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  2. CQM-5604

CRP: Revise timing of cataract surgery procedure

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    • Other
    • Resolution: Unresolved
    • Moderate
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      Brief description of measure:
      ​CMS133: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery
      Percentage of cataract surgeries for patients aged 18 and older with a diagnosis of uncomplicated cataract and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved in the operative eye within 90 days following the cataract surgery

      Description of issue:
      For CMS133v11: 2023 measure specification definition and guidance states to consider cataract surgery performed during January 1 - September 30 of the reporting period or starts 92 days or more before the end of measurement period. Testing the recently published specification's logic using edge cases identified that cataract surgeries starting on September 30th may not be pulled into the initial population as intended.

      The measure developer proposes updating the logic to ensure procedures performed through the end of the day on September 30th are included in the initial population to more accurately align with the overall measure intent.

      Goal of review:
      Obtain clinical and technical feedback
      Show
      Brief description of measure: ​CMS133: Cataracts: 20/40 or Better Visual Acuity within 90 Days Following Cataract Surgery Percentage of cataract surgeries for patients aged 18 and older with a diagnosis of uncomplicated cataract and no significant ocular conditions impacting the visual outcome of surgery and had best-corrected visual acuity of 20/40 or better (distance or near) achieved in the operative eye within 90 days following the cataract surgery Description of issue: For CMS133v11: 2023 measure specification definition and guidance states to consider cataract surgery performed during January 1 - September 30 of the reporting period or starts 92 days or more before the end of measurement period. Testing the recently published specification's logic using edge cases identified that cataract surgeries starting on September 30th may not be pulled into the initial population as intended. The measure developer proposes updating the logic to ensure procedures performed through the end of the day on September 30th are included in the initial population to more accurately align with the overall measure intent. Goal of review: Obtain clinical and technical feedback
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      Proposed solution:
      CURRENT:
      define 'Cataract Surgery Between January and September of Measurement Period'
      ["Procedure, Performed": "Cataract Surgery"] CataractSurgery
        where Global."NormalizeInterval" ( CataractSurgery.relevantDatetime, CataractSurgery.relevantPeriod ) during "Measurement Period"
          and Global."NormalizeInterval" ( CataractSurgery.relevantDatetime, CataractSurgery.relevantPeriod ) starts 93 days or more before
          end of "Measurement Period"

      PROPOSED:
      define 'Cataract Surgery Between January and September of Measurement Period'
      ["Procedure, Performed": "Cataract Surgery"] CataractSurgery
        where Global."NormalizeInterval" ( CataractSurgery.relevantDatetime, CataractSurgery.relevantPeriod ) during "Measurement Period"
          and Global."NormalizeInterval" ( CataractSurgery.relevantDatetime, CataractSurgery.relevantPeriod ) starts 92 days or more before
          end of "Measurement Period"

      Rationale for change:
      ​The measure specification clearly states that the last date of surgery can be performed on September 30th. However, it appears that in testing, this is not the case and the initial population does not include cases performed on September 30th.
      Show
      Proposed solution: CURRENT: define 'Cataract Surgery Between January and September of Measurement Period' ["Procedure, Performed": "Cataract Surgery"] CataractSurgery   where Global."NormalizeInterval" ( CataractSurgery.relevantDatetime, CataractSurgery.relevantPeriod ) during "Measurement Period"     and Global."NormalizeInterval" ( CataractSurgery.relevantDatetime, CataractSurgery.relevantPeriod ) starts 93 days or more before     end of "Measurement Period" PROPOSED: define 'Cataract Surgery Between January and September of Measurement Period' ["Procedure, Performed": "Cataract Surgery"] CataractSurgery   where Global."NormalizeInterval" ( CataractSurgery.relevantDatetime, CataractSurgery.relevantPeriod ) during "Measurement Period"     and Global."NormalizeInterval" ( CataractSurgery.relevantDatetime, CataractSurgery.relevantPeriod ) starts 92 days or more before     end of "Measurement Period" Rationale for change: ​The measure specification clearly states that the last date of surgery can be performed on September 30th. However, it appears that in testing, this is not the case and the initial population does not include cases performed on September 30th.

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          edave Mathematica EC eCQM Team
          edave Mathematica EC eCQM Team
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