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  2. CQM-6764

Blood transfusion - CMS 1028 (PC-07) Severe Obstetric Complications

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    • Resolution: Answered
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    • Lori Fallstead
    • 402-730-5121
    • CommonSpirit Health
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      Thank you for your question about CMS 1028/PC-07 Severe Obstetric Complications. Specifically the appropriate mapping of the blood transfusion value set. There is an eCQM Known Issue (EKI-23) in which 33 of the 39 codes added to the value set during the 2023 annual update process are not consistent with the intent of the measure.

      Therefore, we recommend implementing CMS1028v2 by mapping the 49 appropriate Blood Transfusion value set codes indicated with an asterisk in the attached document. We do recommend you consult with your EHR vendor and clinical partners. If mapping is conducted, you should maintain documentation in case of a CMS audit.

      You will notice that transfusion of whole blood and transfusion of packed red blood cells are both indicated with an asterisk (found in EKI-23 Table 1), so they will need to be mapped and included along with the other 47 codes in the value set as indicated.
      Show
      Thank you for your question about CMS 1028/PC-07 Severe Obstetric Complications. Specifically the appropriate mapping of the blood transfusion value set. There is an eCQM Known Issue ( EKI-23 ) in which 33 of the 39 codes added to the value set during the 2023 annual update process are not consistent with the intent of the measure. Therefore, we recommend implementing CMS1028v2 by mapping the 49 appropriate Blood Transfusion value set codes indicated with an asterisk in the attached document. We do recommend you consult with your EHR vendor and clinical partners. If mapping is conducted, you should maintain documentation in case of a CMS audit. You will notice that transfusion of whole blood and transfusion of packed red blood cells are both indicated with an asterisk (found in EKI-23 Table 1), so they will need to be mapped and included along with the other 47 codes in the value set as indicated.
    • CMS1028v2
    • CMS0124v12
    • Answer will determine how we complete our mapping on this measure related to blood tranfusions.

      Measure: CMS 1023/PC-07 includes QDM Procedure, Performed8
      Value Set: Blood Transfusion (2.16.840.1.113762.1.4.1029.213).

      PC-07 / QDM Procedure, Performed includes value set 'Blood Tranfusion". This value set includes blood components such as plasma, factor VII, IX, washed blood cells, leukocytes, and many more. The PC-07 measure specs don't indicate what blood or blood componts to include and map.

      My questions are:
      1. Are we to include all of the blood products in the "Blood Transfusion" value set for this measure when mapping?

      2. Are we to include only whole blood and packed red blood cells?

      In NO to either of the questions above, what blood components are considered as a "Blood Transfusion" for PC-07?

      Thanks so much!
      Lori

        1. EKI-23 Table 1.pdf
          112 kB

            JLeflore Mathematica EH eCQM Team
            LFallstead Lori Fallstead
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