Uploaded image for project: 'eCQM Issue Tracker'
  1. eCQM Issue Tracker
  2. CQM-7640

Safe Use for Opioids Discharge Disposition Exclusions

XMLWordPrintable

    • Icon: EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals EH/CAH eCQMs - Eligible Hospitals/Critical Access Hospitals
    • Resolution: Answered
    • Icon: Moderate Moderate
    • None
    • None
    • Whitney Matson
    • Hide
      Thank you for your question regarding CMS506v6, Safe Use of Opioids - Concurrent Prescribing. Patients discharged to other acute inpatient facilities, as defined in the value set "Discharge To Acute Care Facility" (2.16.840.1.113883.3.117.1.7.1.87), are excluded. This value set includes community hospitals, tertiary referral hospitals, and acute care hospitals. Patients transferred to a skilled nursing facility, rehabilitation facility, or LTAC hospital are not excluded. A patient discharged to hospice care, "Hospice Care Referral or Admission"(2.16.840.1.113762.1.4.1116.365), is also excluded from the measure, even if palliative or hospice care is not recorded elsewhere during the patient's hospital stay.

      Out of the list in your example the following would be excluded by this measure:

      *Hospice - Home: 50 Discharged/transferred to Hospice (home)-or alternative setting that is the patient's home such as nursing facility, and will receive in-home hospice services

      *Hospice - Medical Facility: 51 Discharged/transferred to Hospice medical facility- patient went to an IP facility that is qualified and the patient is to receive the general IP hospice level of care or hospice respite care. Used also if the patient is discharged from an IP acute care hospital to remain in hospital under hospice care

      *Transfer to Other Hosp- Inpt: 02 Discharged/transferred to short-term general hospital for Inpatient Care

      We encourage you to map discharge disposition codes to the SNOMEDCT codes consistent with the intent of the SNOMEDCT descriptor.

      Please note, patients who are admitted to an inpatient encounter and subsequently transferred to a skilled nursing level of service within the same facility (swing beds) should not be included in the measure. eCQMs are not able to differentiate patients based upon level of service. We encourage you to work with your EHR vendor to remove these patients from the measure for purposes of reporting. We will look into ways to address this in a future version of the measure.
      Show
      Thank you for your question regarding CMS506v6, Safe Use of Opioids - Concurrent Prescribing. Patients discharged to other acute inpatient facilities, as defined in the value set "Discharge To Acute Care Facility" (2.16.840.1.113883.3.117.1.7.1.87), are excluded. This value set includes community hospitals, tertiary referral hospitals, and acute care hospitals. Patients transferred to a skilled nursing facility, rehabilitation facility, or LTAC hospital are not excluded. A patient discharged to hospice care, "Hospice Care Referral or Admission"(2.16.840.1.113762.1.4.1116.365), is also excluded from the measure, even if palliative or hospice care is not recorded elsewhere during the patient's hospital stay. Out of the list in your example the following would be excluded by this measure: *Hospice - Home: 50 Discharged/transferred to Hospice (home)-or alternative setting that is the patient's home such as nursing facility, and will receive in-home hospice services *Hospice - Medical Facility: 51 Discharged/transferred to Hospice medical facility- patient went to an IP facility that is qualified and the patient is to receive the general IP hospice level of care or hospice respite care. Used also if the patient is discharged from an IP acute care hospital to remain in hospital under hospice care *Transfer to Other Hosp- Inpt: 02 Discharged/transferred to short-term general hospital for Inpatient Care We encourage you to map discharge disposition codes to the SNOMEDCT codes consistent with the intent of the SNOMEDCT descriptor. Please note, patients who are admitted to an inpatient encounter and subsequently transferred to a skilled nursing level of service within the same facility (swing beds) should not be included in the measure. eCQMs are not able to differentiate patients based upon level of service. We encourage you to work with your EHR vendor to remove these patients from the measure for purposes of reporting. We will look into ways to address this in a future version of the measure.
    • CMS0071v14
    • CMS0506v6
    • Increases the rate of patients identified as having concurrent opioid use.

      We are seeing inpatients with the following discharge dispositions in our data from our EMR.  Should encounters with the following discharge dispositions be excluded? 

      • Swing Bed: 61 - Discharged/transferred within this institution to a hospital based Medicare approved swing bed. This is also used when discharged from an acute care hospital to a CAH swing bed
      • Skilled Nursing Facility: 03 - Discharged/transferred to SNF with Medicare certification in anticipation of covered skilled care.
      • Skilled  Nuring Fac - Plan ACH IP Readmit: 83 - Discharged/transferred to a skilled nursing facility (SNF) with Medicare certification with a planned acute care hospital inpatient readmission
      • Hospice - Home: 50 Discharged/transferred to Hospice (home)-or alternative setting that is the patient's home such as nursing facility, and will receive in-home hospice services
      • Hospice - Medical Facility: 51 Discharged/transferred to Hospice medical facility- patient went to an IP facility that is qualified and the patient is to receive the general IP hospice level of care or hospice respite care. Used also if the patient is discharged from an IP acute care hospital to remain in hospital under hospice care
      • Inpatient Rehab Facility/Unit: 62 Discharged/transferred to an inpatient rehabilitation facility including distinct part units of a hospital
      • Transfer to Other Hosp- Inpt: 02 Discharged/transferred to short-term general hospital for Inpatient Care
      • Cancer Center or Childeren's Hospital: 05 Discharged/transferred to a designated cancer center or children's hospital
      • Long Term Care Hospital: 63 Discharged/transferred to a long term care hospital
      • Psychiatric Facility/Unit: 65 Discharged/transferred to a psychiatric hospital or psychiatric distinct part unit of a hospital
      • Critical Access Hospital: 66 Discharged/transferred to a Critical Access Hospital (CAH)

            aweber Mathematica EH eCQM Team
            wmatson Whitney Matson
            Votes:
            0 Vote for this issue
            Watchers:
            4 Start watching this issue

              Created:
              Updated:
              Resolved:
              Solution Posted On: