NQF 480 value set >=37 weeks diagnosis 765.29 is incorrectly removing patients from the initial patient population

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Major
    • Component/s: ValueSet
    • Value set entry is excluding health term newborns
    • Rich Rutherford
    • 610-213-0698
    • Abrazo Health Care
    • Confirm ICD9 Code 716.29 is valid within the value set for the measure
    • Hide
      Thank you for your question. This issue references version 1 of the measure. The April 2014 release (version 3) addresses known issues in the representation of gestational age. The change related to the data element “Physical Exam, Finding” has a SNOMED-CT-only value set, 2.16.840.1.113762.1.4.1045.47, which includes the code 412726003 ‘Length of gestation at birth (observable entity)’.
      Show
      Thank you for your question. This issue references version 1 of the measure. The April 2014 release (version 3) addresses known issues in the representation of gestational age. The change related to the data element “Physical Exam, Finding” has a SNOMED-CT-only value set, 2.16.840.1.113762.1.4.1045.47, which includes the code 412726003 ‘Length of gestation at birth (observable entity)’.
    • CMS9v1/NQF0480
    • Hide
      NQF 480 has an initial patient population #1 specified using AND: "Diagnosis, Active: Gestational age >= 37 weeks" starts during "Occurrence A of Encounter, Performed: Inpatient Encounter". The value set called is "Diagnosis, Active: Gestational age >= 37 weeks" using "Gestational age >= 37 weeks Grouping Value Set (2.16.840.1.113883.3.666.5.1596)". Within this value set requires ICD9 code 765.29. This ICD9 code according to the 2011 ICD9 Coding Guidelines requires "Prematurity and Fetal Growth Retardation". Based on this inclusion criteria health term newborns or being excluded from the measure.
      Show
      NQF 480 has an initial patient population #1 specified using AND: "Diagnosis, Active: Gestational age >= 37 weeks" starts during "Occurrence A of Encounter, Performed: Inpatient Encounter". The value set called is "Diagnosis, Active: Gestational age >= 37 weeks" using "Gestational age >= 37 weeks Grouping Value Set (2.16.840.1.113883.3.666.5.1596)". Within this value set requires ICD9 code 765.29. This ICD9 code according to the 2011 ICD9 Coding Guidelines requires "Prematurity and Fetal Growth Retardation". Based on this inclusion criteria health term newborns or being excluded from the measure.

      Confirm if this is a measure logic issue in which the ICD9 is excluding health term newborn patients from the initial patient population.

      rarutherford@abrazohealth.com
      rich.rutherford@projectnavigation.com

            Assignee:
            Michelle Hinterberg (Inactive)
            Reporter:
            Rich Rutherford (Inactive)
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