CMS154v7 Denominator Exclusion Query

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Done
    • Priority: Major
    • Component/s: Inbox
    • 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.
    • EP
    • 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

            Assignee:
            Mathematica EC eCQM Team (Inactive)
            Reporter:
            Vinay (Inactive)
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              Created:
              Updated:
              Resolved:
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