Please clarify differences between "Diagnosis, Active", "Diagnosis, Inactive", and "Diagnosis, Resolved"

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: Measure
    • None
    • Tamara Bailey
    • 520.750.4324
    • Midas+
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      Quality measures include criteria for diagnoses that are active, inactive, or resolved.
       
      An active diagnosis is one currently present in the patient (e.g. current pneumonia).
      An inactive diagnosis is one that is currently quiescent in the patient but not resolved (e.g. lupus during a remission).
      A resolved diagnosis is one that is no longer present in the patient (e.g. pneumonia in the past that has been cured).

      There is no implied state transition from active to inactive or resolved. For a diagnosis to be marked as 'resolved' or 'inactive' requires explicit action by the provider.
       
      The Diagnosis Active template requires a start (effectiveTime/low) and stop (effectiveTime/high) time. If the condition is still active, the effectiveTime/high would be NULL.
      Where there is a criterion asking if a diagnosis was active in the past, even though that diagnosis may not currently be active, the QRDA would include the diagnosis active template with a stop time.
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      Quality measures include criteria for diagnoses that are active, inactive, or resolved.   An active diagnosis is one currently present in the patient (e.g. current pneumonia). An inactive diagnosis is one that is currently quiescent in the patient but not resolved (e.g. lupus during a remission). A resolved diagnosis is one that is no longer present in the patient (e.g. pneumonia in the past that has been cured). There is no implied state transition from active to inactive or resolved. For a diagnosis to be marked as 'resolved' or 'inactive' requires explicit action by the provider.   The Diagnosis Active template requires a start (effectiveTime/low) and stop (effectiveTime/high) time. If the condition is still active, the effectiveTime/high would be NULL. Where there is a criterion asking if a diagnosis was active in the past, even though that diagnosis may not currently be active, the QRDA would include the diagnosis active template with a stop time.
    • CMS113v1/NQF0469, CMS188v1/NQF0147

      Could someone please clarify what exactly would be the difference between a "Diagnosis, Active" that has a "stop datetime", and a "Diagnosis, Inactive" and a "Diagnosis, Resolved"?

      In the April specifications for PC01, new logic checks have been added for "Diagnosis, Resolved: Perforation of Uterus" etc., PN6 has a logic check for "Diagnosis, Inactive: Cystic Fibrosis" and several measures have checks for "Diagnosis, Active" with the condition that it doesn't end before the encounter starts???

            Assignee:
            Saul Kravitz (Inactive)
            Reporter:
            Tamara Bailey (Inactive)
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              Created:
              Updated:
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