The above mentioned value set is used in EP measures CMS61, CMS64, and CMS69. These measures exclude any cases from the numerator calculation that are either prescribed palliative care or are receiving palliative care during the measurement period. Since this value set includes palliative care only codes, and no comfort measure codes, people receiving comfort measures will “NOT” be excluded from the numerator calculation. We have two questions/concerns related to this:-
1. Why certain EP measures are using the palliative care only value sets that supports no comfort measure codes? Such measures, using the palliative care value set (VOID: 2.16.840.1.113883.3.600.1.1579), will not exclude the cases on comfort measures. Is this intentional?
2. Second concern is a broader one. There were some inconsistencies in the value sets related to comfort measures and palliate care in EH measure sets in 2012 and 2013 updates. The 2014 EH measure sets have reconciled these value sets such that EH measures now only support one value set across all EH measures i.e. 1.3.6.1.4.1.33895.1.3.0.45. This is comfort measures only value set. We recommend that the EP measures follow the similar path and reconcile the value sets , which will create more harmonization and will avoid the burden of duplicate charting/mapping and increase accuracy. We suggest using the value set 1.3.6.1.4.1.33895.1.3.0.45 across EP measures as well.