Loading...

Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
Resolution: Answered
Priority: Blocker
Component/s: None
Labels:
None

Solution:

Hide
Thank you for your question regarding CMS832v3, Hospital Harm - Acute Kidney Injury. CreatinineTestTime is looking for the relevantDatetime or start of relevantPeriod for each creatinine test using the "EarliestOf" function, the two options are provided to allow for differences in how electronic health record systems may report date/time values. Each creatinine test result is then evaluated to determine whether it is (a) 1.5 times higher than the lowest creatinine value within the last 7 days, (b) higher than the sex-specific normal value, and (c) 48 hours to 30 days after the start of the hospitalization.

CreatinineTestTime is assigning a Datetime to each value of CreatinineTest. “Test” is the alias for the “SerumCreatinineSequenceByQuantity” function, which sorts the creatinine values from lowest to highest. The "Encounter with 1.5 Times Serum Creatinine Increase" logic then compares whether the Datetime for the lowest test (“Test”) is 7 days or less before the Datetime for CreatinineTest (CreatinineTestTime).

In your example, the values for creatinine are higher than real-world values so we have modified them by dividing by 100. Assuming Patient ABC has 4 creatinine tests, the lowest value, 0.4 mg/dL, occurs Jan 3, 2026 at 5 am. This would be the value for Test, assuming all other criteria for the IP are met. In this example, only Test 4, Jan 6, 2026 at 7:59 am with a value of 1.14 mg/dL would return QualifyingEncounter, assuming Test 4 occurs between 48 hours and 30 days after admission. Test 4 is more than 1.5 times the value of Test 1 and is higher than the sex-specific normal value of 1.02 mg/dL for females.

Show
Thank you for your question regarding CMS832v3, Hospital Harm - Acute Kidney Injury. CreatinineTestTime is looking for the relevantDatetime or start of relevantPeriod for each creatinine test using the "EarliestOf" function, the two options are provided to allow for differences in how electronic health record systems may report date/time values. Each creatinine test result is then evaluated to determine whether it is (a) 1.5 times higher than the lowest creatinine value within the last 7 days, (b) higher than the sex-specific normal value, and (c) 48 hours to 30 days after the start of the hospitalization. CreatinineTestTime is assigning a Datetime to each value of CreatinineTest. “Test” is the alias for the “SerumCreatinineSequenceByQuantity” function, which sorts the creatinine values from lowest to highest. The "Encounter with 1.5 Times Serum Creatinine Increase" logic then compares whether the Datetime for the lowest test (“Test”) is 7 days or less before the Datetime for CreatinineTest (CreatinineTestTime). In your example, the values for creatinine are higher than real-world values so we have modified them by dividing by 100. Assuming Patient ABC has 4 creatinine tests, the lowest value, 0.4 mg/dL, occurs Jan 3, 2026 at 5 am. This would be the value for Test, assuming all other criteria for the IP are met. In this example, only Test 4, Jan 6, 2026 at 7:59 am with a value of 1.14 mg/dL would return QualifyingEncounter, assuming Test 4 occurs between 48 hours and 30 days after admission. Test 4 is more than 1.5 times the value of Test 1 and is higher than the sex-specific normal value of 1.02 mg/dL for females.
2026 Reporting Period Hosp Inpt eCQMs:

CMS0832v3

Hi Team,

Consider the below CQL statements from cms832v3 :

"Encounter with 1.5 Times Serum Creatinine Increase"
from
"Encounter with Creatinine and without Obstetrical Conditions" QualifyingEncounter,
["Laboratory Test, Performed": "Creatinine Mass Per Volume"] CreatinineTest
let
LowestCreatinineTestWithin7DaysPrior: "LowestSerumCreatinineWithin7DaysPrior"(QualifyingEncounter, CreatinineTest),
CreatinineTestTime: Global."EarliestOf" ( CreatinineTest.relevantDatetime, CreatinineTest.relevantPeriod ),
HospitalWithObservation: Global."HospitalizationWithObservation" (QualifyingEncounter)
where CreatinineTest.result.value >= LowestCreatinineTestWithin7DaysPrior * 1.5
and CreatinineTest.result.value > "Serum Creatinine Normal"
and CreatinineTestTime during Interval[start of HospitalWithObservation + 48 hours, start of HospitalWithObservation + 30 days]
return QualifyingEncounter

LowestSerumCreatinineWithin7DaysPrior(QualifyingEncounter "Encounter, Performed", CreatinineTest "Laboratory Test, Performed")
First(
("SerumCreatinineSequenceByQuantity"(QualifyingEncounter)) Test
where Global."EarliestOf"(Test.relevantDatetime, Test.relevantPeriod) 7 days or less before Global."EarliestOf"(CreatinineTest.relevantDatetime, CreatinineTest.relevantPeriod)
).result.value

Queries:

Consider, Female Patient ABC aged 20 years at the start of InpatientEncounter.relevantPeriod. Consider the patient has IPP Qualifying data, Below mentioned Patient has 4 CreatinineTest.result.values.
Visit 1
Procedure start date(relevantDatetime) : 2026-01-06 07:59:59.000 and has Numeric value of 114.00
Procedure start date(relevantDatetime) : 2026-01-05 07:00:00.000 and has Numeric value of 55.00
Procedure start date(relevantDatetime) : 2026-01-04 06:00:00.000 and has Numeric value of 50.00
Procedure start date(relevantDatetime) : 2026-01-03 05:00:00.000 and has Numeric value of 40.00

1) For Patient ABC how do we identify CreatinineTestTime if a patient has multiple CreatinineTest.result.value on different CreatinineTest.relevantDatetime?
2) We understand the LowestSerumCreatinineWithin7DaysPrior is the lowest serum creatinine value in the 7 days lookback irrespective of the Test.relevantDatetime.

Help us on how to distinguish between CreatinineTestTime (CreatinineTest.relevantDatetime) and Test.relevantDatetime (7DaysPrior).

What will be the CreatinineTestTime (CreatinineTest.relevantDatetime) for the above example.

Kindly assist us on the above queries urgently as client deliverables are dependent upon it.

Details

Description

Attachments

Activity

People

Dates