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  1. eCQM Issue Tracker
  2. CQM-3497

CMS154v7 Denominator Exclusion Query

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    • Thank you for your inquiry and for calling this to our attention. The source you should use for developing and calculating measures in your system is the eCQM logic.
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    • Appropriate Treatment for Children with Upper Respiratory Infection (URI)

      Hi Team,

      We have a query regarding Denominator Exclusion criteria for CMS154v7:

      *Denominator Exclusions *
      "In Hospice"
      union "URI Encounter with Antibiotics Active 30 Days Prior"
      union "Has Competing Diagnosis for Upper Respiratory Infection"

      Definitions:
      URI Encounter with Antibiotics Active 30 Days Prior
      "Encounter with Upper Respiratory Infection" EncounterWithURI
      with ["Medication, Active": "Antibiotic Medications for Pharyngitis"] ActiveAntibiotic
      such that ActiveAntibiotic.relevantPeriod overlaps Interval[Global."ToDate"((start of EncounterWithURI.URI.prevalencePeriod)- 30 days), Global."ToDate"(start of EncounterWithURI.URI.prevalencePeriod))
      return EncounterWithURI.ValidEncounter

      The flow chart released on eCQI website post addendum has a statement which is not in sync with the measure specification released.

      There is one condition in flowchart where it states "Medication, Active": "Antibiotic Medications for Pharyngitis" Overlap starts <= 30 days and >= 1 day before the start of qualifying encounter performed which not the case in HTML.

      The >=1 day logic is not present in the measure specification but present in the flowchart released on eCQI website, kindly confirm which validation should be used to develop the measure

            edave Mathematica EC eCQM Team
            vinaykumarp Vinay (Inactive)
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