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  2. CQM-1313

Issues with macroalbumin result criterion

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Resolved
    • Icon: Minor Minor
    • Guidance
    • None
    • Barbara Katzenberg
    • 617 783 7964
    • Allscripts
    • Intent of criterion "Laboratory Test, Result: Macroalbumin Test (result: 'Positive Finding')"
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      As you noted, the results of a urine test can indicate microalbuminuria or macroalbuminuria. Because there are many factors that lead to this determination, there is no single threshold we can state that would indicate macroalbuminuria. The physician would have to document a positive finding for macroalbuminuria in the medical record. Note that the numerator also includes patients who have been screened for nephropathy. To meet this requirement, the patient can have any urine screening test and no specific result is required. You could check to see if patients meet this lower threshold before applying the more stringent criteria of being positive for macroalbuminuria. We will work with experts to determine if we can make changes during the next update cycle.
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      As you noted, the results of a urine test can indicate microalbuminuria or macroalbuminuria. Because there are many factors that lead to this determination, there is no single threshold we can state that would indicate macroalbuminuria. The physician would have to document a positive finding for macroalbuminuria in the medical record. Note that the numerator also includes patients who have been screened for nephropathy. To meet this requirement, the patient can have any urine screening test and no specific result is required. You could check to see if patients meet this lower threshold before applying the more stringent criteria of being positive for macroalbuminuria. We will work with experts to determine if we can make changes during the next update cycle.
    • CMS134v3/NQF0062

      "Positive finding" for Macroalbumin Test does not reflect the way test results are captured in the hospitals we work with. We only see results for urine, microalbumin, whose numeric result differentiates between microalbuminuria and macroalbuminuria. We also do not have a way to affix a value set code for positive to a numeric result. Please confirm that the intent is that a clinician would need to separately document that the high value returned by the lab is in fact "positive" for macroalbuminuria. This seems burdensome double documentation.

            edave Mathematica EC eCQM Team
            bkatzenberg Barbara Katzenberg (Inactive)
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