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  2. CQM-5828

CMS334v4_Abnormal Presentation

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      ​​Thank you for your question on CMS334, Cesarean Birth. You are correct with your statement that if the patient has abnormal presentation, the patient is excluded from the denominator. The logic only requires that either a diagnosis indicative of abnormal presentation OR an assessment indicative of abnormal presentation be present. Both are not required.
      The "let" statement defines a variable that describes the last ASSESSMENT performed of abnormal presentation. The "let" logic is lengthy:

      let LastAbnormalPresentation: Last(["Assessment, Performed": "Abnormal Presentation"] AbnormalPresentation where Global."EarliestOf"(AbnormalPresentation.relevantDatetime, AbnormalPresentation.relevantPeriod) before or on PCMaternal."LastTimeOfDelivery"(QualifyingEncounter) sort by Global."EarliestOf"(relevantDatetime, relevantPeriod) )

      The remaining logic demonstrates that either diagnosis or assessment of abnormal presentation will exclude the patient:

      where EncounterDiagnosis.code in "Abnormal Presentation") OR

      Global."EarliestOf" ( LastAbnormalPresentation.relevantDatetime, LastAbnormalPresentation.relevantPeriod ) during QualifyingEncounter.relevantPeriod


      I hope this helps. Thank you.
      Show
      ​​Thank you for your question on CMS334, Cesarean Birth. You are correct with your statement that if the patient has abnormal presentation, the patient is excluded from the denominator. The logic only requires that either a diagnosis indicative of abnormal presentation OR an assessment indicative of abnormal presentation be present. Both are not required. The "let" statement defines a variable that describes the last ASSESSMENT performed of abnormal presentation. The "let" logic is lengthy: let LastAbnormalPresentation: Last(["Assessment, Performed": "Abnormal Presentation"] AbnormalPresentation where Global."EarliestOf"(AbnormalPresentation.relevantDatetime, AbnormalPresentation.relevantPeriod) before or on PCMaternal."LastTimeOfDelivery"(QualifyingEncounter) sort by Global."EarliestOf"(relevantDatetime, relevantPeriod) ) The remaining logic demonstrates that either diagnosis or assessment of abnormal presentation will exclude the patient: where EncounterDiagnosis.code in "Abnormal Presentation") OR Global."EarliestOf" ( LastAbnormalPresentation.relevantDatetime, LastAbnormalPresentation.relevantPeriod ) during QualifyingEncounter.relevantPeriod I hope this helps. Thank you.
    • CMS0334v4

      Hi Team,

       

      Consider the below statement of denominator exclusion from cms334v4:

       

      Encounter with Abnormal Presentation

      "Singleton Delivery Encounters at 37 Plus Weeks Gravida 1 Parity 0, No Previous Births" QualifyingEncounter

        let LastAbnormalPresentation: Last(["Assessment, Performed": "Abnormal Presentation"] AbnormalPresentation

            where Global."EarliestOf"(AbnormalPresentation.relevantDatetime, AbnormalPresentation.relevantPeriod)before or on PCMaternal."LastTimeOfDelivery"(QualifyingEncounter)

            sort by Global."EarliestOf"(relevantDatetime, relevantPeriod)

        )

        where exists ( QualifyingEncounter.diagnoses EncounterDiagnosis

            where EncounterDiagnosis.code in "Abnormal Presentation"

        )

          or Global."EarliestOf" ( LastAbnormalPresentation.relevantDatetime, LastAbnormalPresentation.relevantPeriod ) during QualifyingEncounter.relevantPeriod

       

      Query :

      According to above statement if the patient has abnormal presentation the patient would be excluded. Does this mean we need to have a code coming from assessment performed for abnormal presentation as well as encounterdiagnosis.code both? Or even if the code exists in just one of the sections will qualify the patient for the numerator?

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

       

            JLeflore Mathematica EH eCQM Team
            GayatriK4 gayatri kulkarni
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