Thank you for your question. You are absolutely right. The patient does meet all of the measure requirements. However, it is important to note that the measure requires the initial encounter to be the ‘FIRST’ encounter in the 185 days after January 1, 2015. That means your index encounter is on 5/15, not 6/19.   The follow up encounter has to be the ‘MOST RECENT’ encounter that takes place 30-180 days after the ‘FIRST’ encounter. The visit on 12/8 takes place 207 days after 5/15 and does not satisfy the requirements for the follow up encounter. However, the visit on 6/19 occurs 35 days after 5/15 and will be considered the follow up encounter for this measure. In short, the visits that take place on 12/8 and 12/22 should have no impact on the outcome of the measure since you already satisfied the measure requirements with the first two visits.   For more information on how the QDM calculates logic with ‘FIRST’ & ‘MOST RECENT’ functions, please review the QDM: https://ecqi.healthit.gov/system/files/qdm_4_2.pdf Regarding your concern about reporting a score of ‘0’: This is a PQRS program specific question. Please contact the QualityNet Help Desk by phone at 1-866-288-8912 or by email at Qnetsupport@sdps.org .

We have spent a great deal of time on trying to meet CMS90v5 measure. One example is a patient that has a dx of CHF. She was seen in our office on 5-15-15, 6-19-15, 12-8-15, and 12-22-15. Each time she had a functional assesment done. Her 6-19-15 encounter was within the 1st 185 days of 2015. Her 12-8-15 encounter was >30 days and <180 days from the 6-19-15 encounter. She did have a functional assessment done at each encounter. At this point, this was captured on reports through our EHR vendor. However, once the patient had another encounter on 12-22-15, our EHR vendor states this visit is more than 180 days from the 6-19-15 encounter and will no longer count as meeting this measure. It seems to me that we definitely met this eCQM and I do not think CMS means to punish you because the patient had one more visit in 2015? This would mean that once we met the eCQM that we could not let the patient come to our office the rest of the year after 12-8-15, regardless of if she was sick or not, in order to continue to meet this measure. I do not thinks our EHR vendor is interpreting this right. I know that you can report a "0" on an eCQM but we want to know that all the work we did was not useless. Also, we would like to report out eCQMs and PQRS electronically for 2015 and I cannot get anyone to tell me that you will not be penalized for reporting a "0" on a PQRS. I would very much appreciate clarification and help on this matter. If the EHR vendor is not interpreting this eCQM correctly, how do we get help with this?