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  2. CQM-6484

ePC-07 O72.3 for severe maternal morbidity

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    • Jennifer L Harlos
    • 9077292226
    • Alaska Native Medical Center
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      Thank you for your question related to CMS1028v1 Severe Obstetric Complications. For the reporting year 2023, O72.3 (Postpartum coagulation defects) was included in the "Severe Maternal Morbidity (SMM) Diagnoses" (OID 2.16.840.1.113762.1.4.1029.255) value set and would qualify the patient for the numerator. Based on feedback from the field and review by an expert panel, O72.3 has since been removed from the value set effective 1/1/2024. The reason for removal is that the code was deemed too broad and was placing patients in the numerator when a true SMM was not present. Please see Technical Release Notes for reporting period 2024 for notice of this change: Eligible Hospital / Critical Access Hospital eCQMs | eCQI Resource Center (healthit.gov)
      Show
      Thank you for your question related to CMS1028v1 Severe Obstetric Complications. For the reporting year 2023, O72.3 (Postpartum coagulation defects) was included in the "Severe Maternal Morbidity (SMM) Diagnoses" (OID 2.16.840.1.113762.1.4.1029.255) value set and would qualify the patient for the numerator. Based on feedback from the field and review by an expert panel, O72.3 has since been removed from the value set effective 1/1/2024. The reason for removal is that the code was deemed too broad and was placing patients in the numerator when a true SMM was not present. Please see Technical Release Notes for reporting period 2024 for notice of this change: Eligible Hospital / Critical Access Hospital eCQMs | eCQI Resource Center (healthit.gov)
    • CMS1028v1
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      We have a patient pulling into the measure because of final coding with O72.3 (Postpartum coagulation defects). She had an incidental finding of thrombocytopenia during a routine CBC after delivery, which resolved the next day without intervention. Not sure this should really ding as severe maternal morbidity.
      Show
      We have a patient pulling into the measure because of final coding with O72.3 (Postpartum coagulation defects). She had an incidental finding of thrombocytopenia during a routine CBC after delivery, which resolved the next day without intervention. Not sure this should really ding as severe maternal morbidity.

      Coding says there needs to be an obstetric section code correlating with the condition of thrombocytopenia (D69.6), so the O72.3 code is appropriate.  This patient had a scheduled repeat cesarean without hemorrhage and on her routine CBC the next morning her platelets were 136.  They were monitored and on repeat CBC the next morning were back in the normal range without intervention.  Should this patient really pull in for severe maternal mortality?  Thanks

            JLeflore Mathematica EH eCQM Team
            jlharlos Jennifer Harlos
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