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  1. eCQM Issue Tracker
  2. CQM-5079

Comfort Measures Value Set Exclusion criteria of Palliative Care. Need guidance on whether an order for a IP Consult to Palliative Care should be considered an inclusion to comfort measures data element for denominator exclusion.

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    • Icon: EH/CAH eCQMs EH/CAH eCQMs
    • Resolution: Answered
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    • Kristin Ferry
    • 262-787-2181
    • Advocate Aurora Health
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      ​You are correct, palliative care will not count as comfort measures.

      All three measures, VTE-1, VTE-2 and STK-2, use the below logic to exclude patients receiving comfort care from the denominator:

                            Intervention Comfort Measures​

                                  ["Intervention, Order": "Comfort Measures"]

                                 union ["Intervention, Performed": "Comfort Measures"]


      The valueset "Comfort Measures" (1.3.6.1.4.1.33895.1.3.0.45) excludes concepts that identify palliative care. Palliative care is not considered end of life care but more support and symptom management and therefore excluded from the value set. However, Hospice, Terminal and Dying care are included.
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      ​You are correct, palliative care will not count as comfort measures. All three measures, VTE-1, VTE-2 and STK-2, use the below logic to exclude patients receiving comfort care from the denominator:                       Intervention Comfort Measures​                             ["Intervention, Order": "Comfort Measures"]                            union ["Intervention, Performed": "Comfort Measures"] The valueset "Comfort Measures" (1.3.6.1.4.1.33895.1.3.0.45) excludes concepts that identify palliative care. Palliative care is not considered end of life care but more support and symptom management and therefore excluded from the value set. However, Hospice, Terminal and Dying care are included.
    • CMS0104v10, CMS0108v10, CMS0190v10
    • CMS104v9/NQFna, CMS108v9/NQFna, CMS190v9/NQFna
    • VTE-1 (CMS108v9), VTE-2 (CMS190v9), and STK-2 (CMS104v9)

      This question is in relation to IQR eCQM measure for VTE prophylaxis (VTE-1 or VTE-2) - CMSv108v9 and CMS190v9, and Stk-2 (CMS104v9).

      Can you please clarify the data element for comfort measures intervention (ordered or performed). I am interpreting the value set exclusions that Palliative Care would not count as comfort measures.  Is that specific to only diagnosis codes of palliative care being an exclusion to the comfort measures data element? Or, could this mean anything that is specific to palliative care only, such as orders, or consults? Example, if there is an order called "IP referral for Palliative Care Consult" would this be considered an inclusion term for Comfort measures to meet the denominator exclusion criteria?

      Thank you!

            JLeflore Mathematica EH eCQM Team
            kferry Kristin
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