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  2. CQM-1362

Cannot determine what is meant by ending timeframe in Occurrence A of Diagnosis, Active: Fracture - Lower Body

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    • Icon: EC eCQMs EC eCQMs
    • Resolution: Answered
    • Icon: Moderate Moderate
    • Measure
    • Greta Kessler
    • 610-324-1233
    • CECity
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      1. The measure only evaluates people who are having an elective hip replacement. This exclusion is for people who are having a hip replacement due to a traumatic injury. A traumatic injury is defined as multiple fractures of the lower body. Therefore we are looking for a fracture that starts less than one day before the hip replacement surgery and ends at some point after the surgery, but at least one hour after it starts.
      2. The timing for the two fractures is the same because the intent is to define a traumatic injury which, in this case, is defined as multiple fractures.
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      1. The measure only evaluates people who are having an elective hip replacement. This exclusion is for people who are having a hip replacement due to a traumatic injury. A traumatic injury is defined as multiple fractures of the lower body. Therefore we are looking for a fracture that starts less than one day before the hip replacement surgery and ends at some point after the surgery, but at least one hour after it starts. 2. The timing for the two fractures is the same because the intent is to define a traumatic injury which, in this case, is defined as multiple fractures.
    • CMS56v2; CMS66,v2
    • Measure CMS56v2 (also appears in CMS66v2).

      The following are the details for the Denominator Exclusions for 2014 eCQM CMS measure 56v2 (and also CMS66v2).
      Denominator Exclusions =
      • AND:
      o OR:
       AND: "Occurrence A of Diagnosis, Active: Fracture - Lower Body" < 1 day(s) starts before start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
       AND: "Occurrence A of Diagnosis, Active: Fracture - Lower Body" >= 1 hour(s) ends after start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
       AND: "Occurrence B of Diagnosis, Active: Fracture - Lower Body" < 1 day(s) starts before start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
       AND: "Occurrence B of Diagnosis, Active: Fracture - Lower Body" >= 1 hour(s) ends after start of "Occurrence A of Procedure, Performed: Primary THA Procedure"
      o OR:
       AND NOT: "Occurrence A of Diagnosis, Active: Severe Dementia" ends before start of "Measurement Period"
       AND: "Occurrence A of Diagnosis, Active: Severe Dementia" starts before or during "Measurement Period"

      In trying to determine the timeframe for each acceptable diagnosis for a lower body fracture, it states < 1 day(s) starts before the start of the Primary THA Procedure AND ends >= 1 hour after start of the Primary THA Procedure. This does not make sense to me. I am expecting the timeframe for a diagnosis of each lower body fracture to between the start and end times, but if you put these on a timeline, I don’t understand what this is trying to say. See an example below, using Occurrence A of Diagnosis, Active: Fracture - Lower Body as our example:

      A. The Primary THA Procedure is to start at 10/2/2014 at 8 am.
      B. Making the diagnosis for occurrence A of the lower body fracture to have been from 8:01 am on 10/1/2014, given that the first bullet above says: < 1 day(s) start before the start of the procedure.
      C. Given what it says about the end of the occurrence A of the lower body fracture to have been through (end) >= 1 hour(s) ends after start of the procedure. This is another going forward indicator, not an ending.

      1. I need to understand when an acceptable diagnosis for occurrence A of the lower body fracture is to have taken place (start time and end time) and I cannot figure out the end time from the statements above. What is the last acceptable time to have a diagnosis for occurrence A of the lower body fracture?

      2. This assumes the timeframe for diagnosis for occurrence B of the lower body fracture is the same as occurrence A. Is that correct?

            edave Mathematica EC eCQM Team
            greta2115 Greta Kessler (Inactive)
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