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  2. CQM-4776

Clarification on 2022 CMS 122 Palliative Care

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      ​Thank you for your questions regarding the Denominator Exclusions for CMS122v10, Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%).


      The requirement that a patient be 66 or older applies to logic corresponding to the Frailty and Long Term Care exclusions, but does not apply to the Palliative Care exclusion.


      Testing confirms that a patient must meet the 66 or older criteria in order to satisfy the Long Term Care and Frailty requirements. Conversely, the logic for the Palliative Care exclusion operates independent of this age constraint, and will return 'true' for any indication of palliative care regardless of patient age.


      It does appear that, when compared to other measures using this exclusion, the placement of the last closing parenthesis should come prior to the palliative care library call, not after. Thank you for bringing this to our attention; this will be reviewed in the upcoming maintenance cycle.
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      ​Thank you for your questions regarding the Denominator Exclusions for CMS122v10, Diabetes: Hemoglobin A1c (HbA1c) Poor Control (> 9%). The requirement that a patient be 66 or older applies to logic corresponding to the Frailty and Long Term Care exclusions, but does not apply to the Palliative Care exclusion. Testing confirms that a patient must meet the 66 or older criteria in order to satisfy the Long Term Care and Frailty requirements. Conversely, the logic for the Palliative Care exclusion operates independent of this age constraint, and will return 'true' for any indication of palliative care regardless of patient age. It does appear that, when compared to other measures using this exclusion, the placement of the last closing parenthesis should come prior to the palliative care library call, not after. Thank you for bringing this to our attention; this will be reviewed in the upcoming maintenance cycle.
    • CMS0122v10
    • Logic calculation for CMS 122

      The html human readable for CMS 122 has this for the Denominator exceptions when we look at the palliative care section:

      I would interpret this as the patient needing to be 65 or older and has palliative care in the measurement period

      But this is not consistent with the implementation for other measures. It also doesn't seem to be aligned with the summary for Denominator exceptions above

      This seems to indicate that the patient doesn't need to be 65 or older to qualify for denominator exceptions with palliative care.

      I would like clarification as to which one is correct.

      Thanks!

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            edave Mathematica EC eCQM Team
            Antonio rabaey Antonio Rabaey (Inactive)
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