Thank you for your question. The intention of denominator exclusion in measure CMS506v3 “Safe Use of Opioids - Concurrent Prescribing” is to exclude patients receiving hospice or palliative care and those who will receive palliative or hospice care beginning at the time of discharge. The measure uses active hospice and palliative care and referrals to palliative care to exclude these patients but we do not currently exclude patients receiving an evaluation for hospice or palliative care. We appreciate your input on clinical workflow and will continue to evaluate whether excluding patients based on a consult or evaluation for hospice and palliative care fits with the intent of the measure.​ UPDATED: ​As a user noted in ticket 4426, this guidance does not align with the guidance given by CMS72. We are revising our answer above to align with the STK-5/CMS72 measure. CMS506 will exclude patients with consult orders for the comfort measures value set (1.3.6.1.4.1.33895.1.3.0.45) and hospice order value set (2.16.840.1.113883.3.600.1.1579) as exclusions.​​

Current workflow in our facilities utilizes the orders for Hospice consult/evaluation as a means of identifying when a patient is placed in hospice care. The current value set does not allow for the use of the consult/eval order for this measure. Does the use of a hospice consult/eval count as an order for hospice?