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  1. eCQM Issue Tracker
  2. CQM-629

Exclusion clarification

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    • Resolution: Answered
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    • Exclusion criteria and QRDA
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      The order of computation is specified in http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2014_eCQM_Measure_Logic_Guidancev13_April2013.pdf section 2.3.

      At a minimum, you need to supply the 'smoking gun' data for the populations that are calculated. In your example, the numerator is never calculated, because the patient is excluded form the denominator. In this case you are NOT REQUIRED to provide the data supporting the numerator -- there is no smoking gun, because the gun isn't even loaded -- but it is not required. Be careful in the case of measures with multiple numerators, stratifications, etc, to provide all of the smoking gun data for all populations.
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      The order of computation is specified in http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/2014_eCQM_Measure_Logic_Guidancev13_April2013.pdf section 2.3. At a minimum, you need to supply the 'smoking gun' data for the populations that are calculated. In your example, the numerator is never calculated, because the patient is excluded form the denominator. In this case you are NOT REQUIRED to provide the data supporting the numerator -- there is no smoking gun, because the gun isn't even loaded -- but it is not required. Be careful in the case of measures with multiple numerators, stratifications, etc, to provide all of the smoking gun data for all populations.
    • CMS69v1/NQF0421

      If a patient meets the exclusion criteria for any measure. In QRDA generation do we still need to show the rest of the clinical data i.e. numerator or should we stop at the exclusion. i.e. for e.g 0421 a patient may be pregnant (exclusion) but still have a BMI calculated (numerator). Should we show the exclusion as well as the numerator or show the exclusion and stop there.

            julia.skapik Julia Skapik (Inactive)
            kshah Keya Shah (Inactive)
            Nirvish Shah (Inactive)
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              Updated:
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