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  2. CQM-829

NUM criteria

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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    • Measure
    • Elissa Chandler
    • 2677255354
    • NextGen Healthcare Information Systems
    • measure specification and logic questions
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      Response to Question 1#:
      The numerator criteria for CMS 138v2 looks to capture the most recent tobacco use status. The Boolean logic statements ‘AND/AND NOT’ are used to ensure that if a patient was identified as a tobacco non-user at Encounter A, they were not later identified at a subsequent encounter as a tobacco user, and vice versa. If what is confusing is the ordering of the ‘AND NOT’ and ‘AND’ nested bullets, the Measure Authoring Tool (MAT) in which the measure is input does not allow for particular ordering within a nested bullet at this time.

      Response to Question 2#:
      The logic for the tobacco cessation counseling or pharmacotherapy within the Numerator is tied to a timing component of ‘<=24 month(s) starts before or during ‘Measurement End Date’’. Therefore, based on the two scenarios you provided, the second one would be correct. The tobacco use cessation actions need to occur within the timeframe of 24 months before the end of the measurement/reporting period.
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      Response to Question 1#: The numerator criteria for CMS 138v2 looks to capture the most recent tobacco use status. The Boolean logic statements ‘AND/AND NOT’ are used to ensure that if a patient was identified as a tobacco non-user at Encounter A, they were not later identified at a subsequent encounter as a tobacco user, and vice versa. If what is confusing is the ordering of the ‘AND NOT’ and ‘AND’ nested bullets, the Measure Authoring Tool (MAT) in which the measure is input does not allow for particular ordering within a nested bullet at this time. Response to Question 2#: The logic for the tobacco cessation counseling or pharmacotherapy within the Numerator is tied to a timing component of ‘<=24 month(s) starts before or during ‘Measurement End Date’’. Therefore, based on the two scenarios you provided, the second one would be correct. The tobacco use cessation actions need to occur within the timeframe of 24 months before the end of the measurement/reporting period.
    • CMS139v1/NQF0101
    • High importance in measures development process for our dev team

      CMS138v2 most current version

      NUM Criteria:

      Question 1#: The numerator criterion is looking for most recent Tobacco Status for either ‘Tobacco Non User’ or ‘Tobacco User’, correct? As the logic in Spec is extremely confusing, see below.

      The criteria ‘AND NOT’ before the condition for Tobacco User/Non User is to ensure we are capturing the most recent tobacco status within 24 months, correct?

      Question 2#: If patients are identified as a ‘Tobacco User’, does the Tobacco Cessation Counseling have to be documented within 24 months prior to OR equal to the visit where the Tobacco User status was documented?

      Or can Tobacco Cessation Counseling also be documented within 24 months prior to the end of the reporting period and up until the end of the reporting period?

        1. NextGen question CMS138v2_8_27_13.docx
          54 kB
          Elissa Chandler

            eribeiro eldred (Inactive)
            elissa Elissa Chandler (Inactive)
            Cindy Cullen, Minet Javellana (Inactive)
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