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  2. CQM-6412

CRP: Update value set to provide more accurate assessment for Denominator Exclusion criteria

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    • Icon: Other Other
    • Resolution: Resolved
    • Icon: Moderate Moderate
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      We plan to move forward with the proposed change during this annual update.
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      We plan to move forward with the proposed change during this annual update.
    • Not measure related
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      Brief Description of Measure:
      CMS249: Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture

      Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period


      Description of Issue:
      Currently, this measure uses a value set that includes two LOINC codes, "Alcoholic drinks per drinking day - Reported" and "Alcoholic drinks per day". Feedback on this measure has noted that the codes are assessing two different concepts for alcoholic drinks.
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      Brief Description of Measure: CMS249: Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture Percentage of female patients 50 to 64 years of age without select risk factors for osteoporotic fracture who received an order for a dual-energy x-ray absorptiometry (DXA) scan during the measurement period Description of Issue: Currently, this measure uses a value set that includes two LOINC codes, "Alcoholic drinks per drinking day - Reported" and "Alcoholic drinks per day". Feedback on this measure has noted that the codes are assessing two different concepts for alcoholic drinks.
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      Proposed Solution:
      To assess the average number of alcoholic drinks per day, we propose that the "Average Number of Drinks per Drinking Day" value set be removed and that the "Alcoholic drinks per day" code be retained.

      This would entail removing the value set (OID: 2.16.840.1.113883.3.464.1003.106.12.1018) from the measure logic, and replacing it with a Direct Reference Code (DRC) from LOINC '74013-4'.

      Logic/Terminology Before:

      define "First Average Number of Drinks Assessment Indicating More Than Two Per Day":

        First(["Assessment, Performed": "Average Number of Drinks per Drinking Day"] AverageDrinks

            where start of Global."NormalizeInterval"(AverageDrinks.relevantDatetime, AverageDrinks.relevantPeriod)during "Measurement Period"

              and AverageDrinks.result > 2 '{drinks}/d'

            sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)

        )


      valueset "Average Number of Drinks per Drinking Day": 'urn:oid:2.16.840.1.113883.3.464.1003.106.12.1018'


      Logic/Terminology After:

      define "First Average Number of Drinks Assessment Indicating More Than Two Per Day":

        First(["Assessment, Performed": "Alcoholic drinks per day"] AverageDrinks

            where start of Global."NormalizeInterval"(AverageDrinks.relevantDatetime, AverageDrinks.relevantPeriod)during "Measurement Period"

              and AverageDrinks.result > 2 '{drinks}/d'

            sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)

        )


      code "Alcoholic drinks per day": '74013-4' from "LOINC" display 'Alcoholic drinks per day'



      Rationale for Change:
      Retaining only the "Alcoholic drinks per day" code will provide a more consistent representation for the denominator exclusion criteria.
      Show
      Proposed Solution: To assess the average number of alcoholic drinks per day, we propose that the "Average Number of Drinks per Drinking Day" value set be removed and that the "Alcoholic drinks per day" code be retained. This would entail removing the value set (OID: 2.16.840.1.113883.3.464.1003.106.12.1018) from the measure logic, and replacing it with a Direct Reference Code (DRC) from LOINC '74013-4'. Logic/Terminology Before: define "First Average Number of Drinks Assessment Indicating More Than Two Per Day":   First(["Assessment, Performed": "Average Number of Drinks per Drinking Day"] AverageDrinks       where start of Global."NormalizeInterval"(AverageDrinks.relevantDatetime, AverageDrinks.relevantPeriod)during "Measurement Period"         and AverageDrinks.result > 2 '{drinks}/d'       sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)   ) valueset "Average Number of Drinks per Drinking Day": 'urn:oid:2.16.840.1.113883.3.464.1003.106.12.1018' Logic/Terminology After: define "First Average Number of Drinks Assessment Indicating More Than Two Per Day":   First(["Assessment, Performed": "Alcoholic drinks per day"] AverageDrinks       where start of Global."NormalizeInterval"(AverageDrinks.relevantDatetime, AverageDrinks.relevantPeriod)during "Measurement Period"         and AverageDrinks.result > 2 '{drinks}/d'       sort by start of Global."NormalizeInterval"(relevantDatetime, relevantPeriod)   ) code "Alcoholic drinks per day": '74013-4' from "LOINC" display 'Alcoholic drinks per day' Rationale for Change: Retaining only the "Alcoholic drinks per day" code will provide a more consistent representation for the denominator exclusion criteria.

          edave Mathematica EC eCQM Team
          edave Mathematica EC eCQM Team
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            Updated:
            Resolved: