[CYPRESS-862] EP 2015_cypress 3.0.2_CMS61v5c Created: 11/11/16  Updated: 05/07/18  Resolved: 11/15/16

Status: Closed
Project: CYPRESS Issue Tracker
Component/s: None

Type: Question Priority: Moderate
Reporter: Rupesh Gadhave (Inactive) Assignee: David Czulada
Resolution: Answered Votes: 0
Labels: 2016, CYPRESS

Attachments: PNG File 123.png     XML File 18_GP_Adult_C.xml     XML File 36_THREE N_N GP Adult.xml    
Previous Issue Type: Logic affecting more than 1 eCQM

 Description   

DIscrepancy in 2 Patients data.
The Status of Patient is not matching.

We have found discrepancy in the following 2 patients for CMS 61 part c measure:

firstname lastname Clinicalstatuscode (Actual) Cypress Status
GP_Adult C 6 8
THREE N N GP Adult 6 8

The expected status for both the patients is 8 (IPP qualified) however the patients are qualifying for status 6 ( Performance Not Met).
GP Adult C and THREE N N GP Adult patients should ideally qualify for the only 2 conditions mentioned below:
1) Age criteria
2) Encounter performed

However GP Adult C patient is qualified for additional Hypertension (Diagnosis) condition
And
THREE N N GP Adult patient is qualified for additional Patient Characteristic: Current Tobacco Smoker

 Comments   
Comment by David Czulada [ 11/14/16 ]

Rupesh-

Both GP_Adult C and Three N N GP Adult are evaluating in the Denominator for the CMS 61 part b (moderate risk). They both fall into the moderate risk category since they are missing a "Laboratory Test, Performed: High Density Lipoprotein." If these patients had a Laboratory Test, Performed: High Density Lipoprotein with a result >= 60 mg/dL they would fall into the low risk population.

-Dave Czulada

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