Thank you for inquiring about CMS1028/PC-07 Severe Obstetric Complications. We believe there is a typo in the code in your inquiry, since O26.4 is Herpes gestationis and not relevant to the value set in question. The ICD-10 code O26.64, for IHCP or Intrahepatic cholestasis of pregnancy is a new code for 2024 as of October 1, 2023. The eCQM's are updated on an annual basis, and O26.64x are included in the recently published value set for CMS1028v3. You can reference the applicable codes containing this value on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/ . One option to address terminology code updates that are effective prior to, but relevant to the eCQM, would be to map the terminology to the current relevant code in the value set. If mapping is conducted, you should maintain documentation in case of a CMS audit.

This is an equity issue. I work with the Alaska Native population, and we have a high volume of birthing persons affected by Intrahepatic Cholestasis of Pregnancy (IHCP). About 10% of our Alaska Native birthing population is affected by this disease, whereas it's much less common in the general US population (about 0.5%). By not counting this disease as a risk factor under the new code system until 2025, our hospital will be disproportionately affected. Other hospital may not see this affecting their PC-07 numbers at all, or only very slightly, whereas our patient's risk will not be accurately adjusted for about 10% of our patients.