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  2. CQM-5415

CMS871v2- Blood Glucose Lab Query

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    • Resolution: Answered
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      ​​Thank you for your questions. Please see responses based on your scenarios.

      Query Response 1:
      Based on the information you provided, this case would not meet the Initial Population (IP), since the lab test result is outside of the inpatient encounter. However, please note that the timing logic used in both ‘Encounter With Elevated Blood Glucose’ and ‘Encounter With First Blood Glucose Greater Than or Equal to 1000’ does not limit the blood glucose results to the inpatient encounter but is inclusive of time spent in the ED and/or Observation encounters, so long as the transitions between each encounter is equal to 1 hour or less, it will be included in the hospitalization timeframe. Therefore, if your scenario did include an ED encounter and the end of the ED encounter is within 1 hour or less of the Inpatient encounter start, then the case would be included in the IP and would meet Denominator Exclusion criteria.

      Query Response 2:
      Thank you for your inquiry. No, this case does not meet the Denominator Exclusion because the blood glucose result of 1000 mg/dL was not the first result during this hospitalization. The definition, “Encounter With First Blood Glucose Greater Than or Equal to 1000”, looks for the first blood glucose result during the hospitalization and then evaluates if the result is equal to or greater than 1000 in order to be excluded.
      Show
      ​​Thank you for your questions. Please see responses based on your scenarios. Query Response 1: Based on the information you provided, this case would not meet the Initial Population (IP), since the lab test result is outside of the inpatient encounter. However, please note that the timing logic used in both ‘Encounter With Elevated Blood Glucose’ and ‘Encounter With First Blood Glucose Greater Than or Equal to 1000’ does not limit the blood glucose results to the inpatient encounter but is inclusive of time spent in the ED and/or Observation encounters, so long as the transitions between each encounter is equal to 1 hour or less, it will be included in the hospitalization timeframe. Therefore, if your scenario did include an ED encounter and the end of the ED encounter is within 1 hour or less of the Inpatient encounter start, then the case would be included in the IP and would meet Denominator Exclusion criteria. Query Response 2: Thank you for your inquiry. No, this case does not meet the Denominator Exclusion because the blood glucose result of 1000 mg/dL was not the first result during this hospitalization. The definition, “Encounter With First Blood Glucose Greater Than or Equal to 1000”, looks for the first blood glucose result during the hospitalization and then evaluates if the result is equal to or greater than 1000 in order to be excluded.
    • CMS0871v2

      Hi Team,

      We have a query regarding denominator exclusion criteria wrt to the CMS871v2 measure :

      Consider below sections from the measure:

      Encounter With Elevated Blood Glucose Lab :
      "Encounter With Hospitalization Period" Hospitalization
        with ["Laboratory Test, Performed": "Glucose Lab Test Mass Per Volume"] BloodGlucoseLab
          such that BloodGlucoseLab.relevantDatetime during Hospitalization.hospitalizationPeriod
            and BloodGlucoseLab.result >= 200 'mg/dL'
        return Hospitalization.encounter

       

      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 = 2023-06-01 09:00:00.000

      End of InpatientEncounter.relevantPeriod = 2023-06-08 23:59:59.000

      having first Glucose Lab Test Mass Per Volume documented on 2023-06-01 08:00:00.000 with value 1000 mg/dL

       

      Scenario 2 :

      Patient B aged 21 years with

      Start of InpatientEncounter.relevantPeriod = 2023-06-01 09:00:00.000

      End of InpatientEncounter.relevantPeriod = 2023-06-08 23:59:59.000

      having Glucose Lab Test Mass Per Volume documented on 2023-06-01 09:00:00.000 with value 199 mg/dL and Glucose Lab Test Mass Per Volume documented on 2023-06-01 11:00:00.000 with value 1000 mg/dL

       

      #Query 1  :

      From the above scenario 1 and attached image , Please help us understand will the patient A qualify IPP and get excluded ?

       

      #Query 2 : 

      From the scenario 2 and attached image , Please help us understand will the patient B get excluded ?

       

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

        1. CMS871v2_img.png
          CMS871v2_img.png
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            JLeflore Mathematica EH eCQM Team
            GayatriK4 gayatri kulkarni
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