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  1. eCQM Issue Tracker
  2. CQM-713

CMS178v3\NQF0453 Why is the check for neuraxial anesthesia during the encounter written in a non-standard manner

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Answered
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    • Tamara Bailey
    • 520.750.4324
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      Thank you for your question. Rephrasing the logic to use the “during” operator to tie the events together would introduce questions with “concurrent with” and change the intent of the measure. A use case representing the workflow for patients completing a selected surgical episode concurrent with the end of the hospital stay currently does not exist for this measure. The current logic representation avoids introducing uncertainty into the measure and provides the reader with clear inclusion criteria.
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      Thank you for your question. Rephrasing the logic to use the “during” operator to tie the events together would introduce questions with “concurrent with” and change the intent of the measure. A use case representing the workflow for patients completing a selected surgical episode concurrent with the end of the hospital stay currently does not exist for this measure. The current logic representation avoids introducing uncertainty into the measure and provides the reader with clear inclusion criteria.
    • CMS178v1/NQF0453

      In the denominator of SCIPInf9:

      ◦AND: "Occurrence A of Procedure, Performed: Hospital measures-Joint Commission evidence of a surgical procedure requiring general or neuraxial anesthesia" ends during "Occurrence A of Encounter, Performed: Encounter Inpatient"
      ◦AND: "Occurrence A of Procedure, Performed: Hospital measures-Joint Commission evidence of a surgical procedure requiring general or neuraxial anesthesia (start datetime)" >= 1 minute(s) starts after start of "Occurrence A of Encounter, Performed: Encounter Inpatient"

      I'm trying to figure out if I'm missing an important nuance in this logic, that would make writing it as these two lines different from writing one line of:

      ◦AND: "Occurrence A of Procedure, Performed: Hospital measures-Joint Commission evidence of a surgical procedure requiring general or neuraxial anesthesia" during "Occurrence A of Encounter, Performed: Encounter Inpatient"

      The only difference I could see is that if you wrote the 1 line, it would include Anesthesias that started at the exact same time as the beginning of the encounter, where the two separate logic statements would not.

      Given that it's extremely unlikely that an anesthesia would start the exact same minute as the encounter, is there some other reason for writing this check in the more complicated form that was decided on for SCIPInf9 or is this just a case of the measure author's writing style?

            jefferyl.garner Jeffery L. Garner (Inactive)
            tamarabailey Tamara Bailey (Inactive)
            Deborah Krauss (Inactive), Saul Kravitz (Inactive)
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