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  2. CQM-4836

CMS 69: What should the measure outcome be for a BMI result equal to 0

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    • Jeff
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      Thank you for your inquiry about CMS69v9: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The measure logic places all BMI measurements documented within 12 months of the current encounter in chronological order and then looks for the most recent BMI without a null value. In other words, it looks for a BMI with a numeric value. The logic looks at a null value (no value documented) as a BMI not being present.

       

      The measure then determines the range within which the most recent documented BMI falls to evaluate whether the numerator criteria are met. If the most recent BMI documented has a value less than 18.5 kg/m2 then a low BMI follow-up must be documented or ordered to meet the numerator. This is true regardless of how low (below 18.5 kg/m2) the BMI is. If there is not a low BMI follow-up documented or ordered for a most recent BMI that is less than 18.5 kg/m2, even if it is as low as 0 kg/m2, the case will not meet the numerator requirements.

       

      The measure logic definitions that address low BMI are included below. Note the last line for each logic definition that states where most recent BMI result is less than 18.5 kg/m2. There is no lower boundary, so this will apply to any result that is less than 18.5 kg/m2.

       

      Low BMI and Follow Up Provided

      "Most Recent Documented BMI" MostRecentBMI

        with ["Intervention, Performed": "Follow Up for Below Normal BMI"] BelowNormalFollowUp

          such that MostRecentBMI.relevantDatetime 12 months or less on or before day of start of BelowNormalFollowUp.relevantPeriod

            and BelowNormalFollowUp.reason ~ "Underweight (finding)"

        where MostRecentBMI.result < 18.5 'kg/m2'

       

      Low BMI and Order for Follow Up

      "Most Recent Documented BMI" MostRecentBMI

        with ( ( ( ["Intervention, Order": "Follow Up for Below Normal BMI"]

            union ["Intervention, Order": "Referrals Where Weight Assessment May Occur"] ) ReferralLowBMI

            where ReferralLowBMI.reason ~ "Underweight (finding)"

        )

          union ["Medication, Order": "Medications for Below Normal BMI"] ) LowBMIIntervention

          such that MostRecentBMI.relevantDatetime 12 months or less on or before day of LowBMIIntervention.authorDatetime

        where MostRecentBMI.result < 18.5 'kg/m2'

      Show
      Thank you for your inquiry about CMS69v9: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The measure logic places all BMI measurements documented within 12 months of the current encounter in chronological order and then looks for the most recent BMI without a null value. In other words, it looks for a BMI with a numeric value. The logic looks at a null value (no value documented) as a BMI not being present.   The measure then determines the range within which the most recent documented BMI falls to evaluate whether the numerator criteria are met. If the most recent BMI documented has a value less than 18.5 kg/m2 then a low BMI follow-up must be documented or ordered to meet the numerator. This is true regardless of how low (below 18.5 kg/m2) the BMI is. If there is not a low BMI follow-up documented or ordered for a most recent BMI that is less than 18.5 kg/m2, even if it is as low as 0 kg/m2, the case will not meet the numerator requirements.   The measure logic definitions that address low BMI are included below. Note the last line for each logic definition that states where most recent BMI result is less than 18.5 kg/m2. There is no lower boundary, so this will apply to any result that is less than 18.5 kg/m2.   Low BMI and Follow Up Provided "Most Recent Documented BMI" MostRecentBMI   with ["Intervention, Performed": "Follow Up for Below Normal BMI"] BelowNormalFollowUp     such that MostRecentBMI.relevantDatetime 12 months or less on or before day of start of BelowNormalFollowUp.relevantPeriod       and BelowNormalFollowUp.reason ~ "Underweight (finding)"   where MostRecentBMI.result < 18.5 'kg/m2'   Low BMI and Order for Follow Up "Most Recent Documented BMI" MostRecentBMI   with ( ( ( ["Intervention, Order": "Follow Up for Below Normal BMI"]       union ["Intervention, Order": "Referrals Where Weight Assessment May Occur"] ) ReferralLowBMI       where ReferralLowBMI.reason ~ "Underweight (finding)"   )     union ["Medication, Order": "Medications for Below Normal BMI"] ) LowBMIIntervention     such that MostRecentBMI.relevantDatetime 12 months or less on or before day of LowBMIIntervention.authorDatetime   where MostRecentBMI.result < 18.5 'kg/m2'
    • CMS0069v10
    • CMS69v9/NQFna
    • Measure outcomes for CMS 69

      What should the outcome be for a BMI result that's equal to 0 (Height or Weight not measured)?  There isn’t any logic for this scenario (only the guidance statement below ).  Should this fall under a low BMI that is < 18.5 or be thrown out as not meeting the numerator?

      “Height and Weight – An EC or their staff is required to measure both height and weight.  Both height and weight must be measured within 12 months of the current encounter and may be obtained from separate encounters.  Self-reported values cannot be used.”

            edave Mathematica EC eCQM Team
            jjCerner Jeff Jennings
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