Different ECG result value sets contain the same SNOMED code

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Done
    • Priority: Minor
    • Component/s: ValueSet
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      The initial population identifies patients with a primary diagnosis of Acute Myocardial Infarction (AMI) using the AMI Grouping Value Set (2.16.840.1.113883.3.666.5.3011). The denominator further refines the initial population through the electrocardiogram (ECG) result of an acute or evolving MI using the Acute or Evolving MI Grouping Value Set (2.16.840.1.113883.3.666.5.3022). If a case includes one of the codes included in the Acute or Evolving MI value set, the logic looks to see that the ECG did not include any of the STEMI exclusion codes found in the STEMI Exclusions Grouping Value Set (2.16.840.1.113762.1.4.1045.36). If a STEMI exclusion code is identified, the logic stops executing and the case is not included in the measure population.
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      The initial population identifies patients with a primary diagnosis of Acute Myocardial Infarction (AMI) using the AMI Grouping Value Set (2.16.840.1.113883.3.666.5.3011). The denominator further refines the initial population through the electrocardiogram (ECG) result of an acute or evolving MI using the Acute or Evolving MI Grouping Value Set (2.16.840.1.113883.3.666.5.3022). If a case includes one of the codes included in the Acute or Evolving MI value set, the logic looks to see that the ECG did not include any of the STEMI exclusion codes found in the STEMI Exclusions Grouping Value Set (2.16.840.1.113762.1.4.1045.36). If a STEMI exclusion code is identified, the logic stops executing and the case is not included in the measure population.
    • CMS53v5/NQF0163
    • Contradictory information in the value sets will impact calculation

      For CMS 53 (Primary PCI), my question pertains to the 'result' value sets for the ECG Interpretation.
      Consider this block of logic:
      ◦AND: "Occurrence A of Diagnostic Study, Performed: Electrocardiogram (ECG) (result: Acute or Evolving MI)"
      ◦AND NOT: "Occurrence A of Diagnostic Study, Performed: Electrocardiogram (ECG) (result: STEMI Exclusions)"

      Since one of the conditions is an 'AND' and the other condition is an 'AND NOT', I would expect the values in the value sets for Acute or Evolving MI and STEMI Exclusion to contain entirely different values.
      However, I noticed that SNOMED code 401314000 Acute non-ST segment elevation myocardial infarction (disorder) is present in both the "Acute Myocardial Infarction (AMI) Grouping Value Set (2.16.840.1.113883.3.666.5.3011)" and the "STEMI Exclusions Grouping Value Set (2.16.840.1.113762.1.4.1045.36)".

      So if a user documents a result that's coded with 401314000, it would qualify for both result attributes, yet the measure logic indicates that they should be mutually exclusive. Can you please comment on this discrepancy? thanks.

            Assignee:
            Anne Smith (Inactive)
            Reporter:
            Caroline Klink (Inactive)
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              Created:
              Updated:
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