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  2. CQM-6708

Admitted to observation and later updated to inpatient

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      Thank you for your question for CMS72, Antithrombotic Therapy by End of Hospital Day 2. The STK-5 (CMS72) Initial Patient Population uses an ICD-10-CM Principal Diagnosis Code for ischemic stroke to identify the cases included in the STK-5 denominator population. By definition, the ICD-10-CM Principal Diagnosis Code is the code that represents the reason for the patient’s admission to the hospital. In order to pass STK-5, the patient must have a principal diagnosis of ischemic stroke and be given antithrombotics by day 2 of the hospital stay. There is no denominator exclusion or exception for in-house strokes.
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      Thank you for your question for CMS72, Antithrombotic Therapy by End of Hospital Day 2. The STK-5 (CMS72) Initial Patient Population uses an ICD-10-CM Principal Diagnosis Code for ischemic stroke to identify the cases included in the STK-5 denominator population. By definition, the ICD-10-CM Principal Diagnosis Code is the code that represents the reason for the patient’s admission to the hospital. In order to pass STK-5, the patient must have a principal diagnosis of ischemic stroke and be given antithrombotics by day 2 of the hospital stay. There is no denominator exclusion or exception for in-house strokes.
    • CMS0072v11

      A pateint was admitted as observation status for reason other than stroke.  After day two, patient had sudden clinical change, stroke diagnosis and admission was updated to inpatient admission.  Comfort Care order placed same day as stroke diagnosis.

      Because the date/time used in the logic is day of admission to observation and not inpatient, the measure requirements for CMS 72 were not met.  

      I'm wondering if something is incorrect with the logic or our mapping.  In this particular situation, the stroke occured after hospital day 2 (when observation admission is the start date/time used for arrival) of inpateint admission.  

      For this measure, CMS 72, should it only include the date and time of inpateint admission, even when pateint is first admitted to observation?  Or, does this measure use arrival date/time to the hospital regarless if initially admitted to observation?

      If the measure uses arrival date/time to the hospital regardless if initially admitted to observation, how would one meet the intent of the measure when the stroke occurs after day 2?  

      Thank you.

       

       

            JLeflore Mathematica EH eCQM Team
            lgrover Lori Grover
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