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  2. CQM-6812

PC-07 Severe Obstetric Complications code question

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      Thank you for your question about CMS1028/PC-07 Severe Obstetric Complications.

      ICD-10 Code O72.3 was removed from Disseminated Intravascular Coagulation, Severe Maternal Morbidity Diagnosis grouping value set during the last Annual Update (reporting year 2024). The most current measure specifications can be found at the eCQI Resource Center https://ecqi.healthit.gov/ . You can also 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 about CMS1028/PC-07 Severe Obstetric Complications. ICD-10 Code O72.3 was removed from Disseminated Intravascular Coagulation, Severe Maternal Morbidity Diagnosis grouping value set during the last Annual Update (reporting year 2024). The most current measure specifications can be found at the eCQI Resource Center https://ecqi.healthit.gov/ . You can also 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.
    • CMS1028v2
    • Related codes that could cause a severe complication code

      Hello and thanks for taking my question. I was reviewing a case and it initially fell into the PC-07 measure due to code O72.3 coagulation defect. Hospitalization stay was rather uncomplicated and no issues other than some mild thrombocytopenia that did not require any transfusion. There was a code for the thrombocytopenia of D69.6. The problem is, after talking with coding it seems as though in the postpartum phase if a patient has even mild thrombocytopenia like this case, that did not require immediate intervention they will get a code to compliment this and that code is O72.3 coagulation defect. Is this something that is looked at or taken into account with this measure. It seems as though thrombocytopenia in itself will not qualify the patient as Severe complication but the coagulation defect code will and it seems these are linked together through coding. Just when reviewing, there was what would seem to be no complications or no severe complications, but due to the mild thrombocytopenia the severe coagulation defect code got added. Can you add any insight into this, as on the surface this case does not seem to fit into this measure but due to the coagulation code due to the thrombocytopenia they have a severe complication code.

      Thanks for your time and have a great day

            JLeflore Mathematica EH eCQM Team
            wnewell1 William Aaron Newell
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