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EC eCQMs - Eligible Clinicians
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Resolution: Answered
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Minor
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None
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CMS153v4/NQF0033
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Measure logic does not match intent
The logic for the denominator exclusion is as follows:
Denominator Exclusions =
• OR:
o AND: "Occurrence A of Laboratory Test, Order: Pregnancy Test" during "Measurement Period"
o AND: Union of:
"Medication, Order: Isotretinoin"
"Diagnostic Study, Order: X-Ray Study (all inclusive)"
<= 7 day(s) starts after end of "Occurrence A of Laboratory Test, Order: Pregnancy Test"
Per Appendix C of the logic guidance, the granularity of the lookback indicates the gruanularoty to be used when computing that portion of the measure. (A lookback of <=7 days indicates we should compute to the granularity of days.) Since the logic for the Laboratory Test, Order data element is ‘start after end of’ and not concurrent, this means that a lab and a med/x-ray on the same day would not count.
That does not seem in line with the intent of the measure, which likely envisions a workflow where the provider would order an result a pregnancy test, and then order a medication/x-ray upon a negative test result.
- relates to
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QDM-141 Update examples in appendix B.2 to specify timing relationships
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- Resolved
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Rethinking this string of comments. Is the QDM description in Appendix B.2 really incorrect, or is the logic missing critical information. E.g., if the desire is that the order for medication happens at least 1 minute after the order for the pregnancy test, the logic should state that fact (consistent with Appendix B2 as written). Though more complex, it could be written to include another timing requirement:
> 1 minute(s) starts after end of "Occurrence A of Laboratory Test, Order: Pregnancy Test".
Please confirm with the measure developer, but this seems to be a more explicit set of logic rather than expecting an implementer to read through multiple examples in the QDM specification to interpret the intent correctly.