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Exclusion Definition for eCQM CMS128v12

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      Thank you for your question regarding CMS128v12: Anti-depressant Medication Management. Your interpretation is correct in that the provided scenario would not meet denominator exclusion based on the CQL relating to intersect: IPSD on May 1 2022 and active medication from April 1-April 30 2022 (assuming measurement period is 2023). We will consider this scenario during a future measure specification annual update cycle.
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      Thank you for your question regarding CMS128v12: Anti-depressant Medication Management. Your interpretation is correct in that the provided scenario would not meet denominator exclusion based on the CQL relating to intersect: IPSD on May 1 2022 and active medication from April 1-April 30 2022 (assuming measurement period is 2023). We will consider this scenario during a future measure specification annual update cycle.
    • CMS0128v12
    • The cql definition appears to not match the written description.

      We have a question on the cql definition for CMS128v12.  The written description states that patients should be excluded "who were actively on an antidepressant medication in the 105 days prior to the IPSD".

      The cql for the exclusion states:
      exists ( ["Medication, Active": "Antidepressant Medication"] ActiveAntidepressant
      let ActiveMedPeriod: ActiveAntidepressant Meds
      return Meds.relevantPeriod
      intersect Interval[start of "Intake Period",
      end of "Measurement Period"]
      where "IPSD" is not null
      and Global."ToDateInterval" ( ActiveMedPeriod ) overlaps Interval["IPSD" - 105 days, "IPSD" )
      Our question is with the intersect as it appears that if an ActiveAntidepressant Meds relevantPeriod ends prior to the start of the "Intake Period" the intersect will return null and the result of the overlap with Interval["IPSD" - 105 days, 'IPSD"] will also be null and the patient would not be excluded.  Yet the ActiveAntidepressant Med could have been active during the 105 days prior to the IPSD.  For example: 

      Patient has Active Medication from Antidepressant Medication Value set with relevantPeriod
          <low value='20220401100000'/><high value='20220430100000'/>

      which when intersected with the Interval[start of "Intake Period", end of "Measurement Period"] (Interval['20220501000000', '20231231235959']) will return null as they do not intersect.

      This null result will return null when asking if it overlaps IPSD for instance if "Earliest Antidepressant Dispensed During Intake Period" returns
      Dispensed Medication from Antidepressant Medication Value set with relevantPeriod
          <low value='20220501100000'/><high value='20220530100000'/> the IPSD is 20220501.  

      This patient has an active antidepressant during the 105 days prior to the IPSD but asking for the intersect with the Interval[start of the "Intake Period", end of "Measurement Period"] appears to remove the medication from consideration.  

      Are we interpreting the cql correctly?

       

            edave Mathematica EC eCQM Team
            shari.cummins@healthcatalyst.com Shari Ann Cummins
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