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  2. CQM-4117

CMS134v9: Effective date value for QDM datatype-"Laboratory Test, Performed"

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      Thank you for your inquiry and for bringing this issue to our attention. CMS134v9 (Diabetes: Medical Attention for Nephropathy) utilizes relevantPeriod for the "Laboratory Test, Performed: Urine Protein Tests", which requires a start and stop time. This is consistent with the guidance included on page 40 of the QDM manual, Version 5.5 (https://ecqi.healthit.gov/sites/default/files/QDM-v5.5-Guidance-Update-May-2020-508.pdf), for 24-hour urine collection to measure creatinine clearance.

      "Initiation of a 24-hour urine collection for measured creatinine clearance until completion of the 24-hour urine collection – use relevantPeriod to reference the start to stop time for this event."

      CMS129v10, on the other hand, utilizes relevantDatetime for the "Laboratory Test, Performed": "Gleason score in Specimen Qualitative", which corresponds to a single timepoint.

      After evaluating feedback, for the upcoming Annual Update, we will be changing relevantPeriod to relevantDatetime, as it seems most people only record one date and time. For 2021 reporting, if your system only captures a single point in time, one option is to map the single point in time to both the low and high values.







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      Thank you for your inquiry and for bringing this issue to our attention. CMS134v9 (Diabetes: Medical Attention for Nephropathy) utilizes relevantPeriod for the "Laboratory Test, Performed: Urine Protein Tests", which requires a start and stop time. This is consistent with the guidance included on page 40 of the QDM manual, Version 5.5 ( https://ecqi.healthit.gov/sites/default/files/QDM-v5.5-Guidance-Update-May-2020-508.pdf), for 24-hour urine collection to measure creatinine clearance. "Initiation of a 24-hour urine collection for measured creatinine clearance until completion of the 24-hour urine collection – use relevantPeriod to reference the start to stop time for this event." CMS129v10, on the other hand, utilizes relevantDatetime for the "Laboratory Test, Performed": "Gleason score in Specimen Qualitative", which corresponds to a single timepoint. After evaluating feedback, for the upcoming Annual Update, we will be changing relevantPeriod to relevantDatetime, as it seems most people only record one date and time. For 2021 reporting, if your system only captures a single point in time, one option is to map the single point in time to both the low and high values.

      We have realised that for QDM datatype- "Laboratory Test, Performed", for measure CMS134v9 "effectiveTime" is expecting LOW and HIGH values. Whereas, in case of other measures, example CMS129v10, only "effectiveTime" value is expected. Because of this discrepancies, CMS134v10 is failing.
      Help us understand if this an expected behaviour?
      I have attached QRDA files of sample patients with template names "1 Cancer Male" and "A Diabetes Adult" for measures CMS129v10 and CMS134v9 respectively.

      Request you to help us with this query at your earliest as urgent client deliverables are dependent on it.

      Please find below details:

      1. CMS134v10
      <entry>
      <observation classCode="OBS" moodCode="EVN" >
      <!-- Laboratory Test Performed (V4) -->
      <templateId root="2.16.840.1.113883.10.20.24.3.38" extension="2019-12-01"/>
      <id root="1.3.6.1.4.1.115" extension="5f5b75dd6362390480c10b9b"/>
      <code code="1754-1" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
      <text>Urine Protein Tests</text>
      <statusCode code="completed"/>
      <effectiveTime>
      <low value='20190226140000'/>
      <high value='20190226140000'/>
      </effectiveTime>
      <!-- QDM Attribute: Result -->
      <entryRelationship typeCode="REFR">
      <observation classCode="OBS" moodCode="EVN">
      <!-- Conforms to C-CDA R2 Result Observation (V2) -->
      <templateId root="2.16.840.1.113883.10.20.22.4.2" extension="2015-08-01"/>
      <!-- Conforms Result (V4) -->
      <templateId root="2.16.840.1.113883.10.20.24.3.87" extension="2019-12-01"/>
      <id root="1.3.6.1.4.1.115" extension="4977a960-d65d-0138-7618-000c290977d4"/>
      <code code="1754-1" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
      <statusCode code="completed"/>
      <effectiveTime value='20190226140000'/>
      <value xsi:type="PQ" value="0.2" unit="ug/mL"/>
      </observation>
      </entryRelationship>

      </observation>
      </entry>


      2. CMS129v10

      <entry>
      <observation classCode="OBS" moodCode="EVN" >
      <!-- Laboratory Test Performed (V4) -->
      <templateId root="2.16.840.1.113883.10.20.24.3.38" extension="2019-12-01"/>
      <id root="1.3.6.1.4.1.115" extension="5f5b75fa6362390480c11608"/>
      <code code="35266-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
      <text>Gleason score in Specimen Qualitative</text>
      <statusCode code="completed"/>
      <effectiveTime value='20190205080000'/>
      <!-- QDM Attribute: Result -->
      <entryRelationship typeCode="REFR">
      <observation classCode="OBS" moodCode="EVN">
      <!-- Conforms to C-CDA R2 Result Observation (V2) -->
      <templateId root="2.16.840.1.113883.10.20.22.4.2" extension="2015-08-01"/>
      <!-- Conforms Result (V4) -->
      <templateId root="2.16.840.1.113883.10.20.24.3.87" extension="2019-12-01"/>
      <id root="1.3.6.1.4.1.115" extension="53cfb990-d65d-0138-7618-000c290977d4"/>
      <code code="35266-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
      <statusCode code="completed"/>
      <effectiveTime value='20190205080000'/>
      <value xsi:type="PQ" value="5.0" unit="1"/>
      </observation>
      </entryRelationship>

      </observation>
      </entry>

        1. CMS129_Joe_Wade.xml
          24 kB
          Aditi Waje
        2. CMS134v9_Velma_Austin.xml
          15 kB
          Aditi Waje

            edave Mathematica EC eCQM Team
            aditiw Aditi Waje
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