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  1. CYPRESS Issue Tracker
  2. CYPRESS-1494

CMS169v6: B BH Adult appears to lack required data for denominator

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    • Icon: Bug/Issue Bug/Issue
    • Resolution: Resolved
    • Icon: Moderate Moderate

      Cypress patients for measure attached.  

      The CMS169 measure is supposed to have 3 denominator patients according to the Cypress Master Patient List:
      BH Adult, ZFIVE 
      BH Adult, A N
      BH Adult, B

      The patient BH Adult, B appears to lack the required data to be in the denominator.
      It has the following data:
      DX Major Depr F32.0 10/2/2018
      Encounter 99203 on 11/1/2017
      Encounter 99213 on 10/2/2018 
      Encounter 99213 on 11/2/2018
      Encounter 90837 (psych) 12/3/2018
      RX 10/2/2018
      Alcohol Screen 99409 on 10/2/2018

      The Encounter 99213 on 10/2/2018 must be the Index encounter ($BH Encounter) as it must be:
      1) within the measurement period
      2) start before >=42 days of end of measurement period (by Nov. 20)
      3) start before or concurrent with Diagnosis BH Condition (which is 10/2/2018)

      If that is the Index encounter, then the BH Psychotherapy encounter must be no later than 11/13/2018 but the Encounter 90837 is on 12/3/2018 which is 62 days after the Index date.

      The other two patients in the Cypress bundle are passing the denominator are expected.

            laclark Laura Clark
            debbie.mobley@clinigence.com Debbie Mobley
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              Created:
              Updated:
              Resolved: