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  2. CQM-5463

CMS e154v11Appropriate Treatment for Upper Respiratory Infection (URI) Discrepency between gray matter and logic on timing

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    • Resolution: Answered
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    • Jennifer Distefano
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      ​Thank you for your question on CMS154v11.

      The language in the header specifying the denominator exclusion for an active prescription of antibiotics reads the following: "Exclude URI episodes when the patient had an active prescription of antibiotics in the 30 days prior to the episode date but is still active the same day of the encounter."

      This is looking for an active prescription of antibiotics 30 days prior to the episode date, which is correctly specified in the logic. The second half of that exclusion criteria is still relevant because if that specified active prescription continues to be active through the date of the encounter, it still counts as an exclusion. In the logic, we meet this timing criteria using the overlaps operator.

      We will consider providing further clarifications in a future version of the measure.
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      ​Thank you for your question on CMS154v11. The language in the header specifying the denominator exclusion for an active prescription of antibiotics reads the following: "Exclude URI episodes when the patient had an active prescription of antibiotics in the 30 days prior to the episode date but is still active the same day of the encounter." This is looking for an active prescription of antibiotics 30 days prior to the episode date, which is correctly specified in the logic. The second half of that exclusion criteria is still relevant because if that specified active prescription continues to be active through the date of the encounter, it still counts as an exclusion. In the logic, we meet this timing criteria using the overlaps operator. We will consider providing further clarifications in a future version of the measure.
    • EP
    • CMS0154v11
    • Reporting discrepency: Denominator Exclusion gray matter is different than what is stated in the logic.

      The description for Denominator Exclusion and the CQL logic for the Denom Exclusion appear to read different.  

      Gray matter description:  reads to include the first day of the encounter 

      • Encounter with Upper Respiratory Infection and Antibiotics Active 30 Days Prior Or The First Day of the Encounter"

      CQL Logic - does not appear to include the first day of the encounter

      1. Encounter with Upper Respiratory Infection" EncounterWithURI
          with ["Medication, Active": "Antibiotic Medications for Pharyngitis"] ActiveAntibiotic
            such that ( Global."NormalizeInterval" ( ActiveAntibiotic.relevantDatetime, ActiveAntibiotic.relevantPeriod ) overlaps day of Interval[start of EncounterWithURI.relevantPeriod - 30 days, {*}start of EncounterWithURI.relevantPeriod - 1 day]{*})

       

            edave Mathematica EC eCQM Team
            jldistefano Jennifer Distefano (Inactive)
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