VTE Prophylaxis- CMS108 Documentation Question

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Amanda Lopez
    • 9547014242
    • Hide
      Thank you for your inquiry about CMS108 v13 Venous Thromboembolism Prophylaxis. For No VTE prophylaxis due to Medical Reason, providers are required to document both pharmacological AND mechanical VTE Prophylaxis. For Patient refusal reason, document either pharmacological Or mechanical VTE Prophylaxis. see logic below. For Medical Reason "intersect" operator means both needs to be present.

      Encounter with No VTE Prophylaxis Due to Medical Reason
      ( "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"
          intersect "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"
      )
        union ( "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"
            intersect "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure"
        )
      For Patient Refusal, "union" operator means either one.
      Encounter with No VTE Prophylaxis Due to Patient Refusal
      "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission"
        union "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"
      Show
      Thank you for your inquiry about CMS108 v13 Venous Thromboembolism Prophylaxis. For No VTE prophylaxis due to Medical Reason, providers are required to document both pharmacological AND mechanical VTE Prophylaxis. For Patient refusal reason, document either pharmacological Or mechanical VTE Prophylaxis. see logic below. For Medical Reason "intersect" operator means both needs to be present. Encounter with No VTE Prophylaxis Due to Medical Reason ( "No VTE Prophylaxis Medication Due to Medical Reason From Day of Start of Hospitalization To Day After Admission"     intersect "No Mechanical VTE Prophylaxis Due to Medical Reason From Day of Start of Hospitalization To Day After Admission" )   union ( "No VTE Prophylaxis Medication Due to Medical Reason on Day of or Day After Procedure"       intersect "No Mechanical VTE Prophylaxis Due to Medical Reason on Day of or Day After Procedure"   ) For Patient Refusal, "union" operator means either one. Encounter with No VTE Prophylaxis Due to Patient Refusal "No VTE Prophylaxis Due to Patient Refusal From Day of Start of Hospitalization To Day After Admission"   union "No VTE Prophylaxis Due to Patient Refusal on Day of or Day After Procedure"
    • CMS0986v3
    • CMS0108v13
    • Workflow and documentation

      We are looking for clarification on the requirements within the eCQM measure of CMS108.
       
      Specifically, we are working to understand whether or not, with CMS108, providers are required to document both pharmacological AND mechanical VTE Prophylaxis?
       
      Based on the details within the measure, it appears that there is conflicting requirements.
       
      In the "Guidance" section of the rule, it outlines "Reasons for no pharmacological and no mechanical VTA prophylaxis must be explicitly documented by the MD/APN/PA or Pharmacist and linked with VTE prophylaxis."
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      However, in the logic of the rule, the section "Encounter with VTE Prophylaxis Received from Day of Start of Hospitalization to Day After Admission or Procedure", there is an "OR" between "Pharmacological OR Mechanical VTE Prophylaxis Received".
       
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      We would like to know if there is a requirement for documenting both Pharmacological and Mechanical, or if it is sufficient to document one or the other, during the qualifying encounter.
       
      Your assistance is appreciated!

            Assignee:
            Augustine Weber
            Reporter:
            Amanda Lopez
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              Created:
              Updated:
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