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  1. eCQM Issue Tracker
  2. CQM-1527

CMS 147 denominator exception timing

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    • Icon: Annual Update Annual Update
    • Resolution: Duplicate
    • Icon: Minor Minor
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      Thank you for your comments. The AMA acknowledges that in CMS 147v4, the denominator exceptions logic does not adequately capture the intended population. The issue you identified was also raised in CQM-1334. We encourage you to reference this issue to view the discussions that occurred. The AMA believes this issue has been remedied through changes made to the measure logic during the most recent round of annual updates and will be available in CMS 147v5 that will be posted within the near future.
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      Thank you for your comments. The AMA acknowledges that in CMS 147v4, the denominator exceptions logic does not adequately capture the intended population. The issue you identified was also raised in CQM-1334 . We encourage you to reference this issue to view the discussions that occurred. The AMA believes this issue has been remedied through changes made to the measure logic during the most recent round of annual updates and will be available in CMS 147v5 that will be posted within the near future.

      Looking at this measure, there is an issue which perhaps should be addressed before the next annual update (in June). For the allergy/intolerance diagnoses and procedures in the Denominator Exceptions, they must start before or during the measurement period and not end within the first 90 days of the measurement period. As written, this means that a patient who
      a) did not have a vaccination in the October 2014 through March 2015 flu season
      b) was diagnosed with an allergy to eggs on December 31, 2015
      would qualify for the exception, as long as that allergy had no end date (and allergies frequently do not have an end date).
      This seems to not be what was intended. Adding an additional criterion such as:

      AND NOT: "Occurrence A of XXXX" > 89 days starts after start of "Measurement Period"

      would seem to fix the issue.

            edave Mathematica EC eCQM Team
            cendare Daphne Brinkerhoff
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