clarification on exclusions from eCQM 190

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Done
    • Priority: Moderate
    • Component/s: Guidance, Measure
    • Audrey Miller
    • 717-532-8683
    • Hershey Medical Center
    • Yes
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      Thank you for your question. The general surgery value set includes over 3,000 ICD10PCS and SNOMED CT codes representing a number of surgical procedures.

      Q1: If a patient has a procedure using General or Neuraxial Anesthesia, will it be automatically excluded from the measure?

      A: No. Cases are excluded based on the procedure code, not on the presence or absence of anesthesia.

       

      Q2: If a Hip/Knee replacement is excluded from the Denominator, then why are the procedures included in the Numerator?

      A: Hip and Knee replacements are not included in the numerator- there are denominator exclusions for hip and knee replacement.

       

      To view the list of codes included in the General Surgery (as well as hip or knee replacement) value sets:

      1. Create a free UMLS account, which gives you access to the Value Set Authority Center (VSAC) https://www.nlm.nih.gov/vsac/support/usingvsac/requestumlslicense.html

      2. In VSAC, search by the value set OID (2.16.840.1.113883.3.117.1.7.1.255) to retrieve the value set and its contents. https://www.nlm.nih.gov/vsac/support/usingvsac/searchvsac.html

      3. Once you retrieve the value set, you can view it online, or export the value set contents as an excel file for further review and sharing.
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      Thank you for your question. The general surgery value set includes over 3,000 ICD10PCS and SNOMED CT codes representing a number of surgical procedures. Q1: If a patient has a procedure using General or Neuraxial Anesthesia, will it be automatically excluded from the measure? A: No. Cases are excluded based on the procedure code, not on the presence or absence of anesthesia.   Q2: If a Hip/Knee replacement is excluded from the Denominator, then why are the procedures included in the Numerator? A: Hip and Knee replacements are not included in the numerator- there are denominator exclusions for hip and knee replacement.   To view the list of codes included in the General Surgery (as well as hip or knee replacement) value sets: 1. Create a free UMLS account, which gives you access to the Value Set Authority Center (VSAC) https://www.nlm.nih.gov/vsac/support/usingvsac/requestumlslicense.html 2. In VSAC, search by the value set OID (2.16.840.1.113883.3.117.1.7.1.255) to retrieve the value set and its contents. https://www.nlm.nih.gov/vsac/support/usingvsac/searchvsac.html 3. Once you retrieve the value set, you can view it online, or export the value set contents as an excel file for further review and sharing.
    • CMS190v5/NQF0372
    • Getting the most accurate data possible.

      What surgeries are included in "General Surgery" for the Denominator Exclusion and where can I find a list of codes for surgeries that will excluded the case from the measure? If a patient has a procedure using General or Neuraxial Anesthesia, will it be automatically be excluded from the measure?

      If a Hip / Knee replacement is excluded from the Denominator, then why are the procedures includeded in the Numerator - VTE prophylaxis option; also the same with a diagnosis of a VTE prior to admit / transfer to ICU.....thought this would be excluded from the initial population?

            Assignee:
            Joelencia Leflore
            Reporter:
            Audrey Miller (Inactive)
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              Created:
              Updated:
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