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  2. CQM-3427

CMS160v7 Denominator Exclusion 2 for Population Criteria 2

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      Thank you for your question. Since you are asking about Palliative Care Orders, as opposed to Palliative Care Encounters, all of the patients in the four examples would be excluded from the denominator. This is because all scenarios have orders that take place before the end of August. For this period, logic of the measure does not specify that a palliative care order has to take place during May-August, only that it needs to take place before the end of August. Because this is an order as opposed to an encounter (palliative care given), we only use the start time to determine the time of the order and there is no need for an interval.

      If you meant a Palliative Care Encounter, then Patients 1, 2, and 4 would count as denominator exclusions, but Patient 3 would not, since a care encounter would need to overlap with the time period in question (May-August, in this case).
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      Thank you for your question. Since you are asking about Palliative Care Orders, as opposed to Palliative Care Encounters, all of the patients in the four examples would be excluded from the denominator. This is because all scenarios have orders that take place before the end of August. For this period, logic of the measure does not specify that a palliative care order has to take place during May-August, only that it needs to take place before the end of August. Because this is an order as opposed to an encounter (palliative care given), we only use the start time to determine the time of the order and there is no need for an interval. If you meant a Palliative Care Encounter, then Patients 1, 2, and 4 would count as denominator exclusions, but Patient 3 would not, since a care encounter would need to overlap with the time period in question (May-August, in this case).
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      We have a query regarding Denominator Exclusion 2 for Population Criteria 2 of CMS160v7:

      Denominator Exclusion 2
      o exists ( "Palliative Care Order Before End of August" )
      o or exists ( "Encounter Palliative Care Overlaps May through August" )
      o or exists ( "Long Term Care Overlaps May through August" )
      o or exists ( "Expired in May through August" )
      o or exists ( "Disorder Diagnoses Overlaps Depression Encounter in May through August" )

      Definitions:

      Palliative Care Order Before End of August
      o ["Intervention, Order": "Palliative Care"] OrderedPalliativeCare
      o where OrderedPalliativeCare.authorDatetime before end of "May through August of Measurement Period"

      May through August of Measurement Period
      o Interval[start of "Measurement Period" + 4 months, start of "Measurement Period" + 8 months )

      Patient 1,2,3&4 satisfies IPP and measurement period is “01/01/2019 00:00:00 – 12/31/2019 23:59:59”

      Patientid: 1
      Intervention start date (Pallative Care):8/31/2019 23:59:59
      Intervention end date(Pallative Care):9/1/2019 00:00:00

      Patientid: 2
      Intervention start date(Pallative Care):8/31/2019 00:00:00
      Intervention end date(Pallative Care):9/1/2019 00:00:00

      Patientid: 3
      Intervention start date(Pallative Care):1/1/2019 00:00:00
      Intervention end date(Pallative Care):1/5/2019 00:00:00

      Patientid: 4
      Intervention start date(Pallative Care):8/30/2019 23:59:59
      Intervention end date(Pallative Care):9/1/2019 00:00:00

      Please confirm which patient(s) will qualify for denominator exclusion

            edave Mathematica EC eCQM Team
            vinaykumarp Vinay (Inactive)
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