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  2. CQM-5596

CMS156v11_Same Drug Class Question

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      ​Thank you for your inquiry regarding CMS156v11-v2 (2023 Performance Period). For "Same High Risk Medications Ordered on Different Days", your first scenario would fail the criteria for Numerator and your second scenario would meet the criteria. Please see below expected performance according to Bonnie v5.1.2 (https://bonnie.healthit.gov/). Additional examples can be verified in Bonnie v5.1.2.

      If Measurement Period is 2023, Patient A would return false for "Same High Risk Medications Ordered on Different Days":
      Order 1 with RXNorm code 1490727 ("Pain medications, other") with author dateTime on 4/30/2023
      Order 2 with RXNorm code 1490727 ("Pain medications, other") with author dateTime on 4/30/2023
      Order 3 with RXNorm code 1088934 ("Pain medications, skeletal muscle relaxants") with author dateTime on 6/1/2023

      If Measurement Period is 2023, Patient B would return true for "Same High Risk Medications Ordered on Different Days":
      Order 1 with RXNorm code 1738495 ("Central nervous system, antidepressants") with author dateTime on 1/1/2023
      Order 2 with RXNorm code 1099304 ("Central nervous system, antidepressants") with author dateTime on 2/2/2023

      The measure looks for at least two orders of high-risk medications from the same drug class on different days. Medications using codes from the same value set are considered medications from the same drug class.
      - "Anticholinergics, first generation antihistamines"
      - "Anticholinergics, anti Parkinson agents"
      - "Antispasmodics"
      - "Antithrombotic"
      - "Cardiovascular, alpha agonists, central"
      - "Cardiovascular, other"
      - "Central nervous system, antidepressants"
      - "Central nervous system, barbiturates"
      - "Central nervous system, vasodilators"
      - "Central nervous system, other"
      - "Endocrine system, estrogens with or without progestins"
      - "Endocrine system, sulfonylureas, long duration"
      - "Endocrine system, other"
      - "Nonbenzodiazepine hypnotics"
      - "Pain medications, skeletal muscle relaxants"
      - "Pain medications, other"
      Show
      ​Thank you for your inquiry regarding CMS156v11-v2 (2023 Performance Period). For "Same High Risk Medications Ordered on Different Days", your first scenario would fail the criteria for Numerator and your second scenario would meet the criteria. Please see below expected performance according to Bonnie v5.1.2 ( https://bonnie.healthit.gov/ ). Additional examples can be verified in Bonnie v5.1.2. If Measurement Period is 2023, Patient A would return false for "Same High Risk Medications Ordered on Different Days": Order 1 with RXNorm code 1490727 ("Pain medications, other") with author dateTime on 4/30/2023 Order 2 with RXNorm code 1490727 ("Pain medications, other") with author dateTime on 4/30/2023 Order 3 with RXNorm code 1088934 ("Pain medications, skeletal muscle relaxants") with author dateTime on 6/1/2023 If Measurement Period is 2023, Patient B would return true for "Same High Risk Medications Ordered on Different Days": Order 1 with RXNorm code 1738495 ("Central nervous system, antidepressants") with author dateTime on 1/1/2023 Order 2 with RXNorm code 1099304 ("Central nervous system, antidepressants") with author dateTime on 2/2/2023 The measure looks for at least two orders of high-risk medications from the same drug class on different days. Medications using codes from the same value set are considered medications from the same drug class. - "Anticholinergics, first generation antihistamines" - "Anticholinergics, anti Parkinson agents" - "Antispasmodics" - "Antithrombotic" - "Cardiovascular, alpha agonists, central" - "Cardiovascular, other" - "Central nervous system, antidepressants" - "Central nervous system, barbiturates" - "Central nervous system, vasodilators" - "Central nervous system, other" - "Endocrine system, estrogens with or without progestins" - "Endocrine system, sulfonylureas, long duration" - "Endocrine system, other" - "Nonbenzodiazepine hypnotics" - "Pain medications, skeletal muscle relaxants" - "Pain medications, other"
    • CMS0156v11

      Hi Team,

      Consider the below statements :

      Same High Risk Medications Ordered on Different Days  

       "More Than One Order"(["Medication, Order": "Anticholinergics, first generation antihistamines"])  union "More Than One Order"(["Medication, Order": "Anticholinergics, anti Parkinson agents"])  union "More Than One Order"(["Medication, Order": "Antispasmodics"])  union "More Than One Order"(["Medication, Order": "Antithrombotic"])  union "More Than One Order"(["Medication, Order": "Cardiovascular, alpha agonists, central"])  union "More Than One Order"(["Medication, Order": "Cardiovascular, other"])  union "More Than One Order"(["Medication, Order": "Central nervous system, antidepressants"])  union "More Than One Order"(["Medication, Order": "Central nervous system, barbiturates"])  union "More Than One Order"(["Medication, Order": "Central nervous system, vasodilators"])  union "More Than One Order"(["Medication, Order": "Central nervous system, other"])  union "More Than One Order"(["Medication, Order": "Endocrine system, estrogens with or without progestins"])  union "More Than One Order"(["Medication, Order": "Endocrine system, sulfonylureas, long duration"])  union "More Than One Order"(["Medication, Order": "Endocrine system, other"])  union "More Than One Order"(["Medication, Order": "Nonbenzodiazepine hypnotics"])  union "More Than One Order"(["Medication, Order": "Pain medications, skeletal muscle relaxants"])  union "More Than One Order"(["Medication, Order": "Pain medications, other"])  

       

      #Query 1:

      Consider scenario 1:

      Patient A with three documented RXnorm codes with the following data

      Code1 (1490727) : Authordatetime: 4/30/2023 00:00:00 and refills as 0

      Code2 (1490727): Authordatetime: 4/30/2023 00:00:00 and refills as 0

      Code3 (1088934) : Authordatetime:  6/1/2023 00:00:00 and refills as 0

      Will this patient qualify for numerator?

       

       #Query 2:

      Consider scenario 2:

      Patient B with two documented RXnorm codes with the following data

      Code1 (1738495) : Authordatetime: 1/1/2023 00:00:00 and refills as 0

      Code2 (1099304) : Authordatetime: 2/2/2023 00:00:00 and refills as 0

      Will this patient qualify for numerator?

       

      Request you to provide us with the resolution urgently as our client deliverables are dependent on it.

            edave Mathematica EC eCQM Team
            AkashP Akash Pawar
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