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  2. CQM-3633

CMS190v6 Numerator Query

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    • Icon: EC eCQMs - Eligible Clinicians EC eCQMs - Eligible Clinicians
    • Resolution: Answered
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      Thank you for your question. Patients who have documentation of a reason why no VTE prophylaxis was given between arrival and ICU admission (for patients directly admitted as inpatients to the ICU), the day of or the day after ICU admission (or transfer), or the day of or the day after surgery end date are included in the numerator.

      Since “Device, Order not done: Patient Refusal” occurs on the same datetime as ICU admission, this patient may be in the numerator due to the following logic:
      $NoVTEProphylaxisPatientRefusal <= 1 day(s) starts after or concurrent with start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer”
      Please note that in order for the this patient to be in the numerator, the device has to be in the Venous foot pumps (VFP), Graduated compression stocking (GCS), or Intermittent pneumatic compression devices (IPC) value sets.
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      Thank you for your question. Patients who have documentation of a reason why no VTE prophylaxis was given between arrival and ICU admission (for patients directly admitted as inpatients to the ICU), the day of or the day after ICU admission (or transfer), or the day of or the day after surgery end date are included in the numerator. Since “Device, Order not done: Patient Refusal” occurs on the same datetime as ICU admission, this patient may be in the numerator due to the following logic: $NoVTEProphylaxisPatientRefusal <= 1 day(s) starts after or concurrent with start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer” Please note that in order for the this patient to be in the numerator, the device has to be in the Venous foot pumps (VFP), Graduated compression stocking (GCS), or Intermittent pneumatic compression devices (IPC) value sets.
    • EH
    • Intensive Care Unit Venous Thromboembolism Prophylaxis

      Hi Team,

      We have a query related to numerator condition:

      OR: $NoVTEProphylaxisPatientRefusal <= 1 day(s) starts after or concurrent with start of "Occurrence A of Encounter, Performed: ICU Admission or Transfer"

      $NoVTEProphylaxisPatientRefusal =
      ◦Union of:
      ◾"Medication, Administered not done: Patient Refusal" for "Low Dose Unfractionated Heparin for VTE Prophylaxis"
      ◾"Medication, Administered not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE Prophylaxis"
      ◾"Medication, Administered not done: Patient Refusal" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis"
      ◾"Medication, Administered not done: Patient Refusal" for "Warfarin"
      ◾"Medication, Order not done: Patient Refusal" for "Low Dose Unfractionated Heparin for VTE Prophylaxis"
      ◾"Medication, Order not done: Patient Refusal" for "Low Molecular Weight Heparin for VTE Prophylaxis"
      ◾"Medication, Order not done: Patient Refusal" for "Injectable Factor Xa Inhibitor for VTE Prophylaxis"
      ◾"Medication, Order not done: Patient Refusal" for "Warfarin"
      ◾"Device, Applied not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC)"
      ◾"Device, Applied not done: Patient Refusal" for "Venous foot pumps (VFP)"
      ◾"Device, Applied not done: Patient Refusal" for "Graduated compression stockings (GCS)"
      ◾"Device, Order not done: Patient Refusal" for "Intermittent pneumatic compression devices (IPC)"
      ◾"Device, Order not done: Patient Refusal" for "Venous foot pumps (VFP)"
      ◾"Device, Order not done: Patient Refusal" for "Graduated compression stockings (GCS)"

      The patient has got data for Device, Applied (Not Done: Patient Refusal) as well as Device, order (Not Done: Patient Refusal) as per below:

      Device, Applied (Not Done: Patient Refusal) date - (20180808 17:53)
      ICU date - (20180808 18:07) and
      Device, order (Not Done: Patient Refusal) date - (20180808 18:07)

      In the above case "Device, Applied (Not Done: Patient Refusal)" date is before ICU date AND date of Device, order (Not Done: Patient Refusal) is same as the ICU start date .

      Kindly confirm if the patient should be Numerator complaint or not.

            JLeflore Joelencia Leflore
            vinaykumarp Vinay (Inactive)
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