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  2. CQM-6809

CMS 506 Safe Use of Opioids - Inpatient Status

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      Thank you for your question regarding CMS506v6 Safe Use of Opioids - Concurrent Prescribing. Patients who are admitted to an inpatient encounter and subsequently transferred to a ‘sub-acute’ level of service within the same facility (swing beds) should not be included in the measure. The measure requires an ‘Inpatient Encounter’ to meet the denominator population. If your EHR is documenting these patients as an ‘Inpatient Encounter’, they would meet the denominator criteria for this measure. eCQMs are not able to differentiate patients based upon level of service. You will need to work with your EHR vendor to remove these patients from the measure for purposes of reporting. We will explore ways to address this issue in a future version of the measure.
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      Thank you for your question regarding CMS506v6 Safe Use of Opioids - Concurrent Prescribing. Patients who are admitted to an inpatient encounter and subsequently transferred to a ‘sub-acute’ level of service within the same facility (swing beds) should not be included in the measure. The measure requires an ‘Inpatient Encounter’ to meet the denominator population. If your EHR is documenting these patients as an ‘Inpatient Encounter’, they would meet the denominator criteria for this measure. eCQMs are not able to differentiate patients based upon level of service. You will need to work with your EHR vendor to remove these patients from the measure for purposes of reporting. We will explore ways to address this issue in a future version of the measure.
    • CMS0506v6
    • Patients with a true patient class of OBS or ED are pulling in as Inpatients which is not the intent of the measure.

      We have discovered patients included in the IPP that are billed as Outpatient patient class, but also are coded with one of the SNOMED codes in the Inpatient Encounter value sets because they have erroneous admit to inpatient orders which is pulled in by the measure mapping to count it as an Inpatient stay. Since these are obvious errors that should not be included in the IPP what is recommended to exclude these outpatient encounters from the measure?

      Scenario: Physician enters Inpatient admit order due to error, or they change their mind and enter OBS order, but our EHR vendor does not allow orders to be cancelled for IP once placed. The patient class will change appropriately to correct patient class, but our mapping is picking up that IP order and stopping there. Therefore, we see OBS and ED patient class in our measure. 

       

            JLeflore Mathematica EH eCQM Team
            winterh Holly Winters
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