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  2. CQM-1247

EP_CMS64v3_NQFXXXX_Cholesterol_ScreeningB

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Minor Minor
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      For the Denominator in CMS64v3: Denominator 2 logic was incorrect. Denominator 2 should have had an "OR" operator instead of a "AND" operator. The logic has been updated in CMS64v4. A CMS FAQ (FAQ#9062) for this error logic is posted at: https://questions.cms.gov/faq.php?faqId=90622
      The attachment “CMS64v4 Denominator 2 logic with Comments.docx” explains the logic for denominator 2.
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      For the Denominator in CMS64v3: Denominator 2 logic was incorrect. Denominator 2 should have had an "OR" operator instead of a "AND" operator. The logic has been updated in CMS64v4. A CMS FAQ (FAQ#9062) for this error logic is posted at: https://questions.cms.gov/faq.php?faqId=90622 The attachment “CMS64v4 Denominator 2 logic with Comments.docx” explains the logic for denominator 2.
    • Coding-Developement (DECC)

      Under Population Criteria2- Denominator Section-
      I would like to understand better the intent of the two "AND" sections here because if a patient meets the criteria for the first AND, it automatically applies to the second AND. I wasn't sure if we do have to code to thse 2 scenarios or if the first AND is the only intent in this case.

      "■AND: Count >= 3 of: ■OR: FIRST:"Patient Characteristic: Current Cigarette Smoker" starts before or during "Measurement Period"
      ■OR: FIRST:"Diagnosis, Family History: Family History CHD" starts before or during "Measurement Period"
      ■OR: FIRST:"Laboratory Test, Result: High Density Lipoprotein (HDL) (result < 40 mg/dL)" during "Measurement Period"
      ■OR: FIRST: ■OR: "Diagnosis, Active: Diagnosis of hypertension grouped" starts before or during "Measurement Period"
      ■OR: "Medication, Active: Anti-Hypertensive Pharmacologic Therapy" during "Measurement Period"

      ■AND: Count = 2 of: ■OR: FIRST:"Patient Characteristic: Current Cigarette Smoker" starts before or during "Measurement Period"
      ■OR: FIRST:"Diagnosis, Family History: Family History CHD" starts before or during "Measurement Period"
      ■OR: FIRST:"Laboratory Test, Result: High Density Lipoprotein (HDL) (result < 40 mg/dL)" during "Measurement Period"
      ■OR: FIRST: ■OR: "Diagnosis, Active: Diagnosis of hypertension grouped" starts before or during "Measurement Period"
      ■OR: "Medication, Active: Anti-Hypertensive Pharmacologic Therapy" during "Measurement Period"
      "

        1. CMS64v4_Denominator 2 logic with Comments.docx
          19 kB
          Ramya Tallapragada

            edave Mathematica EC eCQM Team
            adetola Adetola Adetunji (Inactive)
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              Created:
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