Major Hi Team,
We have a query regarding Numerator condition of CMS69v7:
*Numerator *
"Has Normal BMI" is not null
or "Has High BMI with Follow Up"
or "Has Low BMI with Follow Up"
Definitions
Has High BMI with Follow Up
o Last(["Physical Exam, Performed": "Body mass index (BMI) [Ratio]"] LastBMI
with "High BMI Follow Up Encounters" HighBMIEncounter
such that LastBMI.relevantPeriod starts 12 months or less on or before end of HighBMIEncounter.relevantPeriod
sort by authorDatetime
).result >= 25 'kg/m2'
High BMI Follow Up Encounters
o "Qualifying Encounters During the Measurement Period" QualifyingEncounter
with ( ["Intervention, Order": "Above Normal Follow-up"]
union ( ["Intervention, Order": "Referrals where weight assessment may occur"] Referral
where Referral.reason in "Overweight or Obese"
)
union ["Medication, Order": "Above Normal Medications"] ) HighBMIInterventions
such that Coalesce(start of HighBMIInterventions.relevantPeriod, HighBMIInterventions.authorDatetime)12 months or less on or before end of QualifyingEncounter.relevantPeriod
Consider a patient with below scenario:
Measurement period: 01/01/2019 00:00:00 – 12/31/2019 23:59:59
Qualifying Encounter Office Visit: 1/1/2019 00:00:00 – 1/1/2019 08:00:00
Most Recent Physical Exam Performed BMI (High): 6/1/2018 00:00:00 – 6/1/2018 04:00:00
Start Date of Medication Order Follow Up for High BMI: 7/1/2018 00:00:00 - END DATE (NULL)
There is no end date on the Medication order because the patient is so overweight that the doctor wants to keep the patient on the medication indefinitely. As a result, the Medication Order Follow Up for High BMI: END DATE (IS NULL)… Meaning that the patient is still on the medication at the end of the reporting period. = 12/31/2019
Please confirm if the above patient will qualify for numerator or not. Also, is the end date on the medication is required for the numerator calculation of this measure?
If the end date of the medication is required, should we be using the last date of the attestation period (since the patient is still taking the medication)?