Brief description of measure CMS153: Chlamydia Screening in Women: Percentage of women 16-24 years of age who were identified as sexually active and who had at least one test for chlamydia during the measurement period. Description of issue The denominator exclusion states to exclude individuals who had an order for an x-ray or for a specified medication "within 7 days" of a pregnancy test. The language "within 7 days" is ambiguous as it can be interpreted as either "7 days after pregnancy test" or "on the day of pregnancy test and 6 days after". The current logic evaluates an 8-day period, which includes the day of pregnancy test and 7 days after. Upon reviewing, the measure developer is proposing to update the logic to evaluate a 7-day period instead of an 8-day period to align with the measure intent. The header will also be updated to provide further clarity. Goal of review Obtain technical feedback

Proposed solution Denominator Exclusions Header before: Women who [...] had an order for an x-ray or for a specified medication within 7 days of the pregnancy test. Denominator Exclusions Header after: Women who [...] had an order for an x-ray or for a specified medication on the date of the pregnancy test or the six days after the pregnancy test.​ ​Logic before: define "Has Pregnancy Test Exclusion":   exists ( ( ["Laboratory Test, Order": "Pregnancy Test"] PregnancyTest         with ["Diagnostic Study, Order": "XRay Study"] XrayOrder           such that XrayOrder.authorDatetime occurs 7 days or less on or after day of PregnancyTest.authorDatetime         where PregnancyTest.authorDatetime during "Measurement Period"    )       union ( ["Laboratory Test, Order": "Pregnancy Test"] PregnancyTestOrder           with ["Medication, Order": "Isotretinoin"] AccutaneOrder             such that AccutaneOrder.authorDatetime occurs 7 days or less on or after day of PregnancyTestOrder.authorDatetime           where PregnancyTestOrder.authorDatetime during "Measurement Period"      )  ) Logic after define "Has Pregnancy Test Exclusion":   exists ( ( ["Laboratory Test, Order": "Pregnancy Test"] PregnancyTest         with ["Diagnostic Study, Order": "XRay Study"] XrayOrder           such that XrayOrder.authorDatetime occurs 6 days or less on or after day of PregnancyTest.authorDatetime         where PregnancyTest.authorDatetime during "Measurement Period"    )       union ( ["Laboratory Test, Order": "Pregnancy Test"] PregnancyTestOrder           with ["Medication, Order": "Isotretinoin"] AccutaneOrder             such that AccutaneOrder.authorDatetime occurs 6 days or less on or after day of PregnancyTestOrder.authorDatetime           where PregnancyTestOrder.authorDatetime during "Measurement Period"      )  ) Rationale for change ​The intent of the measure is to exclude patients who had an x-ray or an order for a specified medication during a 7-day period, including the day of the pregnancy test and 6 days after the pregnancy test. The change is proposed to align with the measure intent.