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  2. CQM-7267

CMS832 Hospital Harm - Acute Kidney Injury Low and High Creatinine Results

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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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      Thank you for your question on CMS832v2, Hospital Harm – Acute Kidney Injury.

      Specific to the values used to identify the 1.5 times and 2 times serum creatinine increase, the measure evaluates the highest creatinine value (HighCreatinineTest.result.value) during the encounter and the lowest creatinine value (LowCreatinineTest.result.value) within the 7 days prior to the highest creatinine value.

      Per the examples provided, in both encounters, the highest creatinine value is 2.0 (on 10/8).
       
      In the first example, the lowest creatinine value is 0.9 (on 9/20). Since the lowest value is not within 7 days prior to the highest value, this patient would not meet the numerator.

      In the second example, the lowest creatinine value is 0.7 (on 10/6), which corresponds to both 1.5 times and 2 times increase based on the highest creatinine value. Therefore, this encounter would meet the numerator criteria for AKI (stage 2 or greater).
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      Thank you for your question on CMS832v2, Hospital Harm – Acute Kidney Injury. Specific to the values used to identify the 1.5 times and 2 times serum creatinine increase, the measure evaluates the highest creatinine value (HighCreatinineTest.result.value) during the encounter and the lowest creatinine value (LowCreatinineTest.result.value) within the 7 days prior to the highest creatinine value. Per the examples provided, in both encounters, the highest creatinine value is 2.0 (on 10/8).   In the first example, the lowest creatinine value is 0.9 (on 9/20). Since the lowest value is not within 7 days prior to the highest value, this patient would not meet the numerator. In the second example, the lowest creatinine value is 0.7 (on 10/6), which corresponds to both 1.5 times and 2 times increase based on the highest creatinine value. Therefore, this encounter would meet the numerator criteria for AKI (stage 2 or greater).
    • CMS0832v2

      The solution provided on https://oncprojectracking.healthit.gov/support/browse/CQM-7220 explained how to determine the values to be used in 'Encounter with 1.5 Times Serum Creatinine Increase' definition. It stated 'In reviewing creatinine values 7 days out from 9/20, the highest creatinine value is 1.19 mg/dL (9/23/25 10:01)' - based on the example provided in that Jira.

      Based on the metadata, the intent of ‘Encounter with 1.5 Times Serum Creatinine Increase’ definition is to 'evaluate if any serum creatinine value obtained between 48 hours after the start of the encounter and either 30 days after the start of the encounter or discharge, whichever is sooner, is at least 1.5 times higher than the lowest value obtained within the prior 7 days'.

      We are looking for additional clarification on the values to use in the x1.5 or x2 logics. The HighCreatinineTest.result.value and LowCreatinineTest.result.value are defined as ‘Last’ or ‘First’ result values in the qualifying encounter, respectively.

      How does the CQL logic indicate to evaluate the ‘highest’ within 7 days of the lowest, instead of the and ‘Highest’ identified by "HighestSerumCreatinine"(QualifyingEncounter) function?

      Can you explain which values will be used for the x1.5 or x2 logic in the following examples:

      Male Patient admitted 9/20/25 0600
      Creatinine Datetime Value
      9/20/2025 7:13 0.9
      9/21/2025 7:13 1
      9/22/2025 13:06 1.13
      9/23/2025 10:01 1.4
      9/29/2025 7:01 1.7
      10/2/2025 10:00 1.5
      10/6/2025 10:00 1.7
      10/7/2025 9:00 1.8
      10/8/2025 10:00 2
      10/9/2025 10:00 Discharge
       
      Male Patient admitted 9/20/25 0600
      Creatinine Datetime Value
      9/20/2025 7:13 0.9
      9/21/2025 7:13 1
      9/22/2025 13:06 1.13
      9/23/2025 10:01 1.4
      9/29/2025 7:01 1.7
      10/2/2025 10:00 1.5
      10/6/2025 10:00 0.7
      10/7/2025 9:00 1.8
      10/8/2025 10:00 2
      10/9/2025 10:00 Discharge

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            aweber Mathematica EH eCQM Team
            TWILL2014 Talisa Williams
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