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  2. CQM-5440

CMS1028v1-Validation Queries

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      ​​Thank you for your question about CMS1028v1/PC-07.

      Query #1: All 3 will qualify for the IP as the delivery procedure is during the hospitalization.

      Query #2: If the patient expires any time during the hospitalization (including ED or OBS) the patient will be in the numerator. So if the patient expires in ED, Observation or IP, the patient will be in the numerator as long as the conditions are met for the hospitalization encounter. The HospitalizationWithEDOBTriageObservation function returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter. The ED visit must end within one hour of the start of the OBS/IP visit. The OBS visit must end within one hour of the start of the IP visit.

      Query #3: The patient will meet the denominator exclusions if the patient has a COVID diagnosis any time during the hospitalization (including ED or OBS) AND either a respiratory condition related to COVID OR a respiratory support procedure related to COVID.

      Hope this helps.

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      ​​Thank you for your question about CMS1028v1/PC-07. Query #1: All 3 will qualify for the IP as the delivery procedure is during the hospitalization. Query #2: If the patient expires any time during the hospitalization (including ED or OBS) the patient will be in the numerator. So if the patient expires in ED, Observation or IP, the patient will be in the numerator as long as the conditions are met for the hospitalization encounter. The HospitalizationWithEDOBTriageObservation function returns the total interval from the start of any immediately prior emergency department visit or OB Triage visit through the observation visit to the discharge of the given encounter. The ED visit must end within one hour of the start of the OBS/IP visit. The OBS visit must end within one hour of the start of the IP visit. Query #3: The patient will meet the denominator exclusions if the patient has a COVID diagnosis any time during the hospitalization (including ED or OBS) AND either a respiratory condition related to COVID OR a respiratory support procedure related to COVID. Hope this helps.
    • CMS1028v1

      Hi Team,

      Consider statements below from CMS1028v1:

      PCMaternal.Delivery Encounter with Age Range :
      "Encounter with Age Range" EncounterWithAge
        with ["Procedure, Performed": "Delivery Procedures"] DeliveryProcedure
          such that Global."NormalizeInterval" ( DeliveryProcedure.relevantDatetime, DeliveryProcedure.relevantPeriod ) starts during day of "HospitalizationWithEDOBTriageObservation"(EncounterWithAge)

       

      Scenario 1:

      Patient A aged 21 years with

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

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

      having delivery procedure documented on 5/10/2023 9:00 

       

      Scenario 2:

      Patient B aged 30 years with

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

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

      having delivery procedure documented on 5/16/2023 10:00

       

      Scenario 3:

      Patient C aged 28 years with

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

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

      having delivery procedure documented on 5/14/2023 10:00

       

      Query #1 :

      From the above scenarios and statements , Please help us understand which of the above three patients will qualify for IPP ?

       

      Delivery Encounters with Expiration :
      "Delivery Encounters At Greater than or Equal to  Weeks Gestation" TwentyWeeksPlusEncounter

      where TwentyWeeksPlusEncounter.dischargeDisposition in "Patient Expired"

       

      Query #2 :

      As per the above statement please help us understand what will be the validation for "Patient Expired", is it during hospitalization (i.e Obs-IP, EDObs-IP,ED-IP,only IP) or during IP encounter ?

      If it is during hospitalization then what will be the location of the patient (eg :in case of ED-IP will it be ED or IP)

       

       Delivery Encounters with COVID and Respiratory Condition or Procedure :
      "Delivery Encounters At Greater than or Equal to 20 Weeks Gestation" TwentyWeeksPlusEncounter
        where exists ( TwentyWeeksPlusEncounter.diagnoses EncounterDiagnoses
            where EncounterDiagnoses.code in "COVID 19 Confirmed"

       

      Query #3 :

      As per the above statement please help us understand what will be the validation for "COVID 19 Confirmed", is it during hospitalization (i.e Obs-IP, EDObs-IP,ED-IP,only IP) or during IP encounter ?

       

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

            JLeflore Joelencia Leflore
            GayatriK4 gayatri kulkarni (Inactive)
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