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Potential Opioid Overuse

eCQMs for pre-rulemaking Period

Specifications
Attachment Size
CMS460v2.html 336.93 KB
CMS460v2.zip 465.11 KB
CMS460v2-TRN.xlsx 24.55 KB
Release Notes

Header

  • Updated eCQM Version Number.

    Measure Section: eCQM Version Number

    Source of Change: Standards Update

  • Updated measure developer name from 'The Lewin Group' to 'Mathematica'.

    Measure Section: Measure Developer

    Source of Change: Measure Lead

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Updated the clinical recommendation statement to align with CDC Guideline updates and to improve clarity.

    Measure Section: Clinical Recommendation Statement

    Source of Change: Measure Lead

  • Added text to identify the Quality Data Model (QDM) version used in the measure specification.

    Measure Section: Guidance

    Source of Change: Standards Update

  • Added text to indicate whether the measure is patient-based or episode-based.

    Measure Section: Guidance

    Source of Change: Standards Update

  • Corrected typographical errors and spacing issues in the Guidance.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Spelled out measurement period (MP) and medication(s)/(med(s))to align with the Clinical Quality Language (CQL) Style Guide.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Revised the guidance regarding the relevant period for opioid medications to align with the logic change.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Updated the cancer exclusion narrative to better align with the timing of the measure logic.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Updated the palliative and hospice care exclusion narrative to align with changes to the measure logic and value sets.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Updated the numerator header statement to clarify the measure intent and more closely align with the measure logic.

    Measure Section: Numerator

    Source of Change: Measure Lead

Logic

  • Condensed the timing logic of the cancer exclusion by replacing the starts 1 year or less before start of and starts during with 'starts 2 years or less before end of 'Measurement Period'.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Revised the Palliative and Hospice Care logic by creating a new define statement using 'Palliative or Hospice Care' grouping value set and removing the datatype intervention recommended to harmonize logic and value set with other measures.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Revised the 'MedicationRelevantPeriod' function's logic to calculate the opioid medication relevant period using the prescription start date plus the days supplied, otherwise calculate using the prescription start and stop dates to more closely capture the highest possible dose.

    Measure Section: Functions

    Source of Change: Measure Lead

  • Replaced the 'DayMonthTimings' Library by using the new expand operator in the 'CalculateDailyMMEPerMedicaion' function to condense the overall measure logic.

    Measure Section: Functions

    Source of Change: Measure Lead

  • Revised the Opioid Medication Period function by adding 'sort by' to ensure the collapsed period intervals are returned in ascending order.

    Measure Section: Functions

    Source of Change: Measure Lead

  • Updated CQL expression to conform with the HL7 Standard: Clinical Quality Language Specification, Release 1 STU 4 (CQL 1.4).

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • Spelled out measurement period (MP) and medication(s) (med(s)) to align with the CQL Style Guide.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Updated version number of the Measure Authoring Tool (MAT) Global Common Functions Library (MATGlobalCommonFunctions-5.0.000). Updated definitions and functions in the MAT Global Common Functions Library to align with standards changes, CQL Style Guide, and to include one new function related to calculating length of hospital stays with observation stays.

    Measure Section: Multiple Sections

    Source of Change: Standards Update

  • CQL Library version update: Updated version number of the OpioidData Library (OpioidData-3.1.000) and harmonized with other opioid measures.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • CQL Library version update: Updated version number of the Potential Opioid Overuse Library (PotentialOpioidOveruse-2.1.000).

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Revised inline comment within the 'Gaps in Active Opioid Periods' to more accurately describe what the logic executes.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • Revised the EnsureMicrogramQuantity function by replacing the 'mcg' with UCUM unit 'ug' and corrected the inline comment by replacing 'milligrams' with 'micrograms' to ensure accuracy of the statement.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

  • CQL Library version update: Updated version number of the ConversionLogic Library (ConversionLogic -3.1.000).

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Value set Outpatient Consultation (2.16.840.1.113883.3.464.1003.101.12.1008): Deleted 1 SNOMED CT code (17436001) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Opioid Medications (2.16.840.1.113883.3.3157.1004.26): Added 22 RxNorm codes and deleted 17 RxNorm codes based on terminology updates and harmonized opioid ingredient value sets with other opioid measures where possible.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set All Primary and Secondary Cancer (2.16.840.1.113762.1.4.1111.161): Added 335 SNOMED CT codes and deleted 2 SNOMED CT codes (716654007, 690801000119108) based on expert review or public feedback and terminology updates, to ensure patients with primary or secondary cancers are excluded.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Replaced extensional value sets Palliative Care (2.16.840.1.113762.1.4.1111.162) and Hospice Care (2.16.840.1.113883.3.3157.1004.20) with grouping value set Palliative or Hospice Care (2.16.840.1.113883.3.600.1.1579) based on expert review or public feedback to harmonize with other measures.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: Jun 24, 2020