We are coming across and use case that we wanted to get a confirmation for CMS124. We have a customer that has couple of patients documented for Gender as Female (Now) who also have a documentation that they are transgender. Please see the two use cases below and provide a guideline.
Case 1: Patient was a male and now is a female transgender
In this scenario according to our customer patient does have the physiology to perform cervical cancer screening and I was not able to find any standard guidelines on this matter. Upon further clarification customer established a standard workflow that they follow where they would identify these patients as female and also set the identifier for transgender. Hence, the customer mentioned that these patients should not be considered for IPP in the measure. Could you please confirm on the same??
Case 2: Patient was a female and now is a male transgender
In this scenario, according to our customer since the patient used to be female, they still have the physiology which allows our customers to perform cervical cancer screen. Upon further clarification, they follow this standard of documentation for any transgender patient. Hence, these patients should count in the IPP of the measure. Could you please confirm if this would be ok for us consider as a part of the IPP logic??

Also if this logic to identify gender holds true, would we have to make this change appropriately to all measures that are specifically looking at gender specific information? Below are some of the other measures that will get affected based on your response.
CMS125 Breast cancer screen – looks for female patients
CMS129 Prostate cancer – looks for male patients
CMS153 Chlamydia Screening for Women – looks for female patients
CMS158 Pregnant women that had HBsAg testing – looks for female patients