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  2. CQM-6326

Excluding Hospice from another facility

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    • Resolution: Answered
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      Thank you for your inquiry about CMS125v11, Breast Cancer Screening. This measure identifies patients who are in hospice care anytime during the measurement period via the QDM datatypes and codes below. If information is documented in a structured field in EHR using any of the codes mentioned below, the record can be used to evaluate against the denominator exclusion criteria. You may want to work with your EHR vendor to determine how best to capture hospice-related data within structured fields.

      - "Encounter, Performed" using a code from "Encounter Inpatient" value set (2.16.840.1.113883.3.666.5.307)
      - "Encounter, Performed" using a code from "Hospice Encounter" value set (2.16.840.1.113883.3.464.1003.1003)
      - "Assessment, Performed" using code "Hospice care [Minimum Data Set]" (LOINC Code 45755-6)
      - "Intervention, Order" using a code from "Hospice Care Ambulatory" value set (2.16.840.1.113883.3.526.3.1584)
      - "Intervention, Performed" using a code from "Hospice Care Ambulatory" value set (2.16.840.1.113883.3.526.3.1584)
      As you noted, this measure is currently not specified to capture and exclude patients who are deceased during the measurement period.
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      Thank you for your inquiry about CMS125v11, Breast Cancer Screening. This measure identifies patients who are in hospice care anytime during the measurement period via the QDM datatypes and codes below. If information is documented in a structured field in EHR using any of the codes mentioned below, the record can be used to evaluate against the denominator exclusion criteria. You may want to work with your EHR vendor to determine how best to capture hospice-related data within structured fields. - "Encounter, Performed" using a code from "Encounter Inpatient" value set (2.16.840.1.113883.3.666.5.307) - "Encounter, Performed" using a code from "Hospice Encounter" value set (2.16.840.1.113883.3.464.1003.1003) - "Assessment, Performed" using code "Hospice care [Minimum Data Set]" (LOINC Code 45755-6) - "Intervention, Order" using a code from "Hospice Care Ambulatory" value set (2.16.840.1.113883.3.526.3.1584) - "Intervention, Performed" using a code from "Hospice Care Ambulatory" value set (2.16.840.1.113883.3.526.3.1584) As you noted, this measure is currently not specified to capture and exclude patients who are deceased during the measurement period.
    • CMS0125v11
    • Patient was discharged from another facility in to hospice facility, and died quickly. Neither were our facilities, and it wasn't our discharge order.

      Having trouble finding a way to exclude the patient based on current value sets, as we didn't actually place the order or ever have a hospice encounter with the patient.  We only have a scanned CC document with the info from other facilities, so its not in a discreet field.  Unfortunately death doesn't exclude the patient (somehow)

      This issue effects multiple measures.

            edave Mathematica EC eCQM Team
            Mdecker Marianne Decker
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