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  2. CQM-4858

CMS 056 "Less than one day on or before"

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      Thank you for your question about the denominator exclusions for CMS56v10. The intent is to exclude lower body fractures that are on the same day (within 24 hours) of the operation to avoid including operations due to trauma. The way the current logic is specified is that it will not allow for the lower body fractures that occur exactly 24 hours before the THA procedure to be excluded. In your example, the lower body fracture will need to occur a minute after 12:00 AM to be considered for the denominator exclusions. We are currently investigating the issue and will propose a solution during this upcoming annual update.
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      Thank you for your question about the denominator exclusions for CMS56v10. The intent is to exclude lower body fractures that are on the same day (within 24 hours) of the operation to avoid including operations due to trauma. The way the current logic is specified is that it will not allow for the lower body fractures that occur exactly 24 hours before the THA procedure to be excluded. In your example, the lower body fracture will need to occur a minute after 12:00 AM to be considered for the denominator exclusions. We are currently investigating the issue and will propose a solution during this upcoming annual update.
    • CMS0056v10
    • Not sure how to write measure logic

      Hi, I have a question about how we should treat DENEX in 056.

      We're looking at the lower body fracture workflow and the logic is this:

      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
      )

      The less than 1 day is the issue here. The lower body fracture date is

      2020-11-18 00:00:00.000

      and the time of the THA procedure is 

      2020-11-19 00:00:00.000

      Because this is exactly one day, the logic would say we wouldn't include it.
      BUT since it wasn't done at exactly midnight, this is more of a question if we need to include a time for the logic

      But then again, the description of the measure is this:
      Exclude patients with two or more fractures indicating trauma at the time of the total hip arthroplasty

      So that might be right, if the hip fractures actually happened the day before the hip arthroplasty, then we shouldn't count it?

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