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  2. CQM-5768

CMS69v11 narrative / technical specs

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      Thank you for your inquiry regarding CMS69v11: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. Per the measure specifications, the BMI must be documented during the encounter or during the measurement period. If the documented BMI is outside of normal parameters, then a follow-up plan must be documented during the encounter or during the measurement period. If more than one BMI is reported during the measurement period, and any of the documented BMI assessments is outside of normal parameters, documentation of an appropriate follow-up plan during an encounter or during the measurement period will be used to determine if performance is met. There is no requirement in the guidance or numerator logic that the follow-up plan must be documented after the most recent BMI.

      Numerator

       
      exists "High BMI and Follow up Provided"
        or exists "Low BMI and Follow up Provided"
        or "Has Normal BMI"
      High BMI and Follow up Provided

       
      ( "Documented High BMI during Measurement Period" HighBMI
          with ( "High BMI Interventions Ordered"
            union "High BMI Interventions Performed" ) HighBMIInterventions
            such that ( Coalesce(start of Global."NormalizeInterval"(HighBMIInterventions.relevantDatetime, HighBMIInterventions.relevantPeriod), HighBMIInterventions.authorDatetime)during "Measurement Period" )
      )
      Low BMI and Follow up Provided

       
      ( "Documented Low BMI during Measurement Period" LowBMI
          with ( "Low BMI Interventions Ordered"
            union "Low BMI Interventions Performed" ) LowBMIInterventions
            such that ( Coalesce(start of Global."NormalizeInterval"(LowBMIInterventions.relevantDatetime, LowBMIInterventions.relevantPeriod), LowBMIInterventions.authorDatetime)during "Measurement Period" )
      )
      Show
      Thank you for your inquiry regarding CMS69v11: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. Per the measure specifications, the BMI must be documented during the encounter or during the measurement period. If the documented BMI is outside of normal parameters, then a follow-up plan must be documented during the encounter or during the measurement period. If more than one BMI is reported during the measurement period, and any of the documented BMI assessments is outside of normal parameters, documentation of an appropriate follow-up plan during an encounter or during the measurement period will be used to determine if performance is met. There is no requirement in the guidance or numerator logic that the follow-up plan must be documented after the most recent BMI. Numerator   exists "High BMI and Follow up Provided"   or exists "Low BMI and Follow up Provided"   or "Has Normal BMI" High BMI and Follow up Provided   ( "Documented High BMI during Measurement Period" HighBMI     with ( "High BMI Interventions Ordered"       union "High BMI Interventions Performed" ) HighBMIInterventions       such that ( Coalesce(start of Global."NormalizeInterval"(HighBMIInterventions.relevantDatetime, HighBMIInterventions.relevantPeriod), HighBMIInterventions.authorDatetime)during "Measurement Period" ) ) Low BMI and Follow up Provided   ( "Documented Low BMI during Measurement Period" LowBMI     with ( "Low BMI Interventions Ordered"       union "Low BMI Interventions Performed" ) LowBMIInterventions       such that ( Coalesce(start of Global."NormalizeInterval"(LowBMIInterventions.relevantDatetime, LowBMIInterventions.relevantPeriod), LowBMIInterventions.authorDatetime)during "Measurement Period" ) )
    • CMS0069v11
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      We are working with a third party vendor and we are disagreeing on how the BMI measure should be built. The vendor insists the technical specs are still reflecting the look forward period, while the narrative guidance specifies BMI/follow up can be counted anytime during the measurement year.
      Show
      We are working with a third party vendor and we are disagreeing on how the BMI measure should be built. The vendor insists the technical specs are still reflecting the look forward period, while the narrative guidance specifies BMI/follow up can be counted anytime during the measurement year.

      We are working with a third party vendor on quality measures and we are disagreeing on how to measure BMI for 2023.  I have seen many tickets posted about how the measure guidance does not match the technical specs for CMS69v9 and CMS69v10.  I have seen tickets on how for CMS69v11, again, the measure guidance should be followed (which allows a BMI and a follow up anytime within the measurement year, not necessarily requiring the follow up after the most recent BMI).  Our vendor is insisting the technical specs are still built to require a BMI follow up after the most recent BMI.  Are there updated technical specs that our vendor has missed?  Are they failing to understand the technical specs correctly?  Any insight or additional documentation available on this issue would be so helpful.  Thank you!

            edave Mathematica EC eCQM Team
            lfreeman22 Lindsey Freeman (Inactive)
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