CMS 155v4.1: Discrepancy: description and population criteria

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Done
    • Priority: Minor
    • Component/s: Measure
    • None
    • Elissa Chandler
    • 267-725-5354
    • NextGen Healthcare Information Systems
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      The intent of the measure is to include only people who are 17 by the end of the measurement period. The “Age At” operator calculates against the first day of the measurement period (1/1). If the patient is 16 years old (<17) on 1/1, then the patient will be 17 at the end of the measurement period (12/31). For your example, a person who is 16 at the beginning of the measurement period (16 on 1/1/2016) will be included in the measure, because they are <17 on 1/1/2016. This would also mean patients need to be 3 on the first day of the measurement period and so would turn 4 before the end of the measurement period. Exams that count for the measure would only be performed during the time the patient is either 3 or 4 years old.
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      The intent of the measure is to include only people who are 17 by the end of the measurement period. The “Age At” operator calculates against the first day of the measurement period (1/1). If the patient is 16 years old (<17) on 1/1, then the patient will be 17 at the end of the measurement period (12/31). For your example, a person who is 16 at the beginning of the measurement period (16 on 1/1/2016) will be included in the measure, because they are <17 on 1/1/2016. This would also mean patients need to be 3 on the first day of the measurement period and so would turn 4 before the end of the measurement period. Exams that count for the measure would only be performed during the time the patient is either 3 or 4 years old.
    • CMS155v4/NQF0024
    • high, impacts measure development

      QUESTION: CMS 155v4.1. Please see Attachment with Screenshot.

      1. There is a discrepancy between the description and population criteria. According to the description, patients from 3 – 17 years old would be included from the Initial Population. However, the population Criteria stated, age < 17 years at measurement period. This would exclude any patients who is exactly 17 years old.

      So the question is, should patients who are 17 at the measurement period be included? If so, this will lead to our second question.

      2. If a patient is turning 17 (or 3) on the last day of the measurement period (12/31/2016) and has all physical exams documented on the first day of the measurement period (1/1/2016), technically this patient is ONLY 16 (or 2) during the exams were completed. Would he/she be included in the Initial population?

        1. NextGen Question submitted to JIRA_CMS155v4.1.docx
          22 kB

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Elissa Chandler (Inactive)
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