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  2. CQM-6486

CMS816v2 : Query Regarding Numerator

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      Thank you for your inquiry specific to CMS816v2 Hospital Harm – Severe Hypoglycemia. All three of your scenarios (Patients A, B, and C) meet the numerator criteria. In each case, a severe hypoglycemic event occurred during the inpatient encounter. The conditions that define a severe hypoglycemic event are met, which include the following during the encounter:

      - A glucose result less than 40 mg/dL. [Patient A glucose = 0 mg/dL; Patient B glucose = 2 mg/dL; Patient C glucose = 10 mg/dL]

      AND

       - A hypoglycemic medication administered within 24 hours prior to the start of the severe hypoglycemic event (i.e., the glucose result less than 40 mg/dL). [Patient A, B, and C were all administered the hypoglycemic medication 1 hour prior to the documented glucose test values]

      AND

      - No subsequent repeat test for glucose with a result greater than 80 mg/dL within five minutes of the time of the initial glucose test with result less than 40mg/dL. [Patient A, B, and C have no documented repeat glucose test]

      To answer your final query: Yes, a value of 0 mg/dL as the result of a glucose test is considered valid, so does meet the condition of a glucose result < 40 mg/dL for the measure.
      Show
      Thank you for your inquiry specific to CMS816v2 Hospital Harm – Severe Hypoglycemia. All three of your scenarios (Patients A, B, and C) meet the numerator criteria. In each case, a severe hypoglycemic event occurred during the inpatient encounter. The conditions that define a severe hypoglycemic event are met, which include the following during the encounter: - A glucose result less than 40 mg/dL. [Patient A glucose = 0 mg/dL; Patient B glucose = 2 mg/dL; Patient C glucose = 10 mg/dL] AND  - A hypoglycemic medication administered within 24 hours prior to the start of the severe hypoglycemic event (i.e., the glucose result less than 40 mg/dL). [Patient A, B, and C were all administered the hypoglycemic medication 1 hour prior to the documented glucose test values] AND - No subsequent repeat test for glucose with a result greater than 80 mg/dL within five minutes of the time of the initial glucose test with result less than 40mg/dL. [Patient A, B, and C have no documented repeat glucose test] To answer your final query: Yes, a value of 0 mg/dL as the result of a glucose test is considered valid, so does meet the condition of a glucose result < 40 mg/dL for the measure.
    • CMS0816v2

      Hi Team,

      Consider statements below from CMS816v2:

      A hypoglycemic medication administered within 24 hours prior to the start of the severe hypoglycemic event (i.e., the glucose result less than 40 mg/dL)

      Encounter With Severe Hypoglycemic Harm Event :
      "Encounter With Hypoglycemic Medication Administration" QualifyingEncounter
        where exists ( ["Laboratory Test, Performed": "Glucose Lab Test Mass Per Volume"] BloodGlucoseLab1
            with ["Medication, Administered": "Hypoglycemics Severe Hypoglycemia"] HypoglycemicMed
              such that Global."NormalizeInterval" ( HypoglycemicMed.relevantDatetime, HypoglycemicMed.relevantPeriod ) starts 24 hours or less before or on BloodGlucoseLab1.relevantDatetime
                and Global."NormalizeInterval" ( HypoglycemicMed.relevantDatetime, HypoglycemicMed.relevantPeriod ) starts during Global."HospitalizationWithObservation" ( QualifyingEncounter )
            without ["Laboratory Test, Performed": "Glucose Lab Test Mass Per Volume"] BloodGlucoseLab2
              such that BloodGlucoseLab2.relevantDatetime during Global."HospitalizationWithObservation" ( QualifyingEncounter )
                and BloodGlucoseLab2.relevantDatetime 5 minutes or less after BloodGlucoseLab1.relevantDatetime
                and BloodGlucoseLab2.result > 80 'mg/dL'
            where BloodGlucoseLab1.relevantDatetime during Global."HospitalizationWithObservation" ( QualifyingEncounter )
              and BloodGlucoseLab1.result < 40 'mg/dL'
        )

      Scenario1 :

      Patient A aged 21 years with

      Start of InpatientEncounter.relevantPeriod = 11/12/2023 4:00

      End of InpatientEncounter.relevantPeriod = 11/12/2023 7:00

      having Glucose Lab Test Mass Per Volume documented on 11/12/2023 6:00 with value 0 mg/dL and with Hypoglycemics Severe Hypoglycemia medication administered on 11/12/2023 5:00 

       

      Patient B aged 21 years with

      Start of InpatientEncounter.relevantPeriod = 11/12/2023 4:00

      End of InpatientEncounter.relevantPeriod = 11/12/2023 7:00

      having Glucose Lab Test Mass Per Volume documented on 11/12/2023 5:00 with value 2 mg/dL and with Hypoglycemics Severe Hypoglycemia medication administered on 11/12/2023 4:00 

       

      Patient C aged 21 years with

      Start of InpatientEncounter.relevantPeriod = 11/12/2023 4:00

      End of InpatientEncounter.relevantPeriod = 11/12/2023 7:00

      having Glucose Lab Test Mass Per Volume documented on 11/12/2023 6:00 with value -10 mg/dL and with Hypoglycemics Severe Hypoglycemia medication administered on 11/12/2023 5:00 

      Query : 

      Which of the above patients will qualify for the numerator? Can glucose value 0 be considered as valid glucose value?

            JLeflore Mathematica EH eCQM Team
            GayatriK4 gayatri kulkarni
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