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  2. CQM-6062

CMS 125v11 27 months vs October 1 two years prior

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    • Resolution: Answered
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    • Stephanie Rose
    • 917-733-2247
    • HealthEfficient
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      ​​Thank you for your inquiry about CMS125v11: Breast Cancer Screening. The numerator requires a patient have one or more mammograms 2 years prior from the start of measurement period. The logic takes an interval of ["October 1 Two Years Prior to the Measurement Period", end of "Measurement Period"]. The upper boundary being October 1, two years prior and the lower boundary being the end of the measurement period. In your example, the lookback period would be from the end of the reporting period (10/1/21).
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      ​​Thank you for your inquiry about CMS125v11: Breast Cancer Screening. The numerator requires a patient have one or more mammograms 2 years prior from the start of measurement period. The logic takes an interval of ["October 1 Two Years Prior to the Measurement Period", end of "Measurement Period"]. The upper boundary being October 1, two years prior and the lower boundary being the end of the measurement period. In your example, the lookback period would be from the end of the reporting period (10/1/21).
    • CMS0125v12
    • CMS0125v11
    • The revised language in the numerator appears to give an additional year to meet the numerator and conflicts with the description.

      The numerator was updated on CMS 125v11 to add clarity to any time on or between October 1 two years prior to the measurement period and the end of the measurement period. However, this makes it appear that you are looking two years prior to the beginning of the measurement period. For a 1/1/23-12/31/23 reporting period this would be 10/1/2020. Which is vastly different than the description which indicates 27 months prior to the END of the reporting period which would be 10/1/21. Can you clarify whether we are looking back from the beginning of the reporting period or the end of the reporting period (10/1/20 or 10/1/21 for a 2023 reporting period).

            edave Mathematica EC eCQM Team
            srose@healthefficient.org Stephanie Rose
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