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  1. QRDA Issue Tracker
  2. QRDA-1218

CMS1206 Excessive Radiation

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    • Icon: Question/Guidance Question/Guidance
    • Resolution: Resolved
    • Icon: Moderate Moderate
    • None
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    • CMS1206v1
    • Implementation concerns
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      Thank you for your inquiry on CMS1206v1 (Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography (CT) in Adults (Facility OQR)).

      The rationale for associating the CT scan to a non-event is to ensure that the OQR version of the measure (CMS1206v1) will not include any scans that are accounted for in the IQR version of the measure (CMS1074v1). To tie the CT scan to all possible outpatient encounter types would require a value set that contains all possible outpatient codes, which we decided was prohibitive to develop.

      Specific to your question asking if Age at the start of the Measurement Period refers to a quarter, the measurement period is a parameter to this measure and could be a quarter or a year. This determination is made by whoever is generating the measure report. The measure itself, ensure that the patient was at least 18 years of age at the start of the measurement period being reported on.

      Specific to this outpatient measure, only CT scans performed in an outpatient setting are considered. CT scans performed in an inpatient setting will be reported in CMS1074 (Inpatient version of the measure) and would not be accommodated in CMS1206v1.

      Finally, Diagnostic Study, Performed in QDM allows for components so the value for noise will be reported as one component and the value for dose will be another component. Each component will have a code and a result.
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      Thank you for your inquiry on CMS1206v1 (Excessive Radiation Dose or Inadequate Image Quality for Diagnostic Computed Tomography (CT) in Adults (Facility OQR)). The rationale for associating the CT scan to a non-event is to ensure that the OQR version of the measure (CMS1206v1) will not include any scans that are accounted for in the IQR version of the measure (CMS1074v1). To tie the CT scan to all possible outpatient encounter types would require a value set that contains all possible outpatient codes, which we decided was prohibitive to develop. Specific to your question asking if Age at the start of the Measurement Period refers to a quarter, the measurement period is a parameter to this measure and could be a quarter or a year. This determination is made by whoever is generating the measure report. The measure itself, ensure that the patient was at least 18 years of age at the start of the measurement period being reported on. Specific to this outpatient measure, only CT scans performed in an outpatient setting are considered. CT scans performed in an inpatient setting will be reported in CMS1074 (Inpatient version of the measure) and would not be accommodated in CMS1206v1. Finally, Diagnostic Study, Performed in QDM allows for components so the value for noise will be reported as one component and the value for dose will be another component. Each component will have a code and a result.

      This measure is associating the CT scan to a Non-Eevent, Not Inpatient Encounter. Most hospital data is associated to an inpatient or an outpatient visit. It would be easier to find , Report on, and sort data if it was associated to an actual Outpatient Encouter. Is there some reason for not doing this?

      Age at the start of the Measurement Period, does that refer to a Quarter? So the calculation is comparing Date of Birth to the start of a Quarter, and the Quarter is determined by the CT Scan date?

       

      What if the scan was done as an Outpatient, say in the Emergency Department and then the patient transferred to an Inpatient setting.  What is the relationship of the CT Scan time to the Inpatient Encounter Time?

       

      Diagnostic, Study in the QDM 5.6 does not have fields for 

      • Calculated CT global noise" 
      • Calculated CT size-adjusted dose" 
      • How do we transmit these via a QRDA I file?

            yanheras Yan Heras
            megbutler Margaret Butler
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