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  2. CQM-1147

Logic or Cypress error in CMS64v3

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Delivered
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    • David Chronister
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      The intent of CMS64 is that there should be an LDL result in order to be in the denominator. The denominator logic does not explicitly specify a result, only that an LDL test was performed. In the test record "Heart_Adult A" the performance of an LDL test is recorded but not a test result. The case falls into the denominator but not the numerator.

      The commenter is correct that this does not precisely match the guidance and the disposition of this particular test record does not meet the intent of the measure. This will be addressed in the next annual measure update. We would expect the impact of this issue in the field to be minor as an LDL result would generally be present when a test is performed.
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      The intent of CMS64 is that there should be an LDL result in order to be in the denominator. The denominator logic does not explicitly specify a result, only that an LDL test was performed. In the test record "Heart_Adult A" the performance of an LDL test is recorded but not a test result. The case falls into the denominator but not the numerator. The commenter is correct that this does not precisely match the guidance and the disposition of this particular test record does not meet the intent of the measure. This will be addressed in the next annual measure update. We would expect the impact of this issue in the field to be minor as an LDL result would generally be present when a test is performed.
    • CMS61v1/NQFna, CMS64v1/NQFna

      The Guidance section of the eCQM for CMS64v3 states, "This is a two -part measure which is paired with CMS 61: Preventive Care and Screening: Cholesterol – Fasting Low Density Lipoprotein (LDL-C) Test Performed. If the fasting LDL-C results are documented this measure CMS 64 should also be reported.". The Cypress tool gave me one patient who does not have an LDL-C result and expects this patient to be counted in the initial patient population and the denominator but not meet the numerator of the measure. Based on the guidance, this patient should not be in the denominator at all since he does not have an LDL-C result. The master patient in question is A, Heart_Adult.

            mcannon Miriam Cannon (Inactive)
            DavidC David Chronister (Inactive)
            Miriam Cannon (Inactive)
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