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  2. CQM-6153

VTE Dx Code missing from Value Set

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    • Icon: EH/CAH eCQMs EH/CAH eCQMs
    • Resolution: Answered
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    • Beth Sahlmann
    • 814-449-2547
    • Veterans Health Administration
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      ​Thank you for your inquiry. Both VTE-1(CMS108) and VTE-2 (CMS190) measures exclude patients with diagnosis of Venous Thromboembolism from the initial population. The value set Venous Thromboembolism (OID 2.16.840.1.113883.3.117.1.7.1.279), used in these measures, represents concepts for diagnoses of venous thromboembolism (VTE), including a pulmonary embolism. The ICD-10-CM code I82.442 (Acute embolism and thrombosis of left tibial vein) does not meet the value set concept. Please reference criteria listed in the inclusion criteria of the value set on the Value Set Authority Center (VSAC) website at https://vsac.nlm.nih.gov/. Click on the “Search Value Sets” tab and enter the value set OID to review the codes, click on “Description” to review the inclusion criteria. A patient with diagnosis of I82.442 should be given VTE prophylaxis within the qualifying timeframe as the measure requires.
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      ​Thank you for your inquiry. Both VTE-1(CMS108) and VTE-2 (CMS190) measures exclude patients with diagnosis of Venous Thromboembolism from the initial population. The value set Venous Thromboembolism (OID 2.16.840.1.113883.3.117.1.7.1.279), used in these measures, represents concepts for diagnoses of venous thromboembolism (VTE), including a pulmonary embolism. The ICD-10-CM code I82.442 (Acute embolism and thrombosis of left tibial vein) does not meet the value set concept. Please reference criteria listed in the inclusion criteria of the value set on the Value Set Authority Center (VSAC) website at https://vsac.nlm.nih.gov/ . Click on the “Search Value Sets” tab and enter the value set OID to review the codes, click on “Description” to review the inclusion criteria. A patient with diagnosis of I82.442 should be given VTE prophylaxis within the qualifying timeframe as the measure requires.
    • CMS0108v11, CMS0190v11
    • Cases with VTE are not excluded from the initial patient population.

      In review of cases, those with a diagnosis code of I82.442 (Acute embolism and thrombosis of left tibial vein) are not being excluded from the VTE prophylaxis measures because this code is not in the VTE Value set (Code System OID 2.16.840.1.113883.6.90). This code became effective 10/01/2022, so surprised that it is not included in the 2023 version of this value set.

            JLeflore Mathematica EH eCQM Team
            vhaerisahlmb Beth Sahlmann
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