Thank you for your inquiry regarding CMS1074v1 (Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography (CT) in Adults).
The statements from the denominator inform the software calculating the eCQM that encounters should be included where Global Noise, Size Adjusted Dose, and result are present (not null). Expressed differently, encounters without a CT scan present, or where Global Noise, or Size Adjusted Dose are missing will not be included in the denominator.
The final two statements, “Calculated CT global noise” and “Calculated size-adjusted dose”, associate LOINC codes with the two values, so that the software calculating the measure can discretely identify the necessary data for measure calculation.
The QDM attributes correspond to ‘components’. Please reference pg. 57 of the QDM v5.6 (
https://ecqi.healthit.gov/sites/default/files/QDM-v5.6-508.pdf). As shown in the functions: Global Noise Value, and Size Adjusted Value are both components of "Diagnostic Study, Performed" datatypes.
o AlaraCommon.Global Noise Value(Study "Diagnostic Study, Performed")
singleton from ( Study.components C
where C.code ~ "Calculated CT global noise"
and C.result.unit = '[hnsf\'U]'
return C.result.value as Decimal
o AlaraCommon.Qualifies(Study "Diagnostic Study, Performed", code System.Code, noiseThreshold Decimal, sizeDoseThreshold Decimal)
Study.result ~ code
and ( "Global Noise Value"(Study) >= noiseThreshold
or "Size Adjusted Value"(Study) >= sizeDoseThreshold
A sample QRDA file is expected to be posted for CMS1074v2, as part of the upcoming May 2024 release of the 2025 CMS QRDA I Implementation Guide. Sample files are available on the eCQI Resource Center’s QRDA page (
https://ecqi.healthit.gov/qrda), included in the Schematrons and Sample Files. Please continue to check the QRDA page for updates.
EH/CAH eCQMs
Blocker