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The denominator exceptions were intended to include diagnoses that are listed as “active” in the patient’s problem list. The active status of the diagnosis can start at any time in the past and will continue to remain active, as indicated by the QDM Data Type of ‘Diagnosis, Active’. It is expected that a provider is managing the patients active problem list in the EHR, and if the condition is no longer relevant for the patient, it would be changed to an ‘inactive’ status – which would not qualify the patient for exception from the measure, as specified. A question has been raised that the QDM type “Diagnosis, Active” is being interpreted by some implementers as a status which can start at any time in the past but does not remain definitively active through a specific time period or event, without an additional logic statement “AND NOT ENDS BEFORE THE START OF [encounter/measurement period/etc].” The eCQM measure developers will be addressing this issue during the next round of annual updates and will determine whether a change to the logic is warranted.
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