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  2. CQM-6129

GMCS: Guidance Clarification

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      ​Thank you for your inquiry specific to CMS986v2 [Global Malnutrition Composite Score (GMCS)]. The LOINC code, ‘84291-4 Nutrition and dietetics Risk assessment and screening note’ is recommended for Measure Observation 1 “Malnutrition Risk Screening” and Measure Observation 2 “Nutrition Assessment” when a registered dietitian (RD) or registered dietitian nutritionist (RDN) performs both the "Malnutrition Risk Screening" and "Nutrition Assessment". This guidance is intended for hospital-based eCQM implementers and vendors (e.g., RDs and RDNs, quality improvement experts, coders, informaticists, EHR vendors) to ensure the correct code is reported for the applicable measure observation based on the healthcare profession who performed the specific activity.

      Reporting of this LOINC code should not be for only one measure observation. The denominator is only affected by a Nutrition Screening Not At Risk result and a Nutrition Status Mild or Not Malnourished. Furthermore, all encounters that meet the initial measure population (i.e., hospitalizations during the measurement period for patients aged 65 years and greater with a length of stay of 24 hours and greater) are eligible for the “Malnutrition Risk Screening” (Measure Observation 1). Hospital encounters for patients with “Malnutrition Screening At Risk Result” and those with a “Hospital Dietitian Referral” order are eligible for the “Nutrition Assessment” (Measure Observation 2). If the RD or RDN performs both Measure Observations 1 and 2, they should report LOINC code ‘84291-4 Nutrition and dietetics Risk assessment and screening note’ for both Measure Observation 1 and for Measure Observation 2, as this code appears in both value sets. However, please note that a malnutrition screening result should be reported, as well as a nutrition assessment status. Refer to the CMS986v2 value sets for a complete list of applicable codes. Additional logic is not required in the eCQM specification as the LOINC code appears in the definitions of the applicable measure observations. Both measure components should be reported separately in the QRDA file.
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      ​Thank you for your inquiry specific to CMS986v2 [Global Malnutrition Composite Score (GMCS)]. The LOINC code, ‘84291-4 Nutrition and dietetics Risk assessment and screening note’ is recommended for Measure Observation 1 “Malnutrition Risk Screening” and Measure Observation 2 “Nutrition Assessment” when a registered dietitian (RD) or registered dietitian nutritionist (RDN) performs both the "Malnutrition Risk Screening" and "Nutrition Assessment". This guidance is intended for hospital-based eCQM implementers and vendors (e.g., RDs and RDNs, quality improvement experts, coders, informaticists, EHR vendors) to ensure the correct code is reported for the applicable measure observation based on the healthcare profession who performed the specific activity. Reporting of this LOINC code should not be for only one measure observation. The denominator is only affected by a Nutrition Screening Not At Risk result and a Nutrition Status Mild or Not Malnourished. Furthermore, all encounters that meet the initial measure population (i.e., hospitalizations during the measurement period for patients aged 65 years and greater with a length of stay of 24 hours and greater) are eligible for the “Malnutrition Risk Screening” (Measure Observation 1). Hospital encounters for patients with “Malnutrition Screening At Risk Result” and those with a “Hospital Dietitian Referral” order are eligible for the “Nutrition Assessment” (Measure Observation 2). If the RD or RDN performs both Measure Observations 1 and 2, they should report LOINC code ‘84291-4 Nutrition and dietetics Risk assessment and screening note’ for both Measure Observation 1 and for Measure Observation 2, as this code appears in both value sets. However, please note that a malnutrition screening result should be reported, as well as a nutrition assessment status. Refer to the CMS986v2 value sets for a complete list of applicable codes. Additional logic is not required in the eCQM specification as the LOINC code appears in the definitions of the applicable measure observations. Both measure components should be reported separately in the QRDA file.
    • CMS0986v2
    • Not sure what to do with the Rate Aggregation statement about RD/RDN doing both measure obs for Pop 1 and Pop 2 since Performer is not in the Measure Logic

      The guidance  Rate Aggregation Section mentions a LOINC code for RD or RDN doing the Risk Screening for Pop 1 and the Assessment for Pop 2, and the reporting of a LOINC code for both. Who is this meant to guide? The hospital coders, the staff documenting in an EHR?  Is only one Population meant to be reported? Does this change the Eligible Denominator Count? It isn't in the measure logic statements. Does it impact the QRDA file creation? Thanks

            JLeflore Mathematica EH eCQM Team
            megbutler Margaret Butler
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