eCQM Title | Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture |
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eCQM Identifier (Measure Authoring Tool) | 249 | eCQM Version number | 1.4.000 |
NQF Number | Not Applicable | GUID | a3ce125d-c238-42ce-862e-dba0055dfc66 |
Measurement Period | January 1, 20XX through December 31, 20XX | ||
Measure Steward | Centers for Medicare & Medicaid Services (CMS) | ||
Measure Developer | National Committee for Quality Assurance | ||
Endorsed By | None | ||
Description | |||
Copyright | |||
Disclaimer | |||
Measure Scoring | Proportion | ||
Measure Type | Process | ||
Stratification | |||
Risk Adjustment | |||
Rate Aggregation | |||
Rationale | |||
Clinical Recommendation Statement | |||
Improvement Notation | |||
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Definition | |||
Guidance | |||
Transmission Format | |||
Initial Population | |||
Denominator | |||
Denominator Exclusions | |||
Numerator | |||
Numerator Exclusions | |||
Denominator Exceptions | |||
Supplemental Data Elements |
exists ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 50 and Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")< 64 and exists ( ["Patient Characteristic Sex": "Female"] ) and exists "Qualifying Encounter"
"Initial Population"
"Has Age Dependent Risk Factors"() or exists "Osteoporosis Before Measurement Period" or exists "Independent Risk Factors Applicable Any Time" or exists "Independent Risk Factors Before Measurement Period"
exists ["Diagnostic Study, Order": "DXA (Dual energy Xray Absorptiometry) Scan"] DXA where DXA.authorDatetime during "Measurement Period"
"Combination Risk Factors Applicable Any Time" union "Osteoporotic Fracture From Patient History" union "Parent History of Hip Fracture" union "Osteopenia Before Measurement Period" union "Current Tobacco User" union "Average of More Than Two Drinks Per Drinking Day" union "Glucocorticoid Medication Duration Greater Than or Equal to 90 Days" union "First BMI in Measurement Period Less Than or Equal to 20 kg m2" union ["Patient Characteristic Race": "White"]
{ First(["Assessment, Performed": "Average Number of Drinks per Drinking Day"] AverageDrinks where AverageDrinks.authorDatetime during "Measurement Period" and AverageDrinks.result > 2 sort by authorDatetime )}
( ["Diagnosis": "Rheumatoid Arthritis"] union ["Diagnosis": "Hyperthyroidism"] union ["Diagnosis": "Malabsorption Syndromes"] union ["Diagnosis": "Chronic Liver Disease"] union ["Diagnosis": "Chronic Malnutrition"] ) CombinationRiskDiagnosis where CombinationRiskDiagnosis.prevalencePeriod starts before end "Measurement Period"
{ Tuple { Duration: "Cumulative Medication Duration"("Glucocorticoid Medication Active") } }
{ First(["Assessment, Performed": "Tobacco Use Screening"] TobaccoScreen where TobaccoScreen.result in "Current Tobacco Smoker" and TobaccoScreen.authorDatetime during "Measurement Period" sort by authorDatetime )}
"Initial Population"
"Has Age Dependent Risk Factors"() or exists "Osteoporosis Before Measurement Period" or exists "Independent Risk Factors Applicable Any Time" or exists "Independent Risk Factors Before Measurement Period"
{ First(["Physical Exam, Performed": "BMI Ratio"] BMI where BMI.relevantPeriod during "Measurement Period" and BMI.result is not null sort by start of relevantPeriod )}
"First BMI in Measurement Period" FirstBMI where FirstBMI.result <= 20 'kg/m2'
["Medication, Active": "Glucocorticoids (oral only)"] Glucocorticoid where Glucocorticoid.relevantPeriod starts before start of "Measurement Period"
"Cumulative Glucocorticoid Medication Duration" CumulativeGlucocorticoidMedication where CumulativeGlucocorticoidMedication.Duration >= 90
( ["Diagnosis": "Type 1 Diabetes"] union ["Diagnosis": "End Stage Renal Disease"] union ["Diagnosis": "Osteogenesis Imperfecta"] union ["Diagnosis": "Ankylosing Spondylitis"] union ["Diagnosis": "Psoriatic Arthritis"] union ["Diagnosis": "Ehlers Danlos Syndrome"] union ["Diagnosis": "Cushings Syndrome"] union ["Diagnosis": "Marfan's Syndrome"] union ["Diagnosis": "Hyperparathyroidism"] union ["Diagnosis": "Lupus"] ) IndependentRiskDiagnosis where IndependentRiskDiagnosis.prevalencePeriod starts before end "Measurement Period"
(( ["Procedure, Performed": "Gastric Bypass Surgery"] union ["Medication, Active": "Aromatase Inhibitors"] union ["Medication, Order": "Aromatase Inhibitors"] ) GastricBypassOrAromataseInhibitor where GastricBypassOrAromataseInhibitor.relevantPeriod starts before start "Measurement Period") union "Osteoporosis Fracture Probability"
exists ["Patient Characteristic Birthdate"] BirthDate where Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")>= 50 and Global."CalendarAgeInYearsAt"(BirthDate.birthDatetime, start of "Measurement Period")< 64 and exists ( ["Patient Characteristic Sex": "Female"] ) and exists "Qualifying Encounter"
exists ["Diagnostic Study, Order": "DXA (Dual energy Xray Absorptiometry) Scan"] DXA where DXA.authorDatetime during "Measurement Period"
["Diagnosis": "Osteopenia"] OsteopeniaDiagnosis where OsteopeniaDiagnosis.prevalencePeriod starts before start "Measurement Period"
["Diagnosis": "Osteoporosis"] OsteoporosisDiagnosis where OsteoporosisDiagnosis.prevalencePeriod starts before start "Measurement Period" and OsteoporosisDiagnosis.prevalencePeriod overlaps "Measurement Period"
["Assessment, Performed": "Ten-year probability of all major osteoporosis related fracture"] ProbabilityAssessment where ProbabilityAssessment.result >= 9.3 '%' and ProbabilityAssessment.authorDatetime before start of "Measurement Period"
( ["Diagnosis": "Osteoporotic Fractures"] PathologicalFracture where PathologicalFracture.prevalencePeriod starts before start "Measurement Period" )
["Assessment, Performed": "History of hip fracture in parent"] ParentFractureHistory where ParentFractureHistory.authorDatetime before start of "Measurement Period"
( ["Encounter, Performed": "Office Visit"] union ["Encounter, Performed": "Preventive Care Services - Established Office Visit, 18 and Up"] union ["Encounter, Performed": "Preventive Care Services - Other"] union ["Encounter, Performed": "Preventive Care Services-Initial Office Visit, 18 and Up"] union ["Encounter, Performed": "Outpatient Consultation"] ) ValidEncounter where ValidEncounter.relevantPeriod during "Measurement Period"
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
Sum((collapse(Medication.relevantPeriod))CumulativeMedication return all duration in days of CumulativeMedication )
singleton from ( ["Patient Characteristic Birthdate"] Birthdate let Age: Global."CalendarAgeInYearsAt"(Birthdate.birthDatetime, start of "Measurement Period"), NumberOfRiskFactors: Count("Age Dependent Combination Risk Factors") return ( ( Age between 50 and 54 and NumberOfRiskFactors >= 4 ) or ( Age between 55 and 59 and NumberOfRiskFactors >= 3 ) or ( Age between 60 and 63 and NumberOfRiskFactors >= 2 ) ) )
years between ToDate(BirthDateTime)and ToDate(AsOf)
DateTime(year from Value, month from Value, day from Value, 0, 0, 0, 0, timezone from Value)
["Patient Characteristic Ethnicity": "Ethnicity"]
["Patient Characteristic Payer": "Payer"]
["Patient Characteristic Race": "Race"]
["Patient Characteristic Sex": "ONC Administrative Sex"]
Measure Set |