Background: In an episode of care measure, the episodes of care are identified in the Initial Patient Population, and are always designated by a specific occurrence.

Problem: CMS 161v2 (NQF 0104) calculates episode counts for the IPP and Denominator incorrectly. Specifically for the patient BH_Adult, A, an extra episode of care is incorrectly counted. (See Example Attached)

Testing Results: Cypress reports a value of 2 for the IPP and Denominator of CMS 161 (NQF 0104) for the patient BH_Adult, A when it should report a value of 1 for the IPP and Denominator.

Certification Results: An EHR vendor does not pass certification due to mismatched results.

Solution: Testing being conducted today using Cypress should manually accept a result of 1 for the IPP and Denominator instead of the value of 2 currently being calculated and displayed by the Cypress software. The next release of Cypress will properly calculate the value of 1 for the IPP and Denominator.

Other Considerations: No other patients or measures are affected by this incorrect calculation.