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  2. CQM-5368

STK-2 patient refusal for antithrombotic therapy

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    • Rachel Pritchett
    • TRMC
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      ​​Thank you for your question on CMS104, Discharged on Antithrombotic Therapy. Reasons for not prescribing antithrombotic therapy at hospital discharge must be documented by a physician/APN/PA or pharmacist with one exception: Patient/family refusal of any form of antithrombotic therapy (e.g., “ASA refused,” “Patient refusing antithrombotic therapy”) may be documented by a nurse.

      The value set is "Patient Refusal" (2.16.840.1.113883.3.117.1.7.1.93) and it qualifies the patient for Denominator Exclusion. If the patient has refused an antihrombotic medication at discharge, the EHR should include the codes in the “Patient Refusal” value set. The valuesets for CMS104v11 are easily viewed at https://ecqi.healthit.gov/ecqm/eh/2023/cms104v11 under “Specifications and Data Elements” or directly in VSAC.
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      ​​Thank you for your question on CMS104, Discharged on Antithrombotic Therapy. Reasons for not prescribing antithrombotic therapy at hospital discharge must be documented by a physician/APN/PA or pharmacist with one exception: Patient/family refusal of any form of antithrombotic therapy (e.g., “ASA refused,” “Patient refusing antithrombotic therapy”) may be documented by a nurse. The value set is "Patient Refusal" (2.16.840.1.113883.3.117.1.7.1.93) and it qualifies the patient for Denominator Exclusion. If the patient has refused an antihrombotic medication at discharge, the EHR should include the codes in the “Patient Refusal” value set. The valuesets for CMS104v11 are easily viewed at https://ecqi.healthit.gov/ecqm/eh/2023/cms104v11 under “Specifications and Data Elements” or directly in VSAC.
    • CMS0104v10

      for medication, not discharged: patient refusal for antithrombotic therapy, should nursing documentation of "medication not administered, patient NPO" on the MAR count as a valid denominator exception?  I cannot find any guidance related to accepting nursing documentation versus MD/APP documentation.  Thanks 

            JLeflore Mathematica EH eCQM Team
            rachelp Rachel Pritchett
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