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  2. CQM-6165

CMS69v12-OverweightObese.prevalencePeriod overlaps before Validation

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      Thank you for your question regarding CMS69v11 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. Based on the cases provided in your question, Patients A and C would be included in the numerator while Patient B would not. Patient B is not included in the numerator because their overweight/obese diagnosis begins at the exact date and time as the intervention and does not overlap before the intervention. We hope this helps.
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      Thank you for your question regarding CMS69v11 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. Based on the cases provided in your question, Patients A and C would be included in the numerator while Patient B would not. Patient B is not included in the numerator because their overweight/obese diagnosis begins at the exact date and time as the intervention and does not overlap before the intervention. We hope this helps.
    • CMS0069v12

      Hi Team,

      Consider below statement from Numerator of CMS69v12:

      High BMI Interventions Performed
      ( ["Intervention, Performed": "Follow Up for Above Normal BMI"] HighInterventionsPerformed
          where HighInterventionsPerformed.reason in "Overweight or Obese"
            or ( exists ["Diagnosis": "Overweight or Obese"] OverweightObese
                where OverweightObese.prevalencePeriod overlaps before Global."NormalizeInterval" ( HighInterventionsPerformed.relevantDatetime, HighInterventionsPerformed.relevantPeriod )
            )
      )

      Query:

      Need more clarity on Overlaps before validation.

      Consider below scenarios (2024 as measurement year)

      Patient A:
      Age - 20 years
      Qualifying Encounter code- 10197000
      Encounter start date- 11/20/2024 16:15:00.000
      Encounter end date- 11/20/2024 16:45:00.000

      Body mass index (BMI) [Ratio]- 39156-5
      BMI start date- 11/20/2024 16:20:00.000
      BMI end date- 11/20/2024 16:30:00.000
      BMI Result- 28.5'kg/m2' 

      Follow Up for Above Normal BMI(InterventionsPerformed)- 182922004
      HighInterventionsPerformed start date- 11/20/2024 16:30:00.000
      HighInterventionsPerformed end date- 11/20/2024 16:40:00.000

      Diagnosis code- 162863004
      Diagnosis start date- 10/20/2024 16:20:00.000
      Diagnosis end date- 11/20/2024 16:40:00.000

      Patient B:
      Age - 20 years
      Qualifying Encounter code- 10197000
      Encounter start date- 11/20/2024 16:15:00.000
      Encounter end date- 11/20/2024 16:45:00.000

      Body mass index (BMI) [Ratio]- 39156-5
      BMI start date- 11/20/2024 16:20:00.000
      BMI end date- 11/20/2024 16:30:00.000
      BMI Result- 28.5'kg/m2'  

      Follow Up for Above Normal BMI(InterventionsPerformed)- 182922004
      HighInterventionsPerformed start date- 11/20/2024 16:30:00.000
      HighInterventionsPerformed end date- 11/20/2024 16:40:00.000

      Diagnosis code- 162863004
      Diagnosis start date- 11/20/2024 16:30:00.000
      Diagnosis end date- 11/22/2024 16:20:00.000

      Patient C:
      Age - 20 years
      Qualifying Encounter code- 10197000
      Encounter start date- 11/20/2024 16:15:00.000
      Encounter end date- 11/20/2024 16:45:00.000

      Body mass index (BMI) [Ratio]- 39156-5
      BMI start date- 11/20/2024 16:20:00.000
      BMI end date- 11/20/2024 16:30:00.000
      BMI Result- 28.5'kg/m2' 

      Follow Up for Above Normal BMI(InterventionsPerformed)- 182922004
      HighInterventionsPerformed start date- 11/20/2024 16:30:00.000
      HighInterventionsPerformed end date- 11/20/2024 16:40:00.000

      Diagnosis code- 162863004
      Diagnosis start date- 10/20/2024 16:20:00.000
      Diagnosis end date- 12/21/2024 16:20:00.000

      Which patients mentioned above will qualify for Numerator?

      Kindly assist us on the above queries urgently as client deliverables are dependent upon it.

            edave Mathematica EC eCQM Team
            AkashP Akash Pawar
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