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  2. CQM-6661

Denom exclusion for Discharge to Acute Care Facility CMS506

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      Thank you for your question regarding CMS506v5 Safe Use of Opioids - Concurrent Prescribing.

      The measure excludes patients who are transferred to another facility which is part of a ‘Denominator Exclusion’ "Excludes patients with cancer, or who re receiving palliative care or hospice care at the time of the encounter or who are discharged to another inpatient care facility or expire during the inpatient stay". The code referred to in the question, "428371000124100 Patients discharged to healthcare facility for hospice care (procedure)" is part of value set "Hospice Care Referral or Admission" OID (2.16.840.1.113883.3.600.1.1579) which can appear as an “Intervention, Order” or as an “Intervention, Performed”.
      The exclusion also covers “Discharge To Acute Care Facility” OID (2.16.840.1.113883.3.117.1.7.1.87),

      Hospice Care Referral or Admission OID (2.16.840.1.113762.1.4.1116.365),
      or if the “Patient Expired" OID (2.16.840.1.113883.3.117.1.7.1.309).

      You can reference the applicable codes containing these value sets on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/. Click on the “Search Value Sets” tab and enter the value set ID to review codes included in the respective value set.
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      Thank you for your question regarding CMS506v5 Safe Use of Opioids - Concurrent Prescribing. The measure excludes patients who are transferred to another facility which is part of a ‘Denominator Exclusion’ "Excludes patients with cancer, or who re receiving palliative care or hospice care at the time of the encounter or who are discharged to another inpatient care facility or expire during the inpatient stay". The code referred to in the question, "428371000124100 Patients discharged to healthcare facility for hospice care (procedure)" is part of value set "Hospice Care Referral or Admission" OID (2.16.840.1.113883.3.600.1.1579) which can appear as an “Intervention, Order” or as an “Intervention, Performed”. The exclusion also covers “Discharge To Acute Care Facility” OID (2.16.840.1.113883.3.117.1.7.1.87), Hospice Care Referral or Admission OID (2.16.840.1.113762.1.4.1116.365), or if the “Patient Expired" OID (2.16.840.1.113883.3.117.1.7.1.309). You can reference the applicable codes containing these value sets on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/ . Click on the “Search Value Sets” tab and enter the value set ID to review codes included in the respective value set.
    • CMS0506v5
    • Cannot complete validation on whether encounters should be excluded for their discharge status

      The VSAC documentation states patients discharged to healthcare facility for hospice care (procedure) as a denominator exclusion. Does this apply to patients tranferred to a higher level of care regardless of what that care is, or do they need to be transferred for hospice care or a procedure only? Thank you

            JLeflore Mathematica EH eCQM Team
            LISAWOLFKRMC LISA WOLF
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