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  2. CQM-6429

CMS165v11 Exclusion logic for BP's taken during day of Inpatient or ED encounter

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    • Resolution: Answered
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    • Jeff
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      Thank you for your inquiry regarding CMS165v11, Controlling High Blood Pressure (2023 performance period). A qualifying blood pressure reading would be one that is NOT documented on the same day as an ED visit. In your scenario, the qualifying blood pressure documented on day 1, NOT on the same day as an ED visit, should count towards the numerator. Please see relevant logic below for your reference.

      Qualifying Diastolic Blood Pressure Reading

              ["Physical Exam, Performed": "Diastolic blood pressure"] DiastolicBP
                without ( ["Encounter, Performed": "Encounter Inpatient"]
                  union ["Encounter, Performed": "Emergency Department Evaluation and Management Visit"] ) DisqualifyingEncounter
                  such that Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of DisqualifyingEncounter.relevantPeriod
                where DiastolicBP.result.unit = 'mm[Hg]'
                  and Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of "Measurement Period"

      Blood Pressure Days

              ( "Qualifying Diastolic Blood Pressure Reading" DBPExam
                  return date from Global."LatestOf" ( DBPExam.relevantDatetime, DBPExam.relevantPeriod )
              )
                intersect ( "Qualifying Systolic Blood Pressure Reading" SBPExam
                    return date from Global."LatestOf" ( SBPExam.relevantDatetime, SBPExam.relevantPeriod )
                )

      Lowest Diastolic Reading on Most Recent Blood Pressure Day

              First("Qualifying Diastolic Blood Pressure Reading" DBPReading
                  where Global."LatestOf"(DBPReading.relevantDatetime, DBPReading.relevantPeriod)same day as "Most Recent Blood Pressure Day"
                  sort by(result as Quantity)
              )
      Show
      Thank you for your inquiry regarding CMS165v11, Controlling High Blood Pressure (2023 performance period). A qualifying blood pressure reading would be one that is NOT documented on the same day as an ED visit. In your scenario, the qualifying blood pressure documented on day 1, NOT on the same day as an ED visit, should count towards the numerator. Please see relevant logic below for your reference. Qualifying Diastolic Blood Pressure Reading         ["Physical Exam, Performed": "Diastolic blood pressure"] DiastolicBP           without ( ["Encounter, Performed": "Encounter Inpatient"]             union ["Encounter, Performed": "Emergency Department Evaluation and Management Visit"] ) DisqualifyingEncounter             such that Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of DisqualifyingEncounter.relevantPeriod           where DiastolicBP.result.unit = 'mm[Hg]'             and Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of "Measurement Period" Blood Pressure Days         ( "Qualifying Diastolic Blood Pressure Reading" DBPExam             return date from Global."LatestOf" ( DBPExam.relevantDatetime, DBPExam.relevantPeriod )         )           intersect ( "Qualifying Systolic Blood Pressure Reading" SBPExam               return date from Global."LatestOf" ( SBPExam.relevantDatetime, SBPExam.relevantPeriod )           ) Lowest Diastolic Reading on Most Recent Blood Pressure Day         First("Qualifying Diastolic Blood Pressure Reading" DBPReading             where Global."LatestOf"(DBPReading.relevantDatetime, DBPReading.relevantPeriod)same day as "Most Recent Blood Pressure Day"             sort by(result as Quantity)         )
    • CMS0165v11

      Question about the exclusion logic for BP's taken during Inpatient or ED encounter

      • Example:
        Patient had Office Visit on day 1 with a qualifying blood pressure reading documented
      • ED visit on Day 3 with a qualifying blood pressure reading documented

      Would the previous most recent BP taken during the office visit qualifying the patient for the numerator or would the most recent BP result taken during the ED visit cause the patient to be excluded from the numerator?

      ["Physical Exam, Performed": "Diastolic blood pressure"] DiastolicBP
        without ( ["Encounter, Performed": "Encounter Inpatient"]
          union ["Encounter, Performed": "Emergency Department Visit"] ) DisqualifyingEncounter
          such that Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of DisqualifyingEncounter.relevantPeriod
        where DiastolicBP.result.unit = 'mm[Hg]'
          and Global."LatestOf" ( DiastolicBP.relevantDatetime, DiastolicBP.relevantPeriod ) during day of "Measurement Period

            edave Mathematica EC eCQM Team
            jjCerner Jeff Jennings
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