Need clarification on exclusion from IPP by SNOMED but not ICD-10 Dx

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      ​Thank you for your inquiry on CMS108, Venous Thromboembolism Prophylaxis (VTE-1) and CMS190, Intensive Care Unit Venous Thromboembolism Prophylaxis (VTE-2).

      The 5 ICD-10 codes provided are related to superficial veins / upper extremity veins and chronic VTE, which do not meet the intent of Venous Thromboembolism value set (2.16.840.1.113883.3.117.1.7.1.279). The cases continue to be in the measure’s initial patient population (IPP). However, the ICD-10 codes you provided are not sufficient for inclusion in the numerator.
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      ​Thank you for your inquiry on CMS108, Venous Thromboembolism Prophylaxis (VTE-1) and CMS190, Intensive Care Unit Venous Thromboembolism Prophylaxis (VTE-2). The 5 ICD-10 codes provided are related to superficial veins / upper extremity veins and chronic VTE, which do not meet the intent of Venous Thromboembolism value set (2.16.840.1.113883.3.117.1.7.1.279). The cases continue to be in the measure’s initial patient population (IPP). However, the ICD-10 codes you provided are not sufficient for inclusion in the numerator.
    • CMS108v9/NQFna
    • Patients are being excluded from the IPP for VTE-1 & VTE-2 based on a SNOMED code that is mapped to an ICD-10 code by our IMO load. I would like clarification on if these patients should be excluded.

      While validating a sample of patients that did not meet the IPP for VTE-1 & 2 I found 5 patients that were excluded based on the SNOMED code 429098002 that was included in Value Set 2.16.840.1.113883.3.117.1.7.1.279 (Venous Thromboembolism) although none of the ICD-10 codes that were on the accounts were included in the Value Set.  Our EHR (EPIC) maps SNOMED codes to ICD-10 codes through a data load from IMO. 

       The ICD-10 codes that were associated with these 5 accounts were:

      1. I82.611 - Acute embolism and thrombosis of superficial veins of right upper extremity
      2. I82.522 - Chronic embolism and thrombosis of left iliac vein
      3. I82.612 Acute embolism and thrombosis of superficial veins of left upper extremity
      4. I82.619 Acute embolism and thrombosis of superficial veins of unspecified upper extremity
      5. I82.C19 Acute embolism and thrombosis of unspecified internal jugular vein

       The SNOMED code was not found anywhere in the patient record except for the mapping to the ICD-10 Dx code.

      Can you clarify if it is appropriate for these 5 patients to be excluded from the IPP based on this mapping?  

       

            Assignee:
            Joelencia Leflore
            Reporter:
            Beth Eilers (Inactive)
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