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  2. CQM-1674

Understanding logic of diagnosis active during reporting period

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Minor Minor
    • Measure
    • Mangala Mayekar
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      Thank you for your question. The first block states that the patient had diagnosis before the visit started and ended sometime during or after the visit. The second block states that the physician diagnosed the patient during visit. Regarding diagnosis timing, it will always be during the measurement period since it is tied to the timing for the encounter. Please note that the logic for the initial population was updated to the new version of QDM in May 2015. The new logic doesn’t change the intent of the measure, but should make the timing clearer.
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      Thank you for your question. The first block states that the patient had diagnosis before the visit started and ended sometime during or after the visit. The second block states that the physician diagnosed the patient during visit. Regarding diagnosis timing, it will always be during the measurement period since it is tied to the timing for the encounter. Please note that the logic for the initial population was updated to the new version of QDM in May 2015. The new logic doesn’t change the intent of the measure, but should make the timing clearer.
    • CMS146v3/NQF0002, CMS154v3/NQF0069
    • High

      In CMS146,

      The measures states,
      OR: "Occurrence A of Encounter, Performed: Ambulatory/ED Visit" during

      OR: "Occurrence A of Diagnosis, Active: Acute Pharyngitis"
      OR: "Occurrence A of Diagnosis, Active: Acute Tonsillitis"

      OR
      OR: "Occurrence A of Diagnosis, Active: Acute Pharyngitis"
      OR: "Occurrence A of Diagnosis, Active: Acute Tonsillitis"
      starts during "Occurrence A of Encounter, Performed: Ambulatory/ED Visit"

      In the second block only the startdate is mentioned for diagnosis,
      But the first block says encounter during diagnosis, so for this we need to also consider the enddate for diagnosis during the reporting period.
      This is also mentioned in the guidance of the measure that the diagnosis is during the reporting period.

      Please suggest if our understanding is correct.

      Similar issue is encountered in measure CMS154

            edave Mathematica EC eCQM Team
            mangalam Mangala (Inactive)
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