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  2. CQM-1350

What is occurrence A and occurrence B in this case? Does it mean recording pulse two times in the same visit since it says "Occurrence A of PE finding before start of occurrence A & Occurrence B of PE finding before start of occurrence A"?

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    • Resolution: Answered
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    • Dr. Shah
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      If a patient were to meet this particular denominator exception, the patient’s heart rate would need to be measured twice during the same visit (Occ A & B), and both values must be < 50 beats per minute. Occ B also has the constraint that it must be the most recent heart rate result that was taken before Occ A of a patient’s heart rate. An example scenario of an appropriate denominator exception for a patient would be:
      Visit Start Time: 8:00am
      Heart Rate Result (52 bpm) : 8:01am
      Heart Rate Result (49 bpm) : 8:10am (Serves as Occurrence B of Physical Exam)
      Heart Rate Result (46 bpm) : 8:23am (Serves as Occurrence A of Physical Exam)
      Visit End Time: 8:30am
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      If a patient were to meet this particular denominator exception, the patient’s heart rate would need to be measured twice during the same visit (Occ A & B), and both values must be < 50 beats per minute. Occ B also has the constraint that it must be the most recent heart rate result that was taken before Occ A of a patient’s heart rate. An example scenario of an appropriate denominator exception for a patient would be: Visit Start Time: 8:00am Heart Rate Result (52 bpm) : 8:01am Heart Rate Result (49 bpm) : 8:10am (Serves as Occurrence B of Physical Exam) Heart Rate Result (46 bpm) : 8:23am (Serves as Occurrence A of Physical Exam) Visit End Time: 8:30am
    • CMS145v3/NQF0070

      My question is regarding CQM Title: "Coronary Artery Disease (CAD): Beta-Blocker Therapy—Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF <40%)" - CMS 145 / NQF 0070.

      What is occurrence A and occurrence B in this case? Does it mean recording pulse two times in the same visit since it says "Occurrence A of PE finding before start of occurrence A & Occurrence B of PE finding before start of occurrence A"? Please clarify and advise...

      Here is what it says in denominator exception:
      Denominator Exceptions 2 =
      AND:
      OR:
      AND: MOST RECENT:"Occurrence B of Physical Exam, Finding: Heart Rate" starts before start of "Occurrence A of Physical Exam, Finding: Heart Rate"
      AND:
      OR:
      AND: "Occurrence A of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Office Visit"
      AND: "Occurrence B of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Office Visit"
      OR:
      AND: "Occurrence A of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Care Services in Long-Term Residential Facility"
      AND: "Occurrence B of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Care Services in Long-Term Residential Facility"
      OR:
      AND: "Occurrence A of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Face-to-Face Interaction"
      AND: "Occurrence B of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Face-to-Face Interaction"
      OR:
      AND: "Occurrence A of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Home Healthcare Services"
      AND: "Occurrence B of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Home Healthcare Services"
      OR:
      AND: "Occurrence A of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Nursing Facility Visit"
      AND: "Occurrence B of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Nursing Facility Visit"
      OR:
      AND: "Occurrence A of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Outpatient Consultation"
      AND: "Occurrence B of Physical Exam, Finding: Heart Rate (result < 50 bpm)" during "Occurrence A of Encounter, Performed: Outpatient Consultation"

      Thanks, Dr. Shah

            edave Mathematica EC eCQM Team
            Wolverine451 Atif (Inactive)
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