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  1. eCQM Issue Tracker
  2. CQM-7030

CMS 506 Safe Use of Opioids - consider excluding patients that expired from the IPP

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      Thank you for your feedback regarding CMS506v6 Safe Use of Opioids - Concurrent Prescribing. This measure currently excludes patients who have expired from the denominator:

      “Inpatient hospitalizations where patients have cancer that begins prior to or during the encounter or are ordered or are receiving palliative or hospice care (including comfort measures, terminal care, and dying care) during the hospitalization or in an emergency department encounter or observation stay immediately prior to hospitalization, patients discharged to another inpatient care facility, and patients who expire during the inpatient stay.”

      You will need to work with your EHR vendor to address this issue as these patients should be ‘Excluded’ from the ‘Denominator’ population. We will review the exclusion logic for potential updates, in the next AU cycle.
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      Thank you for your feedback regarding CMS506v6 Safe Use of Opioids - Concurrent Prescribing. This measure currently excludes patients who have expired from the denominator: “Inpatient hospitalizations where patients have cancer that begins prior to or during the encounter or are ordered or are receiving palliative or hospice care (including comfort measures, terminal care, and dying care) during the hospitalization or in an emergency department encounter or observation stay immediately prior to hospitalization, patients discharged to another inpatient care facility, and patients who expire during the inpatient stay.” You will need to work with your EHR vendor to address this issue as these patients should be ‘Excluded’ from the ‘Denominator’ population. We will review the exclusion logic for potential updates, in the next AU cycle.
    • CMS0506v6
    • Patients that have a discharge disposition of "expired" are in the IPP for the measure and then excluded. In validating a case CMS failed us because a patient that expired was in the IPP.

      Our hospital was under CMS validation. One of the charts requested was for the Safe Use of Opioids (CMS-506) eCQM. The patient qualified for the measure because he was an inpatient less than 120 days, was over 18 years old and was on a Scheduled II and III Opioid" medication at discharge with a discharge status of "expired". The eCQM outcome according to our vendor code was "excluded". The CMS validator indicated the patient should not have been in the measure population as there would be no opioids or benzodiazepines at discharge due to the discharge status. The way our EHR works is that home medications documented can automatically be listed as discharge medications when the patient is discharged no matter what the discharge status was. The discharge status of "expired" does not automatically discontinue medications. I am asking the measure stewards to consider that patients that expired be excluded from the IPP rather than being excluded later in the algorithm. Otherwise CMS validators will continue to fail these cases even though the EHR vendors are following the measure algorithm. 

            JLeflore Mathematica EH eCQM Team
            nancy.kreller Nancy Kreller
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