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  2. CQM-5754

Old Pregnancies Left on Problem List are Excluding Patients

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      ​​Thank you for your inquiry regarding CMS69v11: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The measure logic is set up to exclude patients with a pregnancy diagnosis that overlaps with the measurement period. If the pregnancy diagnosis is documented as ending before the measurement period, the patient will not be excluded. Providers are encouraged to use their best clinical judgment when reviewing patient's active diagnoses to ensure they are an accurate representation of the patient's health at the time of the qualifying encounter.
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      ​​Thank you for your inquiry regarding CMS69v11: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The measure logic is set up to exclude patients with a pregnancy diagnosis that overlaps with the measurement period. If the pregnancy diagnosis is documented as ending before the measurement period, the patient will not be excluded. Providers are encouraged to use their best clinical judgment when reviewing patient's active diagnoses to ensure they are an accurate representation of the patient's health at the time of the qualifying encounter.
    • CMS0069v11

      Patients with old pregnancies in their problem list are excluded from the measure "BMI Screening and Follow-Up 18+ Years (CMS 69v10)," even if the pregnancy is from 1994. As long as the pregnancy is on the active diagnosis list the patient is excluded from the measure. I do see that the denominator states "Patients who are pregnant at any time during the measurement period," but the measure logic still seems to exclude patients due to an old pregnancy showing up on their problem list. 

            edave Mathematica EC eCQM Team
            akladnitsky Aleksandr Kladnitsky
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