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  2. CQM-2887

Factor Xa tied to DX/HX afib/flutter/knee/hip replcmnt/ ; pts w/hx of dvt on Factor Xa without these DX/HX won't pass. Need to addend to allow

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    • Factor Xa - Request to remove dx/hx requirements to pass measure
    • Lisa Salvatori
    • 501-622-1844
    • CHI St Vincent Hot Springs
    • Need for addending dx/hx for usage of Factor Xa
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      Thank you for your comment. We are aware of this situation and proposing that using the suggested Z codes would require the addition of logic to allow for encounter diagnoses of history of VTE (see Potential Future State below).

      We welcome feedback on the frequency with which cases would meet the numerator due to use of Oral Factor Xa and presence of the codes Z86.711 or Z86.718, as well as feedback on the benefit or burden to implementers of adding logic to represent the history of codes using the Quality Data Model Encounter, Performed diagnosis attribute.
      Current State:
      •OR:
      ◦AND: "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" satisfies any:
      ◾<= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
      ◾<= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
      ◦AND:
      ◾OR: Union of:
      ◾Intersection of:
      ◾Occurrence A of $EncounterInpatient
      ◾"Encounter, Performed: Encounter Inpatient (diagnosis: Atrial Fibrillation/Flutter)"
      ◾"Diagnosis: Atrial Fibrillation/Flutter" starts before or concurrent with end of Occurrence A of $EncounterInpatient
      ◾"Diagnosis: Venous Thromboembolism" starts before start of Occurrence A of $EncounterInpatient
      ◾

      Potential Future State:
      OR:
      •AND: "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" satisfies any:
      ◦<= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient
      ◦<= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient )
      •AND:
      ◦OR: Union of:
      ◾Intersection of:
      ◾Occurrence A of $EncounterInpatient
      ◾"Encounter, Performed: Encounter Inpatient (diagnosis: Atrial Fibrillation/Flutter)"
      ◾"Diagnosis: Atrial Fibrillation/Flutter" starts before or concurrent with end of Occurrence A of $EncounterInpatient
      ◾"Diagnosis: Venous Thromboembolism" starts before start of Occurrence A of $EncounterInpatient
      ◾Intersection of:
      ◾Occurrence A of $EncounterInpatient
      ◾"Encounter, Performed: Encounter Inpatient (diagnosis: History of VTE)"
      Show
      Thank you for your comment. We are aware of this situation and proposing that using the suggested Z codes would require the addition of logic to allow for encounter diagnoses of history of VTE (see Potential Future State below). We welcome feedback on the frequency with which cases would meet the numerator due to use of Oral Factor Xa and presence of the codes Z86.711 or Z86.718, as well as feedback on the benefit or burden to implementers of adding logic to represent the history of codes using the Quality Data Model Encounter, Performed diagnosis attribute. Current State: •OR: ◦AND: "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" satisfies any: ◾<= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient ◾<= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient ) ◦AND: ◾OR: Union of: ◾Intersection of: ◾Occurrence A of $EncounterInpatient ◾"Encounter, Performed: Encounter Inpatient (diagnosis: Atrial Fibrillation/Flutter)" ◾"Diagnosis: Atrial Fibrillation/Flutter" starts before or concurrent with end of Occurrence A of $EncounterInpatient ◾"Diagnosis: Venous Thromboembolism" starts before start of Occurrence A of $EncounterInpatient ◾ Potential Future State: OR: •AND: "Medication, Administered: Oral Factor Xa Inhibitor for VTE Prophylaxis or VTE Treatment" satisfies any: ◦<= 1 day(s) starts after or concurrent with start of Occurrence A of $EncounterInpatient ◦<= 1 day(s) starts after or concurrent with end of ("Procedure, Performed: General or Neuraxial Anesthesia" <= 1 day(s) ends after or concurrent with start of Occurrence A of $EncounterInpatient ) •AND: ◦OR: Union of: ◾Intersection of: ◾Occurrence A of $EncounterInpatient ◾"Encounter, Performed: Encounter Inpatient (diagnosis: Atrial Fibrillation/Flutter)" ◾"Diagnosis: Atrial Fibrillation/Flutter" starts before or concurrent with end of Occurrence A of $EncounterInpatient ◾"Diagnosis: Venous Thromboembolism" starts before start of Occurrence A of $EncounterInpatient ◾Intersection of: ◾Occurrence A of $EncounterInpatient ◾"Encounter, Performed: Encounter Inpatient (diagnosis: History of VTE)"
    • All areas of IP VTE hospital compliance

          JLeflore Mathematica EH eCQM Team
          Lissasalvatori Lisa Salvatori (Inactive)
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            Updated:
            Resolved:
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