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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

            edave Mathematica EC eCQM Team
            vinaykumarp Vinay (Inactive)
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