[CQM-2923] CMS 52 / NQF 0405: IPP does not match for top and bottom portion of eSpec Created: 12/01/17  Updated: 04/30/19  Resolved: 04/30/19

Status: Closed
Project: eCQM Issue Tracker
Component/s: Guidance, Measure

Type: EC eCQMs - Eligible Clinicians Priority: Moderate
Reporter: Susan Marx (Inactive) Assignee: Mathematica EC eCQM Team (Inactive)
Resolution: Done Votes: 1
Labels: Guidance, Measure

Attachments: PNG File 2017-12-01_1350.png     PNG File 2017-12-01_1351.png    
Contact Name: Susan Marx
Contact Email: susan.marx@allscripts.com
Contact Phone: 919-800-5718
Institution/Name: Allscripts
Solution: The definition of $HIVisit limits the encounters to the measurement period:

$HIVvisit =
Union of:
"Encounter, Performed: Office Visit"
"Encounter, Performed: Face-to-Face Interaction"
"Encounter, Performed: Preventive Care Services - Established Office Visit, 18 and Up"
"Encounter, Performed: Preventive Care Services-Initial Office Visit, 18 and Up"
"Encounter, Performed: Preventive Care - Established Office Visit, 0 to 17"
"Encounter, Performed: Preventive Care- Initial Office Visit, 0 to 17"
"Encounter, Performed: Outpatient Consultation"
during "Measurement Period"
 
In addition, because there is one encounter within at least 90 days after another, there must be 2 encounters.
Solution Posted On:
2018 Performance Period EC eCQMs:
CMS52v6/NQF0405
Impact: Need clarification on mismatch between top and bottom portion of eSpec to complete configuration for 2018 Measure.

 Description   

While reviewing CMS 52v6 / NQF 0405 for configuration, we have noticed a discrepancy in the IPP 1, 2, 3 specification.
The top descriptive part says: at least two visits during the measurement year

The bottom part says: $HIVvisit >= 90 day(s) starts after end of $HIVvisit



 Comments   
Comment by Mathematica EC eCQM Team (Inactive) [ 07/13/18 ]

The denominator statement says there must be at least two visits during the measurement period, with at least 90 days between visits. As such, any 2 encounters that are at least 90 days apart meet the intent of the measure, regardless if there are other encounters between. As long as there are a pair of visits that meet this requirement, the patient will fall into the denominator. Numerator compliance is based on diagnosis or lab test date, not an encounter.

Comment by Kelly Cooper (Inactive) [ 06/14/18 ]

If there are more than 2 encounters, can the timeframe be counted between the first and last HIV encounters?

Comment by Mathematica EC eCQM Team (Inactive) [ 02/07/18 ]

​Because there is one encounter within at least 90 days after another, there must be 2 encounters.

Comment by Sarah Christie (Inactive) [ 12/01/17 ]

Clarification needed is does the intent of the measure require 2 visits during the measurement period or only one?

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