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  1. CYPRESS Issue Tracker
  2. CYPRESS-553

If we are encountering this issue during certification, should this error be ignored by certifying bodies since it is a logic issue to be corrected in the next release?

    Details

    • Type: Implementation Problem
    • Status: Closed
    • Priority: Blocker
    • Resolution: Delivered
    • Labels:
      None
    • Solution:
      Hide
      CMS122v3: Diabetes: Hemoglobin A1c Poor Control
      Patient is numerator compliant if most recent HbA1c level >9%, the most recent HbA1c result is missing, or if there are no HbA1c tests performed and results documented during the measurement period.
      • Numerator =
      o AND:
       OR:
       AND: MOST RECENT:"Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test" during "Measurement Period"
       AND: "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result > 9 %)"
       OR:
       AND: MOST RECENT:"Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"
       AND NOT: "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result)" starts after start of "Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test"
       OR NOT: "Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"
      Problem: Since a “Laboratory Test, Result” is indicative of “Laboratory Test, Performed” it is impossible to indicate that a “Laboratory Test, Result” has taken place after a “Laboratory Test, Performed.” Logically, it will appear that the “Laboratory Test, Result” has taken place at the same time as the “Laboratory Test, Performed.”

      Solution: To be consistent with the intent of the measure, change the “start after start” operand to the “start after or concurrent with start” operand to capture a “Laboratory Test, Result” that occurs concurrently with the “Laboratory Test, Performed”

       OR:
       AND: MOST RECENT:"Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"
       AND NOT:
       OR "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result)" starts after or concurrent with start of "Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test"
      Show
      CMS122v3: Diabetes: Hemoglobin A1c Poor Control Patient is numerator compliant if most recent HbA1c level >9%, the most recent HbA1c result is missing, or if there are no HbA1c tests performed and results documented during the measurement period. • Numerator = o AND:  OR:  AND: MOST RECENT:"Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test" during "Measurement Period"  AND: "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result > 9 %)"  OR:  AND: MOST RECENT:"Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"  AND NOT: "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result)" starts after start of "Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test"  OR NOT: "Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period" Problem: Since a “Laboratory Test, Result” is indicative of “Laboratory Test, Performed” it is impossible to indicate that a “Laboratory Test, Result” has taken place after a “Laboratory Test, Performed.” Logically, it will appear that the “Laboratory Test, Result” has taken place at the same time as the “Laboratory Test, Performed.” Solution: To be consistent with the intent of the measure, change the “start after start” operand to the “start after or concurrent with start” operand to capture a “Laboratory Test, Result” that occurs concurrently with the “Laboratory Test, Performed”  OR:  AND: MOST RECENT:"Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test" during "Measurement Period"  AND NOT:  OR "Occurrence A of Laboratory Test, Result: HbA1c Laboratory Test (result)" starts after or concurrent with start of "Occurrence A of Laboratory Test, Performed: HbA1c Laboratory Test"
    • Impact:
      certification is on hold

      Description

      For NQF 0059: Diabetes: Hemoglobin A1c Poor Control – the numerator is supposed to include patients whose most recent Hemoglobin A1c lab result value is >9%. In this case patient Ashley Briggs has an active diagnosis of Diabetes Mellitus (ICD-9-CM 250.01, dx date Feb 26, 2013) and her most recent Hemoglobin A1c lab result value is 8% (dt Jul 22, 2013). Since the patient's lab result value is <9% she is not included in the numerators. Cypress is expecting this patient (Ashley Briggs) along with patient Jessie Bowman to be included in the numerator (both these patients qualify the initial patient population and denominator requirements of NQF 0059). Since Ashley Briggs is not reported, Cypress is considering it as an error hence the 11 error messages and the failure of the measure.

      The cloned JIRA issue states this is a logic error to be corrected in the next release. If we are encountering this issue during certification, should this error be ignored by certifying bodies?

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              • Assignee:
                dczulada David Czulada
                Reporter:
                KelliKlippenstein Kelli Klippenstein
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