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  2. CQM-6789

Initial Population eCQM CMS506v6

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    • Michelle Conner
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      Thank you for your question regarding CMS506v6. Evaluating data for this measure is retrospective so regardless of what the patient statuses were throughout the stay, the measure evaluates the final documentation. If that final documentation indicates an observation encounter, that data is not evaluated against the measure criteria. Inpatient encounters are defined by the value set Encounter Inpatient (OID 2.16.840.1.113883.3.666.5.307) which includes codes for Emergency hospital admission (procedure), Hospital admission (procedure), and Hospital admission, elective (procedure).
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      Thank you for your question regarding CMS506v6. Evaluating data for this measure is retrospective so regardless of what the patient statuses were throughout the stay, the measure evaluates the final documentation. If that final documentation indicates an observation encounter, that data is not evaluated against the measure criteria. Inpatient encounters are defined by the value set Encounter Inpatient (OID 2.16.840.1.113883.3.666.5.307) which includes codes for Emergency hospital admission (procedure), Hospital admission (procedure), and Hospital admission, elective (procedure).
    • CMS0506v6
    • Initial population including patients with a final billing status of Observation (outpatient) status

      Regarding the Safe Use of Opioids measure for 2024 discharges, could you please clarify the definition of "inpatient encounter"?  If a patient is admitted to inpatient status (and has a Patient Placement admission order of Inpatient), but this order is updated to Observation status, and the case has a final billing status of Observation status, which is considered an outpatient encounter, would this patient be considered as meeting the definition for the Initial Population for this measure?

            JLeflore Mathematica EH eCQM Team
            michelle.conner@healthcatalyst.com Michelle Conner
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