Placenta Accreta and numerator exclusions

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your question about CMS1028 Severe Obstetric Complications. Placenta accreta is not included in the numerator exclusions. The Technical Advisory Panel (TAP) felt that not all cases of placenta accreta require a hysterectomy, and reproductive justice or preservation should be considered.
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      Thank you for your question about CMS1028 Severe Obstetric Complications. Placenta accreta is not included in the numerator exclusions. The Technical Advisory Panel (TAP) felt that not all cases of placenta accreta require a hysterectomy, and reproductive justice or preservation should be considered.
    • CMS1028v3
    • Numerator performance rate impact

      For 2025 you added Hysterectomy and Transfusion for cases of Placenta Increta or Percreta as exclusions criteria for PC-07 so long as no other SMMs were identified. Can you comment as to why you did not include placenta accreta in this exclusion? Standard management for placenta accreta is hysterectomy just as it is for increta/percreta. Additionally, since most cases of placenta accreta spectrum are placenta accreta and not the more significant placental invasion of increta/percreta they often only undergo hysterectomy with our without transfusion and without additional SMM. By keeping these patients in the metric we would be inappropriately identifying standard of care as an SMM.

      Can adding the code for placenta accreta (O43.21) in the numerator exclusion value set be considered for future reporting years?

             O43.211: First trimester
              O43.212: Second trimester
              O43.213: Third trimester

            Assignee:
            Augustine Weber
            Reporter:
            Miranda Schufman
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