CMS 169 temporal logic leaves a hole where assessment may not be considered

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    • Type: Implementation Problem
    • Resolution: Done
    • Priority: Moderate
    • Component/s: Guidance, Measure
    • None
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      ​Thank you for your comment. Your concern regarding the numerator logic in CMS 169v4 is valid and was subesquently addresed in version 5 by adding "starts after or concurrent with" to the logic phrase you noted. The addition of the "concurrent with" logic addresses the concern you noted about the "hole" for assessments that start at the same time as the encounter. Please review CMS 169 v5 as a logic change to the numerator address your concern.

      Regarding submission, submitters are required to use the version of the measure consistent with the reporting year.
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      ​Thank you for your comment. Your concern regarding the numerator logic in CMS 169v4 is valid and was subesquently addresed in version 5 by adding "starts after or concurrent with" to the logic phrase you noted. The addition of the "concurrent with" logic addresses the concern you noted about the "hole" for assessments that start at the same time as the encounter. Please review CMS 169 v5 as a logic change to the numerator address your concern. Regarding submission, submitters are required to use the version of the measure consistent with the reporting year.

      CMS 169 v4 has the following logic in the numerator:

      AND: "Procedure, Performed: BH Assessment for Alcohol or Other Drugs" satisfies all
    satisfies any
        starts after start of Occurrence A of $BHEncounter
        =0 day(s) starts before start of Occurrence A of $BHEncounter

      It seems that the logic this is trying to capture can be described as Assessments that occurred before the encounter (but on the same day) or any assessments that occurred after the encounter.

      The problem we are having is an assessment that is recorded to be at the same time as encounter. This measure uses the temporal "starts after start of" instead of what appears to be the more appropriate "starts after or concurrent with start". This leaves a hole where the assessment is, what I believe to be, incorrectly not considered as meeting this part of the numerator.

      My questions are:

      * Is our interpretation correct that there exists a "hole" where the assessment and encounter occur at the same time? If not, how do we adjust our temporal logic in a way that does not impact other measures?

      * If the measure logic does not match the intention of the measure then what is the guidance related to submission?

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Matthew Dugal
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