We found an OB case that is counting twice in the numerator for ePC-07 OB complications. The patient came in for their delivery encounter (had a blood transfusion), so is correctly included in the numerator. The patient was readmitted within a day of their delivery discharge. According to billing rules, the two encounters get merged into one. However, according to Epic, the eCQM technical specifications don't reference anything about merged encounters. Epic is counting this patient in the measure twice, even though we know it is only possible for a patient to deliver one time during this timeframe.

How should hospitals handle 2 encounters that become merged into one per billing rules? All the coding information would be the exact same and only one claim would be submitted yet it's hitting the eCQM twice. According to Epic their specifications are behaving as expected but it doesn't make sense for hospitals to be penalized twice for one complication.

Thank you.