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  2. CQM-5747

CMS69v11 currently includes ICD10 code O34.219 resulting in old pregnancies being excluded

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      ​​Thank you for your inquiry regarding CMS69v11: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. We appreciate your feedback regarding ICD10CM code O34.219 "Maternal care for unspecified type scar from previous cesarean delivery." The specifications for CMS69v11 are finalized and published, and no updates can be made to this measure version at this time. However, we will evaluate the appropriateness of this code during the next Annual Update cycle.
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      ​​Thank you for your inquiry regarding CMS69v11: Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan. We appreciate your feedback regarding ICD10CM code O34.219 "Maternal care for unspecified type scar from previous cesarean delivery." The specifications for CMS69v11 are finalized and published, and no updates can be made to this measure version at this time. However, we will evaluate the appropriateness of this code during the next Annual Update cycle.
    • CMS0069v11
    • Patients who were pregnant in a previous period are being excluded as if they are pregnant during this measurement period.

      Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan CMS69v11 says to exclude "Patients who are pregnant at any time during the measurement period." The measure goes on to define Pregnancy via value set "Pregnancy or Other Related Diagnoses (2.16.840.1.113883.3.600.1.1623).  This value set includes ICD10CM code O34.219 "Maternal care for unspecified type scar from previous cesarean delivery" which results in excluding patients who were previously pregnant, not necessarily patients who are "pregnant at any time during the measurement period."

            edave Mathematica EC eCQM Team
            akladnitsky Aleksandr Kladnitsky
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