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  2. CQM-6650

HH-01: Hyperkalemia in adults

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    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Answered
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    • Elizabeth Ballard
    • 16678955398
    • MedStar Health
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      Thank you for your question and comments about the Hospital Harm - Severe Hypoglycemia eCQM, CMS816. A severe hypoglycemic event is a glucose result of less than 40 mg/dL that occurs within 24 hours of administration of a hypoglycemic medication, such as insulin. The reason for administering the hypoglycemic medication, such as to treat hyperkalemia, is not considered in the evaluation because any severe hypoglycemic event is considered a harm. Treatment of severe hyperkalemia often involves insulin administration to drive potassium into the cells, primarily by enhancing the activity of the Na-K-ATPase pump in skeletal muscle. It is well recognized that hypoglycemia occurs in 6% to 18% of patients in this setting (https://pubmed.ncbi.nlm.nih.gov/27148740/, https://pubmed.ncbi.nlm.nih.gov/32979855/).
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      Thank you for your question and comments about the Hospital Harm - Severe Hypoglycemia eCQM, CMS816. A severe hypoglycemic event is a glucose result of less than 40 mg/dL that occurs within 24 hours of administration of a hypoglycemic medication, such as insulin. The reason for administering the hypoglycemic medication, such as to treat hyperkalemia, is not considered in the evaluation because any severe hypoglycemic event is considered a harm. Treatment of severe hyperkalemia often involves insulin administration to drive potassium into the cells, primarily by enhancing the activity of the Na-K-ATPase pump in skeletal muscle. It is well recognized that hypoglycemia occurs in 6% to 18% of patients in this setting ( https://pubmed.ncbi.nlm.nih.gov/27148740/, https://pubmed.ncbi.nlm.nih.gov/32979855/) .
    • CMS0816v3
    • Patients are being included in the eCQM population due to insulin and D50 administration for the treatment of a life-threatening condition.

      Has consideration been given to evaluate a coded diagnosis of hyperkalemia to be an exclusion for the HH-01 measure? Treatment of severe hyperkalemia often includes the administration of insulin and glucose (D50) in order to lower the serum potassium concentration by driving potassium into the cells. 

            JLeflore Joelencia Leflore
            elizabeth.ballard Elizabeth D Ballard
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