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  2. CQM-1629

Initial patient population Delivery procedure performed results in fetal demise cases in numerator

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
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      Thank you for your question. This JIRA project is the correct place to submit and receive responses to questions on the eCQMs.

      Regarding the particular question relating to the measure, the initial population is still evaluated in the same way between version 3 and version 4 of the eMeasure. The Quality Data Model defines the “Union of” in the following way:

      “The ‘Union Of’ operator provides a mechanism for specifying that qualifying events must be a member of at least one of the data sets being unioned.” Therefore, the “union of” operator serves the same function in version 4 as the “OR” statements in version 3.

      One important clarification you may find helpful: In both versions you reference, the concept of delivery is represented as a procedure in SNOMED CT and ICD-10-PCS and as a diagnosis in ICD-9, which is why the initial patient population lists both Delivery Procedures and Diagnoses. The IPP logic of “Procedure, Performed: Delivery Procedures” uses a grouping value set that contains SNOMEDCT and ICD-10-PCS codes for delivery procedures. The remaining “Diagnosis, Active” logic statements use only ICD-9 value sets, but represent the same concept- delivery. Thus, a patient who has at least one code found in either the delivery procedure or diagnosis value sets has had a delivery, and belongs in the measure population.
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      Thank you for your question. This JIRA project is the correct place to submit and receive responses to questions on the eCQMs. Regarding the particular question relating to the measure, the initial population is still evaluated in the same way between version 3 and version 4 of the eMeasure. The Quality Data Model defines the “Union of” in the following way: “The ‘Union Of’ operator provides a mechanism for specifying that qualifying events must be a member of at least one of the data sets being unioned.” Therefore, the “union of” operator serves the same function in version 4 as the “OR” statements in version 3. One important clarification you may find helpful: In both versions you reference, the concept of delivery is represented as a procedure in SNOMED CT and ICD-10-PCS and as a diagnosis in ICD-9, which is why the initial patient population lists both Delivery Procedures and Diagnoses. The IPP logic of “Procedure, Performed: Delivery Procedures” uses a grouping value set that contains SNOMEDCT and ICD-10-PCS codes for delivery procedures. The remaining “Diagnosis, Active” logic statements use only ICD-9 value sets, but represent the same concept- delivery. Thus, a patient who has at least one code found in either the delivery procedure or diagnosis value sets has had a delivery, and belongs in the measure population.
    • CMS113v4/NQF0469
    • CMS113v3/NQF0469
    • numerator for elective delivery at >= 37 and < 39 weeks gestation completed in capturing fetal demise cases giving a false rate for the intent of the measure

      Is the change in the initial population from "OR" to "Union Of" in the initial patient population criteria still evaluated in the same way between version 3 and version 4 of the eMeasure?
      Does this mean that a patient in the population can have one of the diagnoses OR a delivery procedure? As opposed to having a delivery procedure AND one of the diagnoses?

      The way this measure is written it is capturing patients with a delivery procedure that is not a live birth and putting it in the numerator. This would not happen in the manual chart abstracted version of this measure. Placing these cases in the numerator gives a falsely inflated rate.

      Is there somewhere else questions can be addressed for clarification and interpretation of the eCQM measures? The Quality Net core measure Question & Answer help desk directed me here but this does not seem like the correct venue for basic questions.

            JLeflore Joelencia Leflore
            mdeligencia Michelle Deligencia (Inactive)
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