PREV-13 Denominator Confirmation Population 2.

[Sally]

In 2019 PREV-13 there is a new note added on page 11 of 27.

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Active Diagnosis of Familial or Pure Hypercholesterolemia are the only acceptable diagnosis that may be utilized for category 2 confirmation. Elevated cholesterol alone is not confirmation of this diagnosis.

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Base on this new note, does that mean the denominator for Population 2 is only confirmed as YES when BOTH conditions are satisfied?

That is, LDL-C ≥ 190 mg/dL documented AND were previously diagnosed with or currently have an active diagnosis of familial or pure hypercholesterolemia ??

Based on the new note, this is now inconsistent with the Confirmation Guidance at the top of page 11 as it uses an OR.

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• If the patient has ever had a fasting or direct laboratory test result of LDL-C ≥ 190 mg/dL documented OR were previously diagnosed with or currently have an active diagnosis of familial or pure hypercholesterolemia select ”Yes”

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Thanks if anyone can help us we appreciate it!!

[Laura Hassey]

Hi Sally - This is a CMS Policy question regarding the PREV-13 Web Interface measure specification.  Please submit your question to the QPP Service Desk and they will get it forwarded to the team that is better suited to answer.

Thank you,

Laura