CMS144 and 135 visits

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
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      Thank you for inquiring about the Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) measure. The measure requires two qualifying encounters and one heart outpatient failure encounter to qualify the patient for the Initial Population. Heart failure encounters are considered qualifying encounters. In the scenario presented, the measure allows for the diagnosis to be captured during the second encounter to meet the IPP of “All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure on or before at least one qualifying encounter”. A third encounter is not required in this scenario.
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      Thank you for inquiring about the Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) measure. The measure requires two qualifying encounters and one heart outpatient failure encounter to qualify the patient for the Initial Population. Heart failure encounters are considered qualifying encounters. In the scenario presented, the measure allows for the diagnosis to be captured during the second encounter to meet the IPP of “All patients aged 18 years and older with two qualifying encounters during the measurement period and a diagnosis of heart failure on or before at least one qualifying encounter”. A third encounter is not required in this scenario.
    • CMS0144v13
    • Clarification on which encounters qualify for Initial Population.

      For CMS 144 and 135 it states
      AgeInYearsAt(date from start of "Measurement Period") >= 18
        and exists ( "Qualifying Outpatient Encounter During Measurement Period" Encounter1
            with "Qualifying Outpatient Encounter During Measurement Period" Encounter2
              such that Encounter2.id !~ Encounter1.id
        )
        and exists "Heart Failure Outpatient Encounter"
       
      We understand that there must be 2 "Qualifying Outpatient Encounter During Measurement Period" and 1 "Heart Failure Outpatient Encounter" to be in the Initial Population.

      Is it possible that the "Heart Failure Outpatient Encounter" could be one of the 2 "Qualifying Outpatient Encounter During Measurement Period" such as Encounter 1 or Encounter 2? 

      For example:
      Encounter 1 - "Patient Provider Interaction"
      Encounter 2 - "Office Visit" with "Diagnosis": "Heart Failure"

      Would the ablove scenario meet the Initial population or would a 3rd encounter have to be present to account for 2 "Qualifying Outpatient Encounter During Measurement Period"

            Assignee:
            AIR EC eCQM Team
            Reporter:
            Joseph Long
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              Created:
              Updated:
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