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Thank you for reaching out with your question concerning CMS144v11/12 and CMS145v11/12 Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) & CAD: Beta-Blocker Therapy-Prior MI or Left Ventricular Systolic Dysfunction. You are correct that there is no procedural logic expression that would allow a patient to meet this exception if they’ve ever had a cardiac pacer implantation procedure. This element is intentionally authored this way, as per our clinical experts,”patients who have advanced atrioventricular block requiring cardiac pacer are usually pacer dependent and usually require a pacemaker re-implantation, even if the original pacer is removed or modified”. Due to these patients having a clinical dependency on cardiac pacer, there is no provision for pacer removal.
Thank you for reaching out with your question concerning CMS144v11/12 and CMS145v11/12 Heart Failure: Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD) & CAD: Beta-Blocker Therapy-Prior MI or Left Ventricular Systolic Dysfunction. You are correct that there is no procedural logic expression that would allow a patient to meet this exception if they’ve ever had a cardiac pacer implantation procedure. This element is intentionally authored this way, as per our clinical experts,”patients who have advanced atrioventricular block requiring cardiac pacer are usually pacer dependent and usually require a pacemaker re-implantation, even if the original pacer is removed or modified”. Due to these patients having a clinical dependency on cardiac pacer, there is no provision for pacer removal.
CMS0144v12, CMS0145v12
CMS0144v11, CMS0145v11
We want to ensure our SQL reports are aligning with the intention of the measure, despite the specification logic seemingly being inconsistent.
For the CMS 144/145, there is a denominator exception for when a patient has an active diagnosis of atrioventricular block and not a pacemaker. In the specifications, this is described in the "Has Diagnosis of Cardiac Pacer in Situ" ** and "Has Cardiac Pacer Device Implanted" data terms.
For "Has Diagnosis of Cardiac Pacer in Situ", the specifications make it clear that this diagnosis must overlap the Heart Failure encounter:
such that CardiacPacerDiagnosis.prevalencePeriod overlaps after ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
For the "Has Cardiac Pacer Device Implanted", the specifications make it clear that this procedure has to have happened prior to the Heart Failure encounter:
such that ( Global."NormalizeInterval" ( ImplantedCardiacPacer.relevantDatetime, ImplantedCardiacPacer.relevantPeriod ) ) starts before
end of ModerateOrSevereLVSDHFOutpatientEncounter.relevantPeriod
The logic seems to be inconsistent, as the latter suggests that once a cardiac pacemaker has been implanted, they will never be able to meet this exception, while the former suggests that if the diagnosis is made inactive/historical by the time the encounter occurs, then they would be able to qualify.
If a patient had a pacemaker, and that pacemaker was removed prior to the heart failure encounter, then would they qualify for this exception since they did not currently have the pacemaker diagnosis, or would they not qualify since they had a history of having the procedure?
Thank you for submitting your question. We will review your ticket and provide a response as soon as possible.
Mathematica EC eCQM Team
added a comment - Thank you for submitting your question. We will review your ticket and provide a response as soon as possible.
Mathematica EC eCQM Team
Angela Reed (Inactive)
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CQM","validSearcher":true,"isShown":true},"assignee":{"name":"Assignee","editHtml":"\n \n <div class=\"field-group aui-field-userlist\" >\n <label for=\"searcher-assigneeSelect\">Assignee</label> <fieldset rel=\"assignee\" class=\"hidden user-group-searcher-params\">\n </fieldset>\n <select class=\"js-usergroup-checkboxmultiselect\" multiple=\"multiple\" id=\"assignee\" name=\"assignee\" data-placeholder-text=\"Enter username or group\">\n <optgroup>\n <option class=\"headerOption\" data-icon=\"https://oncprojectracking.healthit.gov/support/secure/useravatar?size=xsmall&avatarId=10123\" value=\"empty\" title=\"Unassigned\">Unassigned</option>\n </optgroup>\n <optgroup>\n </optgroup>\n </select>\n <input type=\"hidden\" name=\"check_prev_assignee\" value=\"true\">\n </div>\n \n","validSearcher":true,"isShown":true},"customfield_23400":{"name":"2023 Performance Period EC eCQMs","viewHtml":" <div class=\"searcherValue\">\n \n <label class=\"fieldLabel\" for=\"fieldcustomfield_23400\">2023 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EC eCQMs - Eligible Clinicians
Moderate
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