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  2. CQM-7358

Possible Exclusions (ED to Cath Lab and No PCI performed) - Consult for Surgery

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    • Icon: OQR eCQMs - Outpatient Quality Reporting OQR eCQMs - Outpatient Quality Reporting
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      Thank you for your inquiry regarding CMS996v5, Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The measure aligns with clinical guidelines for STEMI by capturing three numerators: PCI procedure within 90 minutes, fibrinolytic therapy in 30 minutes, or transfer to an acute facility within 45 minutes for further diagnostics or treatments. Discharging the patient from the ED so that they can have a Cath Lab in the acute inpatient setting (either on-site or at another facility) within 45 minutes will count towards the numerator as one of the three possible numerator outcomes. To capture this scenario, the discharge disposition needs to be documented as "Discharge To Acute Care Facility".
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      Thank you for your inquiry regarding CMS996v5, Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The measure aligns with clinical guidelines for STEMI by capturing three numerators: PCI procedure within 90 minutes, fibrinolytic therapy in 30 minutes, or transfer to an acute facility within 45 minutes for further diagnostics or treatments. Discharging the patient from the ED so that they can have a Cath Lab in the acute inpatient setting (either on-site or at another facility) within 45 minutes will count towards the numerator as one of the three possible numerator outcomes. To capture this scenario, the discharge disposition needs to be documented as "Discharge To Acute Care Facility".
    • CMS0996v5
    • Measure not counted against the facility when treatment is being given.

      Looking through the new OP-40 STEMI and wondering about certain scenarios. Example scenario: Patient comes in with a STEMI and goes to Cath Lab. The Cath Lab is unable to restore blood flow by PCI. They instead place a ventricular assist device and consult Cardiothoracic surgery. In a scenario like this, would there be consideration for CMS to add this to the denominator exclusions list? If not, what is the rationale behind this since everything was done appropriately except that the patient would possibly need surgery.

            aweber Mathematica EH eCQM Team
            astrain Angelena
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