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  2. CQM-1900

RxNorm Semantic Clinical Drug (SCD) versus Ingredient level codes

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Resolved
    • Icon: Minor Minor
    • ValueSet
    • John Snyder, DTR, RD
    • 570-214-2444
    • Geisinger Health Systems
    • Semantic clinical drug versus Ingredient level RxNorm codes
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      Thank you for your question. The intent of this particular value set is to represent medications given to the patient during hospitalization. Generally speaking, RxNorm value sets used in eCQMs include only semantic clinical drug level terms (except when the value set is intended to be used in the context of a medication allergy or negation statement).

      The inclusion of additional term types in medication value sets is under consideration, as there are complexities associated with this. For example, it may not always be appropriate to include ingredient-level term types in value sets where the strength or dose form of a medication may impact the intent of the value set.


      While vendors/providers should report the drug entities in patient data using the generalized drug concepts included in the defined value sets, it is acceptable to map other term types (e.g. branded drug names) to the terms included in medication value sets. You can find more information and implementation guidance surrounding medication value sets in the eCQM Logic and Implementation Guidance document (Sections 6.2 through 6.4)., which is published in CMS's eCQM library

      (https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/eCQM_Library.html), along with eCQM specifications.
      Show
      Thank you for your question. The intent of this particular value set is to represent medications given to the patient during hospitalization. Generally speaking, RxNorm value sets used in eCQMs include only semantic clinical drug level terms (except when the value set is intended to be used in the context of a medication allergy or negation statement). The inclusion of additional term types in medication value sets is under consideration, as there are complexities associated with this. For example, it may not always be appropriate to include ingredient-level term types in value sets where the strength or dose form of a medication may impact the intent of the value set. While vendors/providers should report the drug entities in patient data using the generalized drug concepts included in the defined value sets, it is acceptable to map other term types (e.g. branded drug names) to the terms included in medication value sets. You can find more information and implementation guidance surrounding medication value sets in the eCQM Logic and Implementation Guidance document (Sections 6.2 through 6.4)., which is published in CMS's eCQM library ( https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/eCQM_Library.html), along with eCQM specifications.
    • CMS108v4/NQF0371
    • CMS108v3/NQF371

      Glycoprotein IIb/IIIa Inhibitors
      Value Set OID: 2.16.840.1.113762.1.4.1045.41

      The value set is defined as an extensional value set at the semantic clinical drug level (SCD) which identified the specific dose form of a medication. If Joint Commissions intent was to capture all medications that include the specific ingredient(s) in these semantic clinical drugs, then the value set should have been defined at the ingredient (i.e. RxNorm TTY = IN, BIN, MIN, or PIN) level. Was it the intent of Joint Commission to gather data on just the semantic clinical drugs in this list or all medications that contain the ingredients in the value set. If it was the latter, then shouldn't the value set been built at the ingredient level so that all medications that contained those specific RxNorm ingredients were easily identified?

            JLeflore Joelencia Leflore
            jwsnyder@geisinger.edu John Snyder (Inactive)
            Amy Michaelson (Inactive), Melissa Eick (Inactive)
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