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  1. QRDA Issue Tracker
  2. QRDA-237

Should Patient Characteristic Birthdate be accurate to days or second?

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    • Icon: QRDA-I Standard QRDA-I Standard
    • Resolution: Done
    • Icon: Minor Minor
    • None
    • Will cause either incorrect measure status calculation for PC-05 or will cause failure in document validation.
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      Each year CMS publishes new CMS QRDA Implementation Guide, you should always use the correct version of CMS QRDA IG for the reporting period you will be reporting on. For example, for the 2016 reporting period, the 2016 CMS QRDA IG and the 2016 CMS QRDA IG Appendix both should be used.

      For the 2016 reporting period, it will be acceptable to submit birthTime that is precise to minutes or seconds to the HQR system. The HQR system only requires that birthTime to be precise at least to the day. The HQR system has also confirmed that the measure engine will properly calculate PC-05 measure logic if birthTime provided is precise to minutes or seconds. The requirement for birthTime precision will be made clear in the 2017 CMS QRDA IG.
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      Each year CMS publishes new CMS QRDA Implementation Guide, you should always use the correct version of CMS QRDA IG for the reporting period you will be reporting on. For example, for the 2016 reporting period, the 2016 CMS QRDA IG and the 2016 CMS QRDA IG Appendix both should be used. For the 2016 reporting period, it will be acceptable to submit birthTime that is precise to minutes or seconds to the HQR system. The HQR system only requires that birthTime to be precise at least to the day. The HQR system has also confirmed that the measure engine will properly calculate PC-05 measure logic if birthTime provided is precise to minutes or seconds. The requirement for birthTime precision will be made clear in the 2017 CMS QRDA IG.

      We have been submitting Eligible Hospital QualityNet test submissions for the PC-05 measure with a Patient Characteristic Birthdate as a time granular to the second. In preparation for the 2016 Reporting Year, the Denominator Exclusion for PC-05 looks for a data element within an hour after the start of Patient Characteristic Birthdate. Upon test submissions to QualityNet we encountered the following conformance error that is sourced to the Reporting Year 2014 EH Supplementary Implementation Guide:

      SHALL contain exactly one (1...1) value. The birthTime SHALL be precise to day (CONF-HR:5300-1).

      1. Are CMS Supplemental Implementation Guides cummulative? For Reporting Year 2015, are Supplemental Implementation Gudes from RY 2014 and RY 2015 both applicable? Additionally, for Reporting Year 2016, will Supplemental Implementation Guides from RY 2014, RY 2015, and RY 2016 all applicable? Or will there be a demarcation for RY 2016 to stand alone since the base standard has moved to QRDA R3?

      2. If CMS Supplemental Implementation Guides are cummulative and we must send a birthTime accurate to day, this essentially invalidates the reporting accuracy of PC-05a in that almost all patients who should be reported as Numerator will instead be reported as Denominator Exclusion.

            yanheras Yan Heras
            Alex Liu Alex Liu
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