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  1. eCQM Issue Tracker
  2. CQM-7341

Definition of "overlaps"

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Icon: Moderate Moderate
    • None
    • None
    • Brandon Roberts
    • CompuMedical Group
    • Hide
      Thank you for your inquiry regarding the Advanced Illness and Frailty exclusion. According to the measure steward, the National Committee for Quality Assurance (NCQA), in your example, a patient with an active frailty diagnosis in 2022, will count for the 2024 reporting year. Since the diagnosis must overlap the measurement period, a frailty diagnosis with an active date of 2022 and no resolved date will qualify for the exclusion, as it indicates an ongoing frailty status.
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      Thank you for your inquiry regarding the Advanced Illness and Frailty exclusion. According to the measure steward, the National Committee for Quality Assurance (NCQA), in your example, a patient with an active frailty diagnosis in 2022, will count for the 2024 reporting year. Since the diagnosis must overlap the measurement period, a frailty diagnosis with an active date of 2022 and no resolved date will qualify for the exclusion, as it indicates an ongoing frailty status.
    • CMS0122v13
    • CMS0122v12
    • Affects whether patients meet the exclusion of CMS122

      We need to confirm the expected functionality of the word "overlaps". In the Exclusion of CMS122 (with similar concepts in other measures), there is the following verbiage:

      • exists ( ["Device, Order": "Frailty Device"] FrailtyDeviceOrder
        where FrailtyDeviceOrder.authorDatetime during day of "Measurement Period"
        )
        or exists ( ["Assessment, Performed": "Medical equipment used"] EquipmentUsed
        where EquipmentUsed.result in "Frailty Device"
        and Global."NormalizeInterval" ( EquipmentUsed.relevantDatetime, EquipmentUsed.relevantPeriod ) ends during day of "Measurement Period"
        )
        or exists ( ["Diagnosis": "Frailty Diagnosis"] FrailtyDiagnosis
        where FrailtyDiagnosis.prevalencePeriod overlaps "Measurement Period"
        )
        or exists ( ["Encounter, Performed": "Frailty Encounter"] FrailtyEncounter
        where FrailtyEncounter.relevantPeriod overlaps "Measurement Period"
        )
        or exists ( ["Symptom": "Frailty Symptom"] FrailtySymptom
        where FrailtySymptom.prevalencePeriod overlaps "Measurement Period"
        )

      The question is, if a patient has a a Frailty Diagnosis with an active date of 2022 with no resolved date (and no other interactions or diagnoses of it since 2022), should that Frailty Diagnosis still count in 2024 reporting year/measurement period? Or does there have to be some sort of indication or interaction or instance of that Frailty Diagnosis in the reporting year/measurement period in order for it to count?

            AIR EC eCQM Team AIR EC eCQM Team
            brandon.roberts Brandon Roberts
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