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  2. CQM-6618

CMS137 Initiation and Engagement of Substance Use Disorder Treatment Initial population

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      Thank you for your question about CMS137v1:
      Initiation and Engagement of Substance Use Disorder Treatment regarding what qualifies as a "new SUD episode" in the Initial Population criteria. As stated in the Definition: the new SUD episode is the first encounter during the Intake Period with a diagnosis of SUD with no encounter or medication treatment for a diagnosis of SUD in the 60 days prior.

      As per the CQL logic, we are looking for a qualifying encounter during the Measurement Period, with a diagnosis of SUD within the "Substance Use Disorder" (2.16.840.1.113883.3.464.1003.106.12.1001) value set, between January 1st and November 14th of the Measurement Period.

      The logic is then using the "History of SUD Diagnosis or Treatment" definition to disqualify patients from the Initial Population/Denominator who meet this criteria: EncounterWithDiagnosis starting in the 60 days or less "before the day of" start of FirstSUDEpisode. The logic is looking for a 60-day lookback period starting on the day before start of FirstSUDEpisode.

      This is how a new SUD episode is being calculated.
      Show
      Thank you for your question about CMS137v1: Initiation and Engagement of Substance Use Disorder Treatment regarding what qualifies as a "new SUD episode" in the Initial Population criteria. As stated in the Definition: the new SUD episode is the first encounter during the Intake Period with a diagnosis of SUD with no encounter or medication treatment for a diagnosis of SUD in the 60 days prior. As per the CQL logic, we are looking for a qualifying encounter during the Measurement Period, with a diagnosis of SUD within the "Substance Use Disorder" (2.16.840.1.113883.3.464.1003.106.12.1001) value set, between January 1st and November 14th of the Measurement Period. The logic is then using the "History of SUD Diagnosis or Treatment" definition to disqualify patients from the Initial Population/Denominator who meet this criteria: EncounterWithDiagnosis starting in the 60 days or less "before the day of" start of FirstSUDEpisode. The logic is looking for a 60-day lookback period starting on the day before start of FirstSUDEpisode. This is how a new SUD episode is being calculated.
    • CMS0137v11

      Hello,

      The initial population for CMS 137 is: Patients age 13 years of age and older as of the start of the measurement period who were diagnosed with a new SUD episode during a visit between January 1 and November 14 of the measurement period.

      We have noted some patients in Epic listed as being included in the denominator but have had the same SUD diagnosis on the problem list starting prior to the measurement period that is qualifying them.  This does not seem to be a new episode.  Can you give additional details on what defines a "new SUD episode"? 

      Thank you in advance.  

            edave Mathematica EC eCQM Team
            olson.peggy2@mayo.edu Peggy Olson
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