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  2. CQM-6432

CMS819 Numerator logic question

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
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      Thank you for your inquiry specific to CMS819v2 (Hospital Harm – Opioid-Related Adverse Event). The Numerator for the measure is inpatient hospitalizations where an opioid antagonist was administered outside of the operating room and within 12 hours following administration of an opioid medication. Your understanding of the intent is correct; opioid antagonists that are administered in the operating room are excluded from the evaluation for the Numerator. In your scenario the Numerator is met because the opioid antagonist (via IV route) was administered outside of the operating room and was within 12 hours following the 9/3/2023 9:00am administration of the opioid medication.
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      Thank you for your inquiry specific to CMS819v2 (Hospital Harm – Opioid-Related Adverse Event). The Numerator for the measure is inpatient hospitalizations where an opioid antagonist was administered outside of the operating room and within 12 hours following administration of an opioid medication. Your understanding of the intent is correct; opioid antagonists that are administered in the operating room are excluded from the evaluation for the Numerator. In your scenario the Numerator is met because the opioid antagonist (via IV route) was administered outside of the operating room and was within 12 hours following the 9/3/2023 9:00am administration of the opioid medication.
    • CMS0819v2

      Can you clarify the outcome expectation in the following scenario:

        start end Location
      Inpatient Encounter 9/1/2023 8:00 9/15/2023 8:00  
      OR location 9/3/2023 8:00 9/3/2023 10:00  
      Opioids Admin Relevant dttm 9/2/2023 8:00  -  outside OR
      Opioids Admin Relevant dttm 9/3/2023 9:00  - in OR
      Opioids Antagonist Admin Relevant dtm (IV route) 9/3/2023 21:00  - outside OR

      Encounter qualifies for IPP/Denominator based on Opioids administered 9/2/2023  8:00:00 AM
       
      For the numerator, the Opioids Antagonist was administered outside of the OR, and there is an Opioid administered 12hrs or less before (administered on 9/3/2023 at 9:00:00 AM). Is it the intent of the measure to exclude only 'opioid antagonists' that were administered in the OR when evaluating the Numerator logic? Is Numerator the expected outcome in this scenario? Thanks|

            JLeflore Joelencia Leflore
            isbelia Isbelia Briceno
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