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  1. eCQM Issue Tracker
  2. CQM-7067

PC-07 Numerator Mapping

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    • Rebecca Pelkey
    • 9196514596
    • WakeMed Hospitals
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      Thank you for your question about CMS1028v2 Severe Obstetric Complications. The clinical intent of the measure is to capture cases that have a severe maternal morbidity diagnosis code or procedure code from the delivery encounter. In the scenario described, the pulmonary embolism "occurred at 10 weeks and was no longer present." Therefore, the condition is not from the delivery encounter and should not be in the numerator based on that condition. An active problem on the problem list with no Present On Admission (POA) data would not be enough to qualify for the numerator.
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      Thank you for your question about CMS1028v2 Severe Obstetric Complications. The clinical intent of the measure is to capture cases that have a severe maternal morbidity diagnosis code or procedure code from the delivery encounter. In the scenario described, the pulmonary embolism "occurred at 10 weeks and was no longer present." Therefore, the condition is not from the delivery encounter and should not be in the numerator based on that condition. An active problem on the problem list with no Present On Admission (POA) data would not be enough to qualify for the numerator.
    • CMS1028v2
    • Patient placed in the numerator due to code listed on the reason for admission.

      We recently had a case where a patient was grouped in the numerator for a severe obstetric complication of O88.219 Pulmonary embolism during pregnancy, antepartum. When reviewing this chart, we noticed that this code was not included in the Final Diagnosis list as it occurred at 10 weeks gestation and was no longer present. Final diagnosis coding did code Z-code for personal hx of PE. We were able to see that the current hospital problem list still included PE during pregnancy. We were wondering if it is still listed as an active problem (with no POA data) would that be enough to classify it as a numerator case?

            JLeflore Joelencia Leflore
            rpelkey@wakemed.org Rebecca Pelkey (Inactive)
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