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  2. CQM-7359

Atrial Ablation surgery in the denominator

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      Thank you for your question regarding CMS71v13 Anticoagulation Therapy for Atrial Fibrillation/Flutter (STK-3). The measure intent is to include patients who have a history of afib/flutter (AF) and subsequently underwent atrial ablation, because they are always at an elevated risk for stroke. Literature indicates that “Recurrent AF after catheter ablation occurs in at least 20 to 40% of patients”.1 The measure specifies a denominator exception for inpatient hospitalizations for patients with a documented reason for not prescribing anticoagulation therapy at discharge. Patients undergoing an atrial ablation procedure can satisfy the denominator exception if there is documentation that this is the reason for not prescribing anticoagulation therapy at discharge, value set “Medical Reason for Not Providing Treatment" 2.16.840.1.113883.3.117.1.7.1.473.

      [1] Darby A. E. (2016). Recurrent Atrial Fibrillation After Catheter Ablation: Considerations For Repeat Ablation And Strategies To Optimize Success. Journal of atrial fibrillation, 9(1), 1427. https://pmc.ncbi.nlm.nih.gov/articles/PMC5089515/
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      Thank you for your question regarding CMS71v13 Anticoagulation Therapy for Atrial Fibrillation/Flutter (STK-3). The measure intent is to include patients who have a history of afib/flutter (AF) and subsequently underwent atrial ablation, because they are always at an elevated risk for stroke. Literature indicates that “Recurrent AF after catheter ablation occurs in at least 20 to 40% of patients”.1 The measure specifies a denominator exception for inpatient hospitalizations for patients with a documented reason for not prescribing anticoagulation therapy at discharge. Patients undergoing an atrial ablation procedure can satisfy the denominator exception if there is documentation that this is the reason for not prescribing anticoagulation therapy at discharge, value set “Medical Reason for Not Providing Treatment" 2.16.840.1.113883.3.117.1.7.1.473. [1] Darby A. E. (2016). Recurrent Atrial Fibrillation After Catheter Ablation: Considerations For Repeat Ablation And Strategies To Optimize Success. Journal of atrial fibrillation, 9(1), 1427. https://pmc.ncbi.nlm.nih.gov/articles/PMC5089515/
    • CMS0071v13
    • Fallouts for patients that have had atrial ablation surgery and no longer have afib.

      Patients with documentation of a history of atrial ablation fall into the denominator...why is this?  I understand that the provider could document the surgery as a reason for not giving anticoagulant at discharge, but this seems to be extra documentation for the provider that is not necessary.  If they were still having afib after the ablation it makes sense to include them due to the afib diagnosis but to include them in the denominator for an atrial ablation surgery seems to work against what the measure is really trying to measure.  

            aweber Mathematica EH eCQM Team
            cobra24 jaime zirkle
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