TKR not in Value Set

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Beth Sahlmann
    • 814-449-2547
    • VHA
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      ​​​Thank you for your question. We will add 0SRC069 (Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Cemented, Open Approach) and Oxidized Zirconium on Polyethylene related ICD-10 codes to the value set Knee Replacement Surgery ICD10PCS (2.16.840.1.113883.3.117.1.7.1.31) in the 2023 AU process. In the meantime, you can map 0SRC069 to one of the SNOMED codes in the current value set Knee Replacement Surgery SNOMED CT (OID: 2.16.840.1.113883.3.117.1.7.1.315), i.e., cemented TKR 179344006 Primary cemented total knee replacement (procedure). If mapping is done, you should maintain documentation in case of a CMS audit.
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      ​​​Thank you for your question. We will add 0SRC069 (Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Cemented, Open Approach) and Oxidized Zirconium on Polyethylene related ICD-10 codes to the value set Knee Replacement Surgery ICD10PCS (2.16.840.1.113883.3.117.1.7.1.31) in the 2023 AU process. In the meantime, you can map 0SRC069 to one of the SNOMED codes in the current value set Knee Replacement Surgery SNOMED CT (OID: 2.16.840.1.113883.3.117.1.7.1.315), i.e., cemented TKR 179344006 Primary cemented total knee replacement (procedure). If mapping is done, you should maintain documentation in case of a CMS audit.
    • CMS0108v11
    • CMS0108v10
    • CMS108v9/NQFna
    • Cases are not meeting the numerator due to codes missing from the total knee replacement value set (OID 2.16.840.1.113883.3.117.1.7.1.261).

      Total Knee Replacement ICD-10-PCS of 0SRC069 (Replacement of Right Knee Joint with Oxidized Zirconium on Polyethylene Synthetic Substitute, Cemented, Open Approach) is not found on the Knee Replacement Surgery Value set (OID 2.16.840.1.113883.3.117.1.7.1.261). Our VTE cases with this code are not being excluded from the measure and/or meeting the numerator per the VTE specifications (CMS108v11 and CMS190v11).

            Assignee:
            Joelencia Leflore
            Reporter:
            Beth Sahlmann
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