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  2. CQM-4829

Update exclusion timing to align with measure language and intent

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    • EP/EC eCQMs
    • Status: Open
    • Moderate
    • Resolution: Unresolved
    • None

    Description

      Brief Description of Measure:

      CMS56: Functional Status Assessment for Total Hip Replacement

      Percentage of patients 18 years of age and older who received an elective primary total hip arthroplasty (THA) and completed a functional status assessment within 90 days prior to the surgery and in the 270-365 days after the surgery

      CMS66: Functional Status Assessment for Total Knee Replacement

      Percentage of patients 18 years of age and older who received an elective primary total knee arthroplasty (TKA) and completed a functional status assessment within 90 days prior to the surgery and in the 270-365 days after the surgery

      Description of Issue:
      ​Currently, there is a mismatch between the narrative for the denominator exclusion for lower body fractures and the CQL logic, as the CQL logic does not carry the indicated timing constraint within the header.

      The header reads as this:
      Exclude patients with two or more fractures indicating trauma at the time of the total hip arthroplasty.....

      Proposed Solution:

      We propose correcting the logic to align with the header. The proposed solution is below:

      Current logic:
      Has Total Hip Arthroplasty with 2 or More Lower Body Fractures
      exists ( "Total Hip Arthroplasty Procedure" THAProcedure
      where Count(["Diagnosis": "Fracture - Lower Body"] LowerBodyFracture
      where LowerBodyFracture.prevalencePeriod starts less than 1 day on or before start of THAProcedure.relevantPeriod )>= 2 )

      Proposed logic:
      Has Total Hip Arthroplasty with 2 or More Lower Body Fractures
      exists ( "Total Hip Arthroplasty Procedure" THAProcedure
      where Count(["Diagnosis": "Fracture - Lower Body"] LowerBodyFracture
      where LowerBodyFracture.prevalencePeriod starts same day as start of Global."NormalizeInterval"(THAProcedure.relevantDatetime, THAProcedure.relevantPeriod) )>= 2)

      Rationale for Change:

      ​We are revising the CQL logic in order to align with the measure intent.

       

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            khancock Mathematica EC eCQM Team
            khancock Mathematica EC eCQM Team
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            Dates

              Created:
              Updated: