[CQM-6792] Which encounters should BMI readings come from? Created: 02/27/24 Updated: 03/05/24 Resolved: 03/05/24 |
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| Status: | Closed |
| Project: | eCQM Issue Tracker |
| Component/s: | None |
| Type: | EC eCQMs - Eligible Clinicians | Priority: | Moderate |
| Reporter: | Salma (Inactive) | Assignee: | Mathematica EC eCQM Team (Inactive) |
| Resolution: | Answered | Votes: | 0 |
| Labels: | None | ||
| Contact Name: | Salma Basnet |
| Contact Email: | sbasnet@ncqa.org |
| Solution: | Thank you for the question regarding CMS69v12: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. The value set “Encounter to Evaluate BMI” defines qualifying encounters for the measure. A patient must have a qualifying encounter during the measurement period to be included in the measure denominator. For patients included in the denominator, all BMIs that meet the criteria in the guidance section are included to evaluate the numerator, regardless of if the BMI was collected during a qualifying encounter. As noted in the measure guidance, if more than one BMI is reported during the measurement period and any of the documented BMI assessments is outside of normal parameters, documentation of an appropriate follow-up plan will be used to determine if the patient is included in the numerator. In your example, the patient would be included in the denominator with the qualifying encounter and would be required to conduct follow-up given the high BMI recorded in December. If no follow-up is conducted for the patient, that patient would not meet numerator criteria.
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| Solution Posted On: | |
| 2023 Performance Period EC eCQMs: |
CMS0069v11
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| Description |
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This question concerns CMS69v12, aka Q-CMS69: PREVENTIVE CARE AND SCREENING: BODY MASS INDEX (BMI) SCREENING AND FOLLOW-UP PLAN. Can you please clarify which encounters BMI readings should come from? The definition of “BMI during Measurement Period” says “where Global."NormalizeInterval" ( BMI.relevantDatetime, BMI.relevantPeriod ) during day of "Measurement Period" which sounds like it should come from any encounter, but the denominator encounter definition “Qualifying Encounter during Measurement Period” is pulled using a value set named "Encounter to Evaluate BMI", which makes us think maybe the BMI should only come from those encounters. Logically it could also make sense to seek out any BMI that occurs in the measurement period as of the latest denominator encounter but there is nothing in the specification mentioning any sort lookback logic. To give a concrete example, a patient is seen for a denominator encounter in June where the BMI is within the recommended range. Then they are seen again in December where a high BMI is recorded but doesn’t qualify as an “Encounter to Evaluate BMI”. Assuming no follow-up is done at any time in the year, is that patient in the numerator or not? |
| Comments |
| Comment by Mathematica EC eCQM Team (Inactive) [ 02/28/24 ] |
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