Brief Description of Measure:

​CMS69: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan:
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or within the previous twelve months AND who had a follow-up plan documented if most recent BMI was outside of normal parameters

Description of Issue:

​The definition statements for "High BMI and Follow up Provided," "High BMI and Order for Follow up," "Low BMI and Follow up Provided," and "Low BMI and Order for Follow up" were revised in the 2022 version of the measure (v10) to include the normalize interval function within logic, allowing flexibility for when data may capture either an interval of time or a single point in time.
 
At that time 'ends' was added to the timing. However, 'ends' was inadvertently omitted from the "Low BMI and Order for Follow up" definition. Although testing reveals that the logic is working as intended even though the timing does not include 'ends' in the clause, for consistency the measure developer plans to align the timing of this definition with the others and add 'ends' to the timing operator.

Proposed Solution:

Current Definition:
"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 Global."NormalizeInterval" ( MostRecentBMI.relevantDatetime, MostRecentBMI.relevantPeriod ) 12 months or less on or before day of LowBMIIntervention.authorDatetime
  where MostRecentBMI.result < 18.5 'kg/m2'

Proposed Definition:
"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 Global."NormalizeInterval" ( MostRecentBMI.relevantDatetime, MostRecentBMI.relevantPeriod ) ends 12 months or less on or before day of LowBMIIntervention.authorDatetime
  where MostRecentBMI.result < 18.5 'kg/m2'

Rationale for Change:

While the logic is currently working as intended, the addition of "ends" to the "Low BMI and Order for Follow up" definition" will create consistency within the logic.