Uploaded image for project: 'eCQM Issue Tracker'
  1. eCQM Issue Tracker
  2. CQM-3476

CMS68v8 Numerator Query

XMLWordPrintable

    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Done
    • Icon: Major Major
    • Measure
    • Hide
      Thank you for your inquiry. In order to meet the intent of the measure, the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available during each eligible encounter. For successful reporting and to receive credit for this measure, the medication list must be documented after the start date and time of each eligible encounter and before the end date and time to meet numerator intent.

      Therefore the nurse visit (assuming it is not an eligible encounter) would not be included in the denominator. The physician visit (assuming it is an eligible encounter) would meet the denominator, but not pass the numerator since medications were not documented by the eligible professional during the eligible encounter.
      Show
      Thank you for your inquiry. In order to meet the intent of the measure, the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available during each eligible encounter. For successful reporting and to receive credit for this measure, the medication list must be documented after the start date and time of each eligible encounter and before the end date and time to meet numerator intent. Therefore the nurse visit (assuming it is not an eligible encounter) would not be included in the denominator. The physician visit (assuming it is an eligible encounter) would meet the denominator, but not pass the numerator since medications were not documented by the eligible professional during the eligible encounter.
    • EP

      Hi Team,

      We have query regarding numerator validation for CMS68v8

      *Numerator *
      "Medications Documented During Qualifying Encounter"

      Definition:

      +Medications Documented During Qualifying Encounter +
      "Qualifying Encounters During Measurement Period" QualifyingEncounterDuringMeasurementPeriod with ["Procedure, Performed": "Documentation of current medications (procedure)"] MedicationsDocumented such that MedicationsDocumented.relevantPeriod during QualifyingEncounterDuringMeasurementPeriod.relevantPeriod

      +Qualifying Encounters During Measurement Period +
      ["Encounter, Performed": "Medications Encounter Code Set"] QualifyingEncounter
      where QualifyingEncounter.relevantPeriod during "Measurement Period"

      We have a scenario which is given below:

      Scenario 1:
      Patient 1 has a Nurse visit on 01/16/19 between 14:00:00 - 15:00:00 and documentation of current medication was done by the nurse (procedure code 428191000124101) during the visit

      Same patient 1 has a physician visit on the same day i.e., 01/16/19 at 16:00:00 - 17:00:00 and during this visit "documentation of current medication was NOT DONE by the physician (procedure code 428191000124101)" during the physician visit as documentation of current medication was already done by the nurse on the same day of the encounter.

      Query:
      1. Even though documentation of current medication was not done during the recent physician visit will the patient still qualify for the numerator? If Yes, then in that case we have to consider the entire day of the encounter and look whether the documentation of medication was done once during the entire day of the encounter and qualify the patient for Numerator.

      OR

      2. The patient will qualify only if documentation of current medication is done during his recent visit i.e., physician visit in this case else will not qualify. And we have to check that documentation of current medication is done between the start date time and end date time of the eligible encounter ONLY i.e, during physician visit in this case

      Request you to provide response for both

            edave Mathematica EC eCQM Team
            vinaykumarp Vinay (Inactive)
            Votes:
            0 Vote for this issue
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved:
              Solution Posted On: