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  2. CQM-3407

CMS2v8 - Denominator Exclusion Query

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      For CMS2: Preventive Care and Screening: Screening for Depression and Follow-Up Plan the CQL timing operator “overlaps before” means the conditions starts before and extends into a qualifying encounter during the measurement period. If the diagnosis of depression or bipolar disorder is made prior to an eligible encounter and does not end prior to the encounter the patient should be excluded. The scenarios described do not have encounter dates, however in all cases the diagnosis extends through the entire measurement period. Therefore, the patient would present with a diagnosis at any eligible encounter during the measurement period and would be excluded. If the condition had abated at some point prior to or during the measurement period and an encounter takes place after the abatement date the patient would not be excluded. Please let us know if we can be of any further assistance.

      Patient 1 – Excluded. The diagnosis extends through the entire measurement period.

      Patient 2: Excluded. The diagnosis overlaps the entire measurement period.

      Patient 3 – Excluded. The diagnosis overlaps the entire measurement period.

      Patient 4[a] – Excluded. The absence of an abatement date implies the condition is still active.

      Patient 4[b] - Excluded. The diagnosis extends through the entire measurement period.

      Patient 5 – Excluded. The diagnosis overlaps and extends through the entire measurement period.​
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      For CMS2: Preventive Care and Screening: Screening for Depression and Follow-Up Plan the CQL timing operator “overlaps before” means the conditions starts before and extends into a qualifying encounter during the measurement period. If the diagnosis of depression or bipolar disorder is made prior to an eligible encounter and does not end prior to the encounter the patient should be excluded. The scenarios described do not have encounter dates, however in all cases the diagnosis extends through the entire measurement period. Therefore, the patient would present with a diagnosis at any eligible encounter during the measurement period and would be excluded. If the condition had abated at some point prior to or during the measurement period and an encounter takes place after the abatement date the patient would not be excluded. Please let us know if we can be of any further assistance. Patient 1 – Excluded. The diagnosis extends through the entire measurement period. Patient 2: Excluded. The diagnosis overlaps the entire measurement period. Patient 3 – Excluded. The diagnosis overlaps the entire measurement period. Patient 4[a] – Excluded. The absence of an abatement date implies the condition is still active. Patient 4[b] - Excluded. The diagnosis extends through the entire measurement period. Patient 5 – Excluded. The diagnosis overlaps and extends through the entire measurement period.​
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    • Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

      We have a query regarding Denominator condition of CMS2v8:

      Denominator Exclusions

      o "Has Diagnosis of Bipolar Starting Before Qualifying Encounter"
      or "Has Diagnosis of Depression Starting Before Qualifying Encounter"

      Definitions

      Has Diagnosis of Bipolar Starting Before Qualifying Encounter

      o exists ( ["Diagnosis": "Bipolar Diagnosis"] DiagnosisBipolar
      with "Qualifying Encounter for Depression Screening" QualifyingEncounter
      such that DiagnosisBipolar.prevalencePeriod overlaps before QualifyingEncounter.relevantPeriod

      Qualifying Encounter for Depression Screening

      o ["Encounter, Performed": "Depression Screening Encounter Codes"] QualifyingEncounter
      o where QualifyingEncounter.relevantPeriod during "Measurement Period"

      As per definition provided in eCQM logic guidance for overlaps before consider below scenario:

      Patient 1:
      Diagnosis Start Date: 3/2/2018 00:00:000 – 12/30/2019 23:59:59
      Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59

      Patient 2:
      Diagnosis Start Date: 1/1/2019 00:00:000 - 12/30/2019 23:59:59
      Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59

      Patient 3:
      Diagnosis Start Date: 3/2/2018 00:00:000 – 12/31/2019 23:59:59
      Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59

      Patient 4:
      Diagnosis Start Date: 12/31/2018 23:59:59 – End Date (NULL)
      Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59

      Patient 4:
      Diagnosis Start Date: 1/1/2019 00:00:000 – 12/31/2019 23:59:59
      Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59

      Patient 5:
      Diagnosis Start Date: 12/31/2018 23:59:59– 12/31/2019 23:59:59
      Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59

      Patient 6:
      Diagnosis Start Date: 01/03/2018 23:59:59– 1/1/2019 00:00:00
      Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59

      Please confirm which patient(s) should pass

          [CQM-3407] CMS2v8 - Denominator Exclusion Query

          Mathematica EC eCQM Team added a comment -

          Thank you for your follow up question. If Patient 6 had a documented eligible encounter on 1/1/2019, this patient would be considered a denominator exclusion. As the diagnosis abates on 1/1/2019, any eligible encounter after this date during the noted measurement period would result in Patient 6 not qualifying as a denominator exclusion.

          To obtain greater consistency in responses for future questions across sites, it would be helpful to limit the question to the area of primary concern or interest within the logic itself, instead of providing pieces of scenarios that may be prone to misinterpretation outside of the context of the full measure. For example, instead of asking whether the patient passes in the following scenarios, it might be better to ask when a diagnosis of bipolar disorder must be present to be considered a denominator exclusion. Then the focus of our responses could be on the relevant logic instead of testing cases, which may differ in other key parameters and result in different answers.

          We hope this helps with any future questions. Please let us know if we can be of any further assistance.​

          Mathematica EC eCQM Team added a comment - Thank you for your follow up question. If Patient 6 had a documented eligible encounter on 1/1/2019, this patient would be considered a denominator exclusion. As the diagnosis abates on 1/1/2019, any eligible encounter after this date during the noted measurement period would result in Patient 6 not qualifying as a denominator exclusion. To obtain greater consistency in responses for future questions across sites, it would be helpful to limit the question to the area of primary concern or interest within the logic itself, instead of providing pieces of scenarios that may be prone to misinterpretation outside of the context of the full measure. For example, instead of asking whether the patient passes in the following scenarios, it might be better to ask when a diagnosis of bipolar disorder must be present to be considered a denominator exclusion. Then the focus of our responses could be on the relevant logic instead of testing cases, which may differ in other key parameters and result in different answers. We hope this helps with any future questions. Please let us know if we can be of any further assistance.​

          Vinay (Inactive) added a comment -

          Hi Team,

          Request you to provide an update at the earliest

          Vinay (Inactive) added a comment - Hi Team, Request you to provide an update at the earliest

          Vinay (Inactive) added a comment - - edited

          Hi Team,

          Thanks for responding.

          Request you to please provide response for Patient 6.
          Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59

          Patient 6:
          Diagnosis Start Date: 01/03/2018 23:59:59
          Diagnosis End Date : 1/1/2019 00:00:00

          Encounter start date: 1/1/2019 00:00:00
          Encounter end date: 1/1/2019 23:59:59

          Please confirm if above patient will be excluded or not

          Vinay (Inactive) added a comment - - edited Hi Team, Thanks for responding. Request you to please provide response for Patient 6. Measurement Period: 1/1/2019 00:00:000 – 12/31/2019 23:59:59 Patient 6: Diagnosis Start Date: 01/03/2018 23:59:59 Diagnosis End Date : 1/1/2019 00:00:00 Encounter start date: 1/1/2019 00:00:00 Encounter end date: 1/1/2019 23:59:59 Please confirm if above patient will be excluded or not

          Vinay (Inactive) added a comment -

          Hi Team,

          Request you provide an update at the earliest

          Vinay (Inactive) added a comment - Hi Team, Request you provide an update at the earliest

          Vinay (Inactive) added a comment -

          Hi Team,

          Request you provide an update at the earliest

          Vinay (Inactive) added a comment - Hi Team, Request you provide an update at the earliest

          Vinay (Inactive) added a comment -

          Hi Team,

          Please provide response at the earliest

          Vinay (Inactive) added a comment - Hi Team, Please provide response at the earliest

          Vinay (Inactive) added a comment -

          Hi Team,

          Please provide response at the earliest

          Vinay (Inactive) added a comment - Hi Team, Please provide response at the earliest

          Vinay (Inactive) added a comment -

          Sorry for the inconvenience.

          I have updated the eCQM measure number. Please provide a response for above query wrt to CMS2v8

          Vinay (Inactive) added a comment - Sorry for the inconvenience. I have updated the eCQM measure number. Please provide a response for above query wrt to CMS2v8

          Mathematica EC eCQM Team added a comment -

          Please clarify the eCQM measure number your inquiry refers to. While the inquiry references CMS138, the content of this inquiry is not related to CMS138. Thank you.

          Mathematica EC eCQM Team added a comment - Please clarify the eCQM measure number your inquiry refers to. While the inquiry references CMS138, the content of this inquiry is not related to CMS138. Thank you.

          Mathematica EC eCQM Team added a comment -

          We continue to investigate the issue noted in your ticket and will provide a response as soon as we are able. Thank you for your patience.

          Mathematica EC eCQM Team added a comment - We continue to investigate the issue noted in your ticket and will provide a response as soon as we are able. Thank you for your patience.

            edave Mathematica EC eCQM Team
            vinaykumarp Vinay (Inactive)
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