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Value Sets
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Resolution: Answered
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Minor
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None
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Measures may calculate incorrectly based on the perceived intent of the measures.
Please see CYPRESS-487 as a related item that started this ticket.
The functional status codes cross the different value sets for measures 56,66, and 90.
For example, code 71955-9 on the Cypress patient example GP_Geriatric, is in all 3 value sets:
"Functional Status, Result: Functional Status Assessment for Hip Replacement" using "Functional Status Assessment for Hip Replacement Grouping Value Set (2.16.840.1.113883.3.464.1003.118.12.1029)"
"Functional Status, Result: Functional Status Assessment for Knee Replacement" using "Functional Status Assessment for Knee Replacement Grouping Value Set (2.16.840.1.113883.3.464.1003.118.12.1030)"
"Functional Status, Result: Functional Status Assessment for Heart Failure" using "Functional Status Assessment for Heart Failure Grouping Value Set (2.16.840.1.113883.3.464.1003.118.12.1031)"
Without uniqueness, theoretically a patient could have an Functional Status with code 71955-9 with the intent to record in relation to a heart failure diagnosis, but then meet the measure for hip replacement since the code is generic and doesn't have a qualifier for the type of Functional Status Assessment being performed ( or relationship to the diagnosis for which the FS is intended for).
It seems the issue is due to the Functional Status Assessment and Result being tied into just 1 condition and value set. The measures would yield better accuracy if the Functional Status Assessment was codified separately from the Result as is done with Procedures or Risk Assessments. For example:
Assessment:
Risk Category Assessment: Adolescent Depression Screening" using "Adolescent Depression Screening LOINC Value Set (2.16.840.1.113883.3.600.2452)"
With Result Attribute:
Attribute: "Result: Depression Screening Result" using "Depression Screening Result SNOMEDCT Value Set (2.16.840.1.113883.3.600.2454)"
Please let me know if any further details are necessary to understand the issue.