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CMS108v10 Numerator Understanding

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
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      Thank you for your question about CMS108v10 “Venous Thromboembolism Prophylaxis.” According to the information provided, both Visit 1 and Visit 2 qualify for VTE-1 Initial population and Denominator, assuming neither visit has an encounter diagnosis in any of the following value sets:

      · Obstetrics (2.16.840.1.113883.3.117.1.7.1.263)

      · Obstetrics VTE (2.16.840.1.113883.3.117.1.7.1.264)

      · Venous Thromboembolism (2.16.840.1.113883.3.117.1.7.1.279)

      Based on the information provided, Visit 1 fails the numerator due to lack of VTE Prophylaxis received. Visit 2 will pass the numerator because VTE prophylaxis (device applied) was received on the same day of admission.


      In addition, please note that code 428411000124104 is included in value set “Intermittent pneumatic compression devices (IPC)” (2.16.840.1.113883.3.117.1.7.1.214), not the value set “Graduated compression stockings (GCS)” (2.16.840.1.113883.3.117.1.7.1.256). However, both value sets include codes that for VTE prophylaxis devices that qualify for the numerator.
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      Thank you for your question about CMS108v10 “Venous Thromboembolism Prophylaxis.” According to the information provided, both Visit 1 and Visit 2 qualify for VTE-1 Initial population and Denominator, assuming neither visit has an encounter diagnosis in any of the following value sets: · Obstetrics (2.16.840.1.113883.3.117.1.7.1.263) · Obstetrics VTE (2.16.840.1.113883.3.117.1.7.1.264) · Venous Thromboembolism (2.16.840.1.113883.3.117.1.7.1.279) Based on the information provided, Visit 1 fails the numerator due to lack of VTE Prophylaxis received. Visit 2 will pass the numerator because VTE prophylaxis (device applied) was received on the same day of admission. In addition, please note that code 428411000124104 is included in value set “Intermittent pneumatic compression devices (IPC)” (2.16.840.1.113883.3.117.1.7.1.214), not the value set “Graduated compression stockings (GCS)” (2.16.840.1.113883.3.117.1.7.1.256). However, both value sets include codes that for VTE prophylaxis devices that qualify for the numerator.
    • CMS0108v10

      Consider statements below from CMS108v10:

      One of the Numerator criteria states:
      Encounter With VTE Prophylaxis Received From Day of Start of Hospitalization To Day After Admission or Procedure
      ( VTE."Encounter With Age Range and Without VTE Diagnosis or Obstetrical Conditions" QualifyingEncounter
      with "VTE Prophylaxis by Medication Administered or Device Applied" VTEProphylaxis
      such that Global."NormalizeInterval" ( VTEProphylaxis.relevantDatetime, VTEProphylaxis.relevantPeriod ) starts during VTE."FromDayOfStartOfHospitalizationToDayAfterAdmission" ( QualifyingEncounter )

      Scenarios:
      Consider the below patient and the visits as given below:
      Patient ABC: Has all the prerequisite to qualify IPP
      Visit #1-
      "Encounter, Performed": "Non-Elective Inpatient Encounter" with code 183452005
      Non-Elective Inpatient Encounter Start Date = 9/1/2021 00:00:00
      Non-Elective Inpatient Encounter End Date = 9/2/2021 4:59:59
      Patient ABC is aged 19 years on 9/10/2021 00:00:00
      Visit #2-
      "Encounter, Performed": "Non-Elective Inpatient Encounter" with code 183452005
      Non-Elective Inpatient Encounter Start Date = 9/2/2021 8:00:00
      Non-Elective Inpatient Encounter End Date = 9/12/2021 23:59:59
      Patient ABC is aged 19 years on 9/10/2021 00:00:00
      Device, Applied: Graduated compression stockings (GCS)" with code 428411000124104 with start date as 9/2/2021 8:30:00

      Query:
      Based on the above scenario, let us know whether visit #1 or visit #2 would meet performance or both the visits would qualify .

            JLeflore Joelencia Leflore
            aditiw Aditi Waje (Inactive)
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