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  2. CQM-1337

Two Principal (Main) Procedures for Denominator Definition CMS171/NQF 0528

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    • Eric Collins
    • 410-872-7969
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      Thank you for your question. The structure of the logic must be considered in conjunction with the design of the value sets. The value set used in the IPP, SCIP Major Surgical Procedure, is based on that used for the paper chart-based CQM. The surgery which is the principal procedure of the encounter must come from this value set.

      The value sets for each population are designed to constrain from the larger population of surgical procedure just those procedures associated with their particular type of surgeries. The codes for each of these specific surgeries are found in the both the individual surgery value set (example Hospital measures-CABG) and the SCIP Major Surgical Procedure value set.

      The logic is only working on the “Principal” surgery. It is not logically contradictory.
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      Thank you for your question. The structure of the logic must be considered in conjunction with the design of the value sets. The value set used in the IPP, SCIP Major Surgical Procedure, is based on that used for the paper chart-based CQM. The surgery which is the principal procedure of the encounter must come from this value set. The value sets for each population are designed to constrain from the larger population of surgical procedure just those procedures associated with their particular type of surgeries. The codes for each of these specific surgeries are found in the both the individual surgery value set (example Hospital measures-CABG) and the SCIP Major Surgical Procedure value set. The logic is only working on the “Principal” surgery. It is not logically contradictory.
    • CMS172v4/NQF0528
    • Contradictory eMeasure definition creates logical dilemma when creating test data.

      In the eMeasure definition for CMS172/nqf0528v4 (April 2013), one of the IPP1 criteria is a procecure with Ordinality Principal:
      ◦AND: "Occurrence A of Procedure, Performed: SCIP Major Surgical Procedure (ordinality: 'Principal')" during "Occurrence A of Procedure, Performed: General or Neuraxial Anesthesia"
      but then one of the Denominator1 criteria is a different procedure, also with Ordinality Principal:
      ◦AND: "Occurrence A of Procedure, Performed: Hospital measures-CABG (ordinality: 'Principal')" during "Occurrence A of Procedure, Performed: General or Neuraxial Anesthesia"

      How can two different procecures simultaneously be the Main (principal) procedure? This reads as logically contradictory.

            JLeflore Joelencia Leflore
            MyProbTrak#10 Eric Collins (Inactive)
            Eric Collins (Inactive)
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