No N/A

Measure status

Select the final audit outcome based on eligibility, evidence, and exclusions.

Note (optional)

Corrective action needed

Indicate whether documentation, outreach, or workflow correction is needed.

Yes No N/A

Corrective action details

Summarize the gap, if any, and the recommended next step.

Auditor sign-off notes

Enter any additional notes supporting the audit conclusion.

Get your results

Enter your email — we'll send you a PDF of your filled-out template, plus the occasional MangoScoop newsletter (templates, workflow tips, product updates). Unsubscribe anytime — link is in every email.

Email (required)

Your name (optional)

Run: Chart Audit for Breast Cancer Screening Measure (Ages 50-74)

Audit Setup and Patient Eligibility

Mammography Evidence Verification

Exceptions, Refusals, and Exclusions

Documentation Quality and Final Determination

Get your results