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  1. eCQM Issue Tracker
  2. CQM-6837

CMS1028 PC-07

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    • Resolution: Answered
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    • Amy Oppong-Bawuah
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      Thank you for question on CMS1028v2: Severe Obstetric Complications. The logic is looking for the first resulted hematocrit, WBC, heart rate and systolic blood pressure value in the interval starting 24 hours prior to the start of the encounter and ending immediately prior to the time of delivery. Therefore, a laboratory test result after the start of the encounter but before the time of delivery meets risk variable criteria.

      Any of the four (4) lab test or physical exam results that have a LOINC-coded result contained in the following value sets or direct reference code within the specified time frame would meet risk adjustment:

      *"Hematocrit lab test" (2.16.840.1.113762.1.4.1045.114)
      *"White blood cells count lab test" (2.16.840.1.113762.1.4.1045.129)
      *code "Heart rate" ("LOINC Code (8867-4)")
      *code "Systolic blood pressure" ("LOINC Code (8480-6)")

      The first lab value(s) resulted in the defined time period should be reported, and the value(s) will be processed according to the methodology report. For more information, please reference the Severe Obstetric Complications Methodology Report posted on the eCQI Resource Center.
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      Thank you for question on CMS1028v2: Severe Obstetric Complications. The logic is looking for the first resulted hematocrit, WBC, heart rate and systolic blood pressure value in the interval starting 24 hours prior to the start of the encounter and ending immediately prior to the time of delivery. Therefore, a laboratory test result after the start of the encounter but before the time of delivery meets risk variable criteria. Any of the four (4) lab test or physical exam results that have a LOINC-coded result contained in the following value sets or direct reference code within the specified time frame would meet risk adjustment: *"Hematocrit lab test" (2.16.840.1.113762.1.4.1045.114) *"White blood cells count lab test" (2.16.840.1.113762.1.4.1045.129) *code "Heart rate" ("LOINC Code (8867-4)") *code "Systolic blood pressure" ("LOINC Code (8480-6)") The first lab value(s) resulted in the defined time period should be reported, and the value(s) will be processed according to the methodology report. For more information, please reference the Severe Obstetric Complications Methodology Report posted on the eCQI Resource Center.
    • CMS1028v2

      Risk adjustment : Laboratory Test, Performed: Hematocrit lab test

      Relevant date/time: 12/31/23 10:39

      Delivery:  1/1/24 07:50 AM,

       Encounter, Performed: ED Visit and OB Triage ; [12/31/23 09:54 PM, 12/31/23 10:25PM

      Encounter start date /time: 12/31 10:25 PM, 01/05/ 02:00PM

      The  laboratory test performed date and time is occurring after the start of the encounter ( and not 24 hours prior to the start of the encounter)but before the the time of delivery,  will this meet the risk variable criteria. In addition does all 4 lab and physical exam result  first resulted value have to fall within the time criteria to meet the risk adjustment criteria?  Also are there defined lab values the results need to meet?

       

            JLeflore Mathematica EH eCQM Team
            Opponga Amy Oppong-Bawuah
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