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CMS122v3: Diabetes_Adult_A

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    • Sonia Galvan
    • 281-660-9543
    • Drummond Group
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      CMS122v3: Diabetes: Hemoglobin A1c Poor Control
      Patient is numerator compliant if most recent HbA1c level >9%, the most recent HbA1c result is missing, or if there are no HbA1c tests performed and results documented during the measurement period.
      • Numerator =
      o AND:
       OR:
       AND: MOST RECENT:"Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test" during "Measurement Period"
       AND: "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result > 9 %)"
       OR:
       AND: MOST RECENT:"Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"
       AND NOT: "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result)" starts after start of "Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test"
       OR NOT: "Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"
      Problem: Since a “Laboratory Test, Result” is indicative of “Laboratory Test, Performed” it is impossible to indicate that a “Laboratory Test, Result” has taken place after a “Laboratory Test, Performed.” Logically, it will appear that the “Laboratory Test, Result” has taken place at the same time as the “Laboratory Test, Performed.”

      Solution: To be consistent with the intent of the measure, change the “start after start” operand to the “start after or concurrent with start” operand to capture a “Laboratory Test, Result” that occurs concurrently with the “Laboratory Test, Performed”

       OR:
       AND: MOST RECENT:"Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"
       AND NOT:
       OR "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result)" starts after or concurrent with start of "Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test"
      Show
      CMS122v3: Diabetes: Hemoglobin A1c Poor Control Patient is numerator compliant if most recent HbA1c level >9%, the most recent HbA1c result is missing, or if there are no HbA1c tests performed and results documented during the measurement period. • Numerator = o AND:  OR:  AND: MOST RECENT:"Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test" during "Measurement Period"  AND: "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result > 9 %)"  OR:  AND: MOST RECENT:"Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"  AND NOT: "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result)" starts after start of "Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test"  OR NOT: "Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period" Problem: Since a “Laboratory Test, Result” is indicative of “Laboratory Test, Performed” it is impossible to indicate that a “Laboratory Test, Result” has taken place after a “Laboratory Test, Performed.” Logically, it will appear that the “Laboratory Test, Result” has taken place at the same time as the “Laboratory Test, Performed.” Solution: To be consistent with the intent of the measure, change the “start after start” operand to the “start after or concurrent with start” operand to capture a “Laboratory Test, Result” that occurs concurrently with the “Laboratory Test, Performed”  OR:  AND: MOST RECENT:"Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"  AND NOT:  OR "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result)" starts after or concurrent with start of "Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test"
    • CMS122v3/NQF0059
    • affecting certification

      To qualify for the numerator count, CMS122v3/NQF 0059 requires one of the following to be true:
      1). HbA1c test result > 9%
      2). Most recent HbA1c result is missing
      3). No HbA1c performed and documented during reporting period

      Patient "Diabetes_Adult_A" does not appear to satisfy any of the criterion above but Cypress v2.5.1 expects this patient to be included in the numerator. Can you confirm this logic is correct?

        1. CMS122v3_DiabetesAdultA.png
          212 kB
          Sonia Galvan

            edave Mathematica EC eCQM Team
            soniagalvan Sonia Galvan (Inactive)
            Jean Colbert (Inactive), Samuel Sayer
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