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EC eCQMs - Eligible Clinicians
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Resolution: Answered
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Moderate
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None
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None
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CMS0165v12
Based on the QDM definition, "Encounter, Performed" diagnoses attribute is intended to capture ALL diagnoses, including the principal diagnosis, i.e., all diagnoses addressed during the encounter represented by the diagnosis (code) used in the expression.'
Can you please confirm if the intent of this datatype/attribute is to qualify only the conditions that were addressed in a particular encounter? Is it also intended to evaluate the active conditions documented in the patient's problem list (the EHR problem list tracks the patient's conditions) even when some of those conditions were not addressed during a particular visit?
Logic example:
- ( ["Encounter, Performed": "Outpatient"]
union ["Encounter, Performed": "Observation"]
union ["Encounter, Performed": "Emergency Department Visit"]
union ["Encounter, Performed": "Nonacute Inpatient"] ) OutpatientEncounter
where exists ( OutpatientEncounter.diagnoses Diagnosis
where Diagnosis.code in "Advanced Illness"
)
and OutpatientEncounter.relevantPeriod starts during day of Interval[start of "Measurement Period" - 1 year,
end of "Measurement Period"]
Scenario:
-A patient has documentation of 'Chronic right-sided heart failure (10335000) in the problem list, active since 2019 (this code is included in the advanced illness valueset)
-Patient has an Outpatient visit on 1/1/2024 - Diagnosis documented for the visit was J45.20 (Mild intermittent asthma - no in the advanced illness valueset)
-Patient has an Outpatient visit on 3/1/2024 - Diagnosis documented for the visit was D50.9 (Iron deficiency anemia - no in the advanced illness valueset)
Question: Does this scenario meet the 'Outpatient Encounters with Advanced Illness'?
Thank you for your guidance