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EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
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Resolution: Done
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Minor
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CMS71v6/NQF0436, CMS72v5/NQF0438, CMS91v6/NQF0437, CMS102v5/NQF0441, CMS104v5/NQF0435, CMS105v5/NQF0439, CMS107v5/NQFna
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"ICU Admission/Transfer" encounters are not qualified under "$EncounterInpatient" nor "$EncoutnerInpatientNonElective" and therefore are excluded from many measure populations (most notably Stroke measures).
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1) ICU Admissions/Transfers are defined in the CQM specifications under the "Encounter, Performed" data category.
1a) This is the same data category where "$EncounterInpatient" and "$EncounterInpatientNonElective" are defined
2) The Value Sets for "$EncounterInpatient" and "$EncounterInpatientNonElective" do not include any of the codes from the Value set for ICU Admission/Transfer
3) Since an encounter can only occupy one "Encounter, Performed" status at any given time, when an encounter is qualifying for "Encounter, Performed: ICU Admission or Transfer", that encounter cannot be qualifying at the same time for "$EncounterInpatient" and "$EncounterInpatientNonElective"
As a result, ICU Admission/Transfer encounters are being excluded from many measures, since they are being recognized as "inpatients". I don't believe this was the intent of the measures.
Proposed Solutions:
A) Add ICU Admission/Transfer SNOMED Codes to the "$EncounterInpatient" and "$EncounterInpatientNonElective" Value sets.
OR
B) Change measure logic so that ICU Admissions/Transfers are defined by "Facility, Location", rather than "Encounter, Performed"
- relates to
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CQM-1328 Encounter, Performed for patients who admit and discharge from ICU
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- Closed
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