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Contact Name:
Kristen Dodge
Contact Email:
kdodge@encorehealthresources.com
Solution:

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Measure CMS122 and CMS163 have an important difference. CMS122 is capturing poor control over a patient’s HBA1c, so for that measure to be a numerator hit you are required to not have the service or have a high HBA1c. For CMS122 a lower score is better. CMS163 is capturing good control of LDL, so it is looking for an LDL level < 100. The Guidance for CMS163 lists what is not considered numerator compliant. Therefore, the statement you suggest would not be appropriate for the numerator of CMS163.

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Measure CMS122 and CMS163 have an important difference. CMS122 is capturing poor control over a patient’s HBA1c, so for that measure to be a numerator hit you are required to not have the service or have a high HBA1c. For CMS122 a lower score is better. CMS163 is capturing good control of LDL, so it is looking for an LDL level < 100. The Guidance for CMS163 lists what is not considered numerator compliant. Therefore, the statement you suggest would not be appropriate for the numerator of CMS163.
2015 Performance Period EP eCQMs :

CMS163v1/NQF0064

Shouldn't the Numerator also contain, "AND: OR NOT: Occurrence A of Laboratory Test, Result: LDL-C Laboratory Test during Measurement Period"?

This was listed in the "Guidance" section of this measure spec. (And, is similar to CMS122/NQF0059 numerator.)