The attached QRDA for test patient Timothy Cook is indicated as a numerator on Cypress. Based on the logic for CMS138v6 (submeasure 1), a patient is a numerator if:

he/she has gotten the appropriate tobacco screening asessment with a end result of smoker or non-smoker

A denominator exception is the following:

OR:
AND: "Occurrence A of Diagnosis: Limited Life Expectancy" starts before end of
"Measurement Period"
AND NOT: "Occurrence A of Diagnosis: Limited Life Expectancy" ends before end
of "Measurement Period"
OR: "Assessment, Performed not done: Medical Reason" for "Tobacco Use Screening"
<= 24 month(s) starts before end of "Measurement Period"

It would make sense for this patient to be a numerator as he had a smoking assessment (LOINC 72166-2) and was identified as a smoker (SNOMEDCT: 160603005) but he also has an active diagnosis code of Limited Life expectancy. Because of this, Timothy Cook is captured as an exception in our system.

Could you provide reasoning for why this patient should be a numerator as well as clarify the logic for Numerator/Denominator Exclusion for CMS138v6 for me?

Thank you!

Kind regards,

Kalena