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  1. eCQM Issue Tracker
  2. CQM-6181

CMS72v11 Medical Reason criteria not met if order discontinued during encounter

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    • Icon: EH/CAH eCQMs EH/CAH eCQMs
    • Resolution: Answered
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    • Lilit Ovanisyan
    • 5592231819
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      Thank you for your inquiry about CMS72v11/STK-5 Antithrombotic Therapy By End of Hospital Day 2. The intent of the exception is to capture inpatient hospitalizations of patients with a documented reason for not administering antithrombotic therapy day of or day after hospital arrival. You may need to discuss with your vendor to how the original documentation is occurring and how it is being updated to mitigate this issue. We hope this helps.
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      Thank you for your inquiry about CMS72v11/STK-5 Antithrombotic Therapy By End of Hospital Day 2. The intent of the exception is to capture inpatient hospitalizations of patients with a documented reason for not administering antithrombotic therapy day of or day after hospital arrival. You may need to discuss with your vendor to how the original documentation is occurring and how it is being updated to mitigate this issue. We hope this helps.
    • CMS0072v11
    • Qualifying patients fall into Denominator category instead of Denominator Exception.

      For STK-5, we noticed that orders qualifying for "Medication Not Ordered: Antithrombotic Therapy> Medical Reason" counted in the Denominator Exception, only if the order was auto discontinued upon discharge. For orders that were entered within day of or day after hospitalization but discontinued during the encounter...those orders did not count patient in Denominator Exception. 

      Example - Denominator Exception

      Admit 1/10/23, "Medical Reason" order entered 1/10/23. Patient discharged 1/17/23. Order auto discontinued. 

       

      Example - Denominator

      Admit 1/10/23, "Medical Reason" order entered 1/10/23. Order discontinued 1/16/23. Patient discharged 1/17/23. 

       

      Seeking clarification whether this was the intent with the Denominator Exception logic.
      "No Antithrombotic Ordered or Administered Day Of or Day After Hospital Arrival"
      No Antithrombotic Ordered or Administered Day Of or Day After Hospital ArrivalTJC."Ischemic Stroke Encounter" IschemicStrokeEncounter
      with "No Antithrombotic Ordered or Administered" NoAntithrombotic
      such that NoAntithrombotic.authorDatetime during day of TJC."CalendarDayOfOrDayAfter" ( start of Global."HospitalizationWithObservation" ( IschemicStrokeEncounter ) )
      No Antithrombotic Ordered or Administered"Reason for Not Ordering Antithrombotic"
      union "Reason for Not Administering Antithrombotic"
      Reason for Not Administering Antithrombotic["Medication, Not Administered": "Antithrombotic Therapy"] NoAntithromboticGiven
      where NoAntithromboticGiven.negationRationale in "Medical Reason"
      or NoAntithromboticGiven.negationRationale in "Patient Refusal"

            JLeflore Mathematica EH eCQM Team
            165899 Lilit Ovanisyan
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              Created:
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