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2018 CMS149v6: Numerator Criteria lookback condition

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    • Dementia: Cognitive Assessment
    • CMS149
    • Critical: The way how measure specification defines numerator criteria is not matching how Bonnie is calculating this criteria.

      According to CMS specification, numerator is met for this measure with below condition:
      Numerator =
      AND: Union of:
      "Assessment, Performed: Standardized Tools for Assessment of Cognition (result)"
      "Intervention, Performed: Cognitive Assessment"
      <= 12 month(s) starts before end of Occurrence A of $DEMEncounters149 (Defined as a set of encounters during measurement period)

      Bonnie only considers numerator met, if that assessment or intervention is performed within <=12 months from the encounter which is overlapping diagnosis. However, numerator condition on the measure specification does not mention that this documentation has to be fulfilled only within <= 12 months from the $DEMEncounter which overlaps the diagnosis. Please advise on how to proceed with this scenario.

      Attaching the screenshots and description: CMS149v6_Bonnie_Issue.pdf

            lizziedy Lizzie Charbonneau
            saileshdixit Sailesh
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