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  2. CQM-6552

CMS771v5: Eligibility Possible Gap

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    • Tara Kalra
    • Healthmonix
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      Thank you for your follow up question regarding CMS771v5, Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic Hyperplasia.

       

      The ‘Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization’ definition was updated in Version 5.0 of the measure so that data collection could not occur after the measurement period ended per CMS’ request. In previous versions where the initial BPH diagnosis could be after the start of the measurement period, data collection such as the 6–12-month urinary symptom score follow up could occur well into the year after the measurement period. To ensure there is no data collection after the measurement period, the measure now only use cases with an initial BPH diagnosis in the 6 months prior to the measurement period.

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      Thank you for your follow up question regarding CMS771v5, Urinary Symptom Score Change 6-12 Months After Diagnosis of Benign Prostatic Hyperplasia.   The ‘Has Initial BPH Diagnosis Starts During or Within 30 Days After End of Hospitalization’ definition was updated in Version 5.0 of the measure so that data collection could not occur after the measurement period ended per CMS’ request. In previous versions where the initial BPH diagnosis could be after the start of the measurement period, data collection such as the 6–12-month urinary symptom score follow up could occur well into the year after the measurement period. To ensure there is no data collection after the measurement period, the measure now only use cases with an initial BPH diagnosis in the 6 months prior to the measurement period.
    • CMS0771v5

      Version 5 of this measure has been updated to where you look for "Male patients with an initial diagnosis of benign prostatic hyperplasia 6 months prior to the measurement period". 

      CQL states:
      NewBPHDiagnosis.prevalencePeriod starts during Interval[start of "Measurement Period" - 6 months, start of "Measurement Period"]
      My concern is that with this logic you are missing initial diagnoses of BPH in the first six months of every performance year.  Can you provide assistance? 

            edave Mathematica EC eCQM Team
            tkalra Tara
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