Hello,

Within our EHR, we have an order placed titled "No Pharmacological VTE prophylaxis" with the physician documented reason of "patient fully ambulating and deemed to be low risk."  Per the CMS eCQM algorithm, I noticed that documentation of a 'low risk indicator for VTE' is considered a reason for why no VTE prophylaxis is given and should meet the numerator.  However, we currently have this reason only mapped to a reason for no pharmacological prophylaxis since the order indicates it's specific to pharmacological, and the process continues to look for mechanical prophylaxis to be addressed with an applicable device placed, or a reason documented for not addressing. 

Due to the CMS algorithm showing that low risk for VTE documentation should meet the numerator, I am questioning if we should actually have this reason mapped to meet numerator regardless whether it's tied to the reason for no pharmacological or no mechanical, as long as it's a reason documented on one of these types?  Essentially, should it be treated similar to patient refusal in that if it's documented on one type (pharmacological or mechanical) it would count towards the numerator, even if the other type isn't addressed?