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  2. CQM-1898

CMS77 (all versions) NUM Criteria

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
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    • Elissa Chandler
    • 267-725-5354
    • NextGen Healthcare Information Systems
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      In general, a documented range or threshold that clearly meets criteria for the numerator can be used to determine numerator compliance. For CMS77, if the most recent result is a documented range or threshold that indicates the copies/mL are <200 the patient should be included as numerator compliant. If the range or threshold does not completely meet numerator criteria, it should not be used to show numerator compliance. For example, if the range was between 150 copies/mL and 250 copies/mL, it would include values that do not meet numerator criteria, so the patient would not be numerator compliant. As this measure is not moving forward into MIPS, we will not be able to add this information to the guidance for this measure.
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      In general, a documented range or threshold that clearly meets criteria for the numerator can be used to determine numerator compliance. For CMS77, if the most recent result is a documented range or threshold that indicates the copies/mL are <200 the patient should be included as numerator compliant. If the range or threshold does not completely meet numerator criteria, it should not be used to show numerator compliance. For example, if the range was between 150 copies/mL and 250 copies/mL, it would include values that do not meet numerator criteria, so the patient would not be numerator compliant. As this measure is not moving forward into MIPS, we will not be able to add this information to the guidance for this measure.
    • CMS77v4/NQFna
    • CMS77v3 and prior versions
    • high impacts measure development

      CMS77: All versions: NUM Criteria

      QUESTION:
      NUM HIV Viral Load Results < 200:
      The measure requires HIV Viral Load test with results less than <200 copies/mL for HIV/AIDS patients. As result, would HIV Viral Load Results returned as ‘< 200’ or ‘>= 200’, or ‘< 20 NOT DETECTED’ be acceptable?

      We are unsure if it would accurate to include HIV Viral Load test Results that are represented as a range OR if only numeric or alpha numeric result would be consider valid HIV Viral Load Results such as ‘20’, ‘190’, ‘200’, ’20 copies/mL’, ‘190 copies/mL’, ‘200 copies/mL’ and etc without the range symbol indicated … should be considered valid.

      Could you please confirm if HIV Viral Load Test Results that are represented as a range would be valid for meeting NUM criteria?

      And could you please provide us with a resource to reference that will indicate for which lab test which type of results are acceptable as we understand not all Lab tests will have a numerical result? This way we can ensure we are accurately capturing Lab Test Results accurately.

            edave Mathematica EC eCQM Team
            elissa Elissa Chandler (Inactive)
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