Is "route" and actual patient dose required for medication mapping

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    • Kim Crady
    • Baptist Health
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      ​Thank you for your question. The medication value sets use RxNorm codes that use the term type "Semantic Clinical Drug (SCD)" when looking for a medication that is administered or upon discharge. For STK-2, we are looking for Antithrombotic Therapy (2.16.840.1.113883.3.117.1.7.1.201) in the numerator. This value set contains codes for anticoagulant and antiplatelet drugs used to reduce stroke mortality and morbidity. It contains codes to represent oral, rectal, and injectable dose forms. For the measure, we are not specifying a dose of a medication, but we are looking to see if a medication is ordered or continued at discharge. For your specific question on mapping, we suggest you use RxNav, which is a publicly available RxNorm terminology tool, located here:

      https://mor.nlm.nih.gov/RxNav/

      With this tool, you can search by RxCUI (which are the codes in the value set), and see what the SCD code maps to as far as brand or generic name drugs.

      For example, code 1037045- dabigatran etexilate 150 MG Oral Capsule maps to the brand name drug Pradaxa 150 MG Oral Capsule.
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      ​Thank you for your question. The medication value sets use RxNorm codes that use the term type "Semantic Clinical Drug (SCD)" when looking for a medication that is administered or upon discharge. For STK-2, we are looking for Antithrombotic Therapy (2.16.840.1.113883.3.117.1.7.1.201) in the numerator. This value set contains codes for anticoagulant and antiplatelet drugs used to reduce stroke mortality and morbidity. It contains codes to represent oral, rectal, and injectable dose forms. For the measure, we are not specifying a dose of a medication, but we are looking to see if a medication is ordered or continued at discharge. For your specific question on mapping, we suggest you use RxNav, which is a publicly available RxNorm terminology tool, located here: https://mor.nlm.nih.gov/RxNav/ With this tool, you can search by RxCUI (which are the codes in the value set), and see what the SCD code maps to as far as brand or generic name drugs. For example, code 1037045- dabigatran etexilate 150 MG Oral Capsule maps to the brand name drug Pradaxa 150 MG Oral Capsule.
    • CMS104v5/NQF0435
    • Correct Mapping to better meet the measures

      (For all measures requiring medication mapping) example - STK-2 CMS104: (two questions)

      According to CQM-1459; the value sets use generalize drug concepts known in RX Norm as Sematic Clinical Drugs. The concepts include the ingredient name, dose form (e.g. oral tab, injectable solution) and strength (e.g. 500 mg).

      The second bullet states the dose form does not always correlate with route - (e.g. injectable solution can be administered intravenously or subcutaneously)

      My first question is this - Is route a necessary component to map to in order to fulfill the requirements of being in the numerator.

      In other words - Exactly what are the required Components needed to map to any specific medication in order to pass the medication -

      You have listed (in the value set), ingredient name, dose form, and strength - But you have also clarified that this "dose strength" MAY NOT be the dose actually given to the patient. (e.g. Strength pertains to medication as packaged - aspirin 500mg oral tab can be administered as ½ a tablet).

      Second question: Is the correct patient dose needed to pass the measure?

      We are seeking clarification on exact parameters for mapping to decrease medication fails.

            Assignee:
            Joelencia Leflore
            Reporter:
            kim crady
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