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Type:
Logic/Intent/Data Elements
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Resolution: Unresolved
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Priority:
Moderate
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None
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Submitted reports for Hybrid Measures may include ineligible cases
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Cari Jones
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4054738842
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INTEGRIS Healthcare
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Clarification of whether OBS billed patients should be removed from the submitted report or whether they will be removed by CMS after submission.
Reports pulled for either of the above mentioned Hybrid Measures for our healthcare system include pts who have been discharged and billed as Observation patients. (were inpatients first, then registration status changed to OBS and billed thusly)
Previous JIRA Q&A CHM-140 response states, "... the initial population for the Hybrid HWR and Hybrid HWM measures only includes inpatient admissions billed as inpatient. If a hospitalization was not billed as inpatient, this would not qualify for the hybrid measures."
Is it acceptable that those patients who were billed as OBS remain in the submitted report, where they will be removed by CMS after submission? OR, does there need to be correction to our mapping for the initial population where the OBS billed patients are not included?