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  2. CQM-6203

ePC-07 Another Cardiomyopathy code that isn't in the VSAC

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    • Resolution: Answered
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    • Jennifer Harlos
    • 9077486070
    • Alaska Native Medical Center
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      Thank you for your inquiry on CMS1028v1Severe Obstetric Complications. ​If the condition occurs during the delivery episode, O99.4x codes should be coded and not O90.3. Codes O99.411, O99.412, O99.413, O99.419 and O99.42 are listed in the Cardiac Disease value set used for risk adjustment when present on admission is yes.
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      Thank you for your inquiry on CMS1028v1Severe Obstetric Complications. ​If the condition occurs during the delivery episode, O99.4x codes should be coded and not O90.3. Codes O99.411, O99.412, O99.413, O99.419 and O99.42 are listed in the Cardiac Disease value set used for risk adjustment when present on admission is yes.
    • CMS1028v1
    • Cardiomyopathy present on admission is not counting as a cardiac disease risk factor for severe maternal morbidity.

      Similar to my previous inquiry, CQM-6130, Peripartum Cardiomyopathy (code O90.3) is not in the VSAC for ePC-07 (CMS1028v2). This patient went on to have Acute Kidney Failure as her SMM diagnosis.  Why isn't this diagnosis code considered a preexisting condition under cardiac disease for the risk variable adjustment in ePC-07?  Thank you.

            JLeflore Mathematica EH eCQM Team
            jlharlos Jennifer Harlos
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