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  2. CQM-5379

CMS871v2- Exclusion Query

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      ​Thank you for your inquiries. We preface the answers to your questions by describing how the “Encounter With First Blood Glucose Greater Than or Equal to 1000” logic evaluates the data to determine if it meets the denominator exclusion criteria:

      1. Is there a blood glucose result >1000 mg/dL during the interval of 1 hour prior to the encounter start and 6 hours after the encounter start?
      a. For Scenario 1: the interval is: on or between 4/11/23 8:00am and 3:00pm
      b. For Scenario 2: the interval is: on or between 5/10 8:00am and 3:00pm
      2. Is the blood glucose result >1000 mg/dL?
      3. Is the blood glucose result of >1000 mg/dL the first blood glucose level documented in that interval?

      Since the answer to all of the above questions is Yes for Scenario 1, the Patient A encounter meets the criteria for exclusion.

      Since the answer to #3 above is No for Scenario 2, the Patient B encounter does not meet the criteria for exclusion. Although there is a documented blood glucose result of >1000 mg/dL during the specified interval, it is preceded in the interval by a blood glucose result that is <1000 mg/dL (400 mg/dL). The >1000 mg/dL result must also be the first result in the interval to meet the exclusion criteria.
      Show
      ​Thank you for your inquiries. We preface the answers to your questions by describing how the “Encounter With First Blood Glucose Greater Than or Equal to 1000” logic evaluates the data to determine if it meets the denominator exclusion criteria: 1. Is there a blood glucose result >1000 mg/dL during the interval of 1 hour prior to the encounter start and 6 hours after the encounter start? a. For Scenario 1: the interval is: on or between 4/11/23 8:00am and 3:00pm b. For Scenario 2: the interval is: on or between 5/10 8:00am and 3:00pm 2. Is the blood glucose result >1000 mg/dL? 3. Is the blood glucose result of >1000 mg/dL the first blood glucose level documented in that interval? Since the answer to all of the above questions is Yes for Scenario 1, the Patient A encounter meets the criteria for exclusion. Since the answer to #3 above is No for Scenario 2, the Patient B encounter does not meet the criteria for exclusion. Although there is a documented blood glucose result of >1000 mg/dL during the specified interval, it is preceded in the interval by a blood glucose result that is <1000 mg/dL (400 mg/dL). The >1000 mg/dL result must also be the first result in the interval to meet the exclusion criteria.
    • CMS0871v2

      Hi Team,

      We have a query regarding denominator exclusion criteria wrt to the CMS8712v2 measure :

      Consider below section from the measure:

      Encounter With First Blood Glucose Greater Than or Equal to 1000

      "Qualifying Encounter" InpatientHospitalization

      with "First Blood Glucose Within 1 Hour Prior To and 6 Hours After Encounter Start" FirstGlucoseResult such that FirstGlucoseResult.result >= 1000 'mg/dL'

       

      First(["Laboratory Test, Performed": "Glucose Lab Test Mass Per Volume"] FirstBloodGlucose

      with("Qualifying Encounter")InpatientEncounter

      such that FirstBloodGlucose.relevantDatetime during Interval[(start of Global."HospitalizationWithObservation"(InpatientEncounter)- 1 hour),(start of Global."HospitalizationWithObservation"(InpatientEncounter)+ 6 hours)]

      sort by relevantDatetime

      )

       

      Scenario 1:

      Patient A aged 20 years with

      Start of InpatientEncounter.relevantPeriod = 4/11/2023 9:00

      End of InpatientEncounter.relevantPeriod = 4/16/2023 10:00

      having first Glucose Lab Test Mass Per Volume documented on 4/11/2023 8:00 with value 1100 mg/dL

      and second on 4/11/2023 11:00 with value 500 mg/dL

       

      Scenario 2:

      Patient B aged 21 years with

      Start of InpatientEncounter.relevantPeriod = 5/10/2023 9:00

      End of InpatientEncounter.relevantPeriod = 5/16/2023 10:00

      having first Glucose Lab Test Mass Per Volume documented on 5/10/2023 8:00 with value 400 mg/dL

      and second on 5/10/2023 11:00 with value 1200 mg/dL

       

      #Query  :

      From the above two scenarios and attached image , Please help us understand which of the above 2 patients will be excluded ?

       

      Kindly assist us on the above queries urgently as client deliverables are dependent upon it.

        1. cms871v2_testcase_scenario.PNG
          cms871v2_testcase_scenario.PNG
          12 kB

            JLeflore Mathematica EH eCQM Team
            GayatriK4 gayatri kulkarni
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