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  1. eCQM Issue Tracker
  2. CQM-707

CMS190v2/NQF0372 Clarification of behavior in the event of multiple ICU admission/transfers during one Inpatient Encounter

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    • Icon: Annual Update Annual Update
    • Resolution: Fixed
    • Icon: Minor Minor
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    • Tamara Bailey
    • 520.750.4324
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      Thank you for your question. The steward agrees that if there is more than 1 ICU admission or transfer during an inpatient encounter, the first encounter must be specifically identified. This is applicable wherever this data element present in the measure. The logic was revised to more accurately represent this concept during the April 2014 annual update. The new logic follows this pattern:

      FIRST (Occurrence A of Encounter, Performed-ICU Admission or Transfer) DURING Occurrence A of Encounter, Performed: Inpatient Encounter
      And in the Denominator Exception:
      FIRST (Occurrence A of Encounter, Performed-ICU Admission or Transfer (LOS <1 day(s)) DURING Occurrence A of Encounter, Performed: Inpatient Encounter
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      Thank you for your question. The steward agrees that if there is more than 1 ICU admission or transfer during an inpatient encounter, the first encounter must be specifically identified. This is applicable wherever this data element present in the measure. The logic was revised to more accurately represent this concept during the April 2014 annual update. The new logic follows this pattern: FIRST (Occurrence A of Encounter, Performed-ICU Admission or Transfer) DURING Occurrence A of Encounter, Performed: Inpatient Encounter And in the Denominator Exception: FIRST (Occurrence A of Encounter, Performed-ICU Admission or Transfer (LOS <1 day(s)) DURING Occurrence A of Encounter, Performed: Inpatient Encounter

      In the Numerator of the VTE2 measure, most of the logic is comparing against the time of the ICU Admission or Transfer, but the logic does not specify what to do if there are more than one ICU Admission/Transfers during an encounter

      For Example

      Patient is admitted as Inpatient on 10/1/13
      Patient is transferred to ICU on 10/2/13
      Patient is transferred to Non-ICU on 10/6/13
      Patient is transferred back to ICU on 10/8/13
      Patient is transferred to Non-ICU on 10/12/13
      Patient is discharged on 10/15/13

      In the legacy measures, in the data dictionary entry for ICU Admission or Transfer Date it states:

      "If a patient was a direct admit to the ICU for more than one day, subsequent transfers back to an ICU during the same hospitalization will NOT be abstracted."

      Should this measure only be evaluating VTE Prophylaxis administered during the FIRST ICU stay or should it be evaluating both?

            abt.associate Abt Associate (Inactive)
            tamarabailey Tamara Bailey (Inactive)
            Deborah Krauss (Inactive), Patricia Van Egmond (Inactive), Saul Kravitz (Inactive), Sharon J. Giarrizzo-Wilson (Inactive)
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