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  2. CQM-7268

CMS68v13 - Numerator Clarification

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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      Thank you for your question regarding CMS68v13 (Documentation of Current Medications in the Medical Record). Please note that the Quality Data Model defines the encounter relevantPeriod to be associated with the patient admission and discharge (start/end or patient arrival and subsequent departure) times, and not related to administrative documentation times. This may require exploration with your EHR vendor to ensure that the most appropriate and clinically relevant encounter start and end times are used for mapping (i.e., the encounter ends when the patient leaves the facility). If you pointed to the clinically relevant encounter start and stop times (both on 9/10/2024 with a duration of ~1 hour) within the EHR, it would correctly classify the scenario presented as not meeting numerator criteria, as the medication review must be documented during the encounter relevantPeriod.
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      Thank you for your question regarding CMS68v13 (Documentation of Current Medications in the Medical Record). Please note that the Quality Data Model defines the encounter relevantPeriod to be associated with the patient admission and discharge (start/end or patient arrival and subsequent departure) times, and not related to administrative documentation times. This may require exploration with your EHR vendor to ensure that the most appropriate and clinically relevant encounter start and end times are used for mapping (i.e., the encounter ends when the patient leaves the facility). If you pointed to the clinically relevant encounter start and stop times (both on 9/10/2024 with a duration of ~1 hour) within the EHR, it would correctly classify the scenario presented as not meeting numerator criteria, as the medication review must be documented during the encounter relevantPeriod.
    • CMS0068v13

      Scenario:

      This is an ambulatory visit 

      Clinical Encounter Date 10-Sep-2024
      Clinical Encounter Closed Date 20-Sep-2024
      Medication Reviewed Date 19-Sep-2024

      For example, assuming the Encounter starts on 10-Sep-2024 where the patient and clinician had a face-to-face interaction and discussed about the current medication list and the patient left the clinic on the same day after the consultation (i.e. between 30 mins - 1hr). However, the encounter was not closed on the day itself due to some reasons and the clinician documented the medication review after 9 days from the start of encounter 19-Sep-2024 and closed the encounter on the next date 20-Sep-2024. 

      In the measure description, it states that Clinician documents medication review on the date of encounter. However, in CQL logic document of current medication must be reviewed during Qualifying encounter.

      Question:

      Does the above scenario valid to qualify for numerator since medication review was documented during the qualifying encounter. relevant period (i.e. 10-Sep-2024 to 20-Sep-2024) even though it is an ambulatory visit?

      or 

      Should the numerator fail since the medication review documentation was not performed on the date of encounter i.e. 10-Sep-2024 instead documented on 19-Sep-2024 before the encounter closed date?

            AIR EC eCQM Team AIR EC eCQM Team
            ShaliniK Shalini
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