STEMI Timing and further Numerator clarification

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    • Type: Hosp Outpt eCQMs - Hospital Outpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Susan Maillis
    • Maimonides Medical Center
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      Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). We have responded to each on your inquiries below:

      For your first question, we would like to clarify the value set for STEMI does not include codes for late onset STEMI. The measure assesses time from ED arrival to time of appropriate treatment as defined by three numerator criteria: fibrinolytic therapy within 30 minutes of ED arrival, PCI within 90 minutes of ED arrival, or discharge to a PCI-capable Acute Care Facility within 45 minutes of ED arrival. Therefore, the clock for inclusion in the measure numerator begins at ED arrival time, regardless of what time a patient received the STEMI diagnosis. The measure developer will consider refinements to capture STEMI onset time to intervention time in a future annual update.

      For your second question, your understanding is correct. If the patient is discharged to acute care within 45 minutes of ED arrival, the patient would meet the third numerator criteria in this scenario.
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      Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). We have responded to each on your inquiries below: For your first question, we would like to clarify the value set for STEMI does not include codes for late onset STEMI. The measure assesses time from ED arrival to time of appropriate treatment as defined by three numerator criteria: fibrinolytic therapy within 30 minutes of ED arrival, PCI within 90 minutes of ED arrival, or discharge to a PCI-capable Acute Care Facility within 45 minutes of ED arrival. Therefore, the clock for inclusion in the measure numerator begins at ED arrival time, regardless of what time a patient received the STEMI diagnosis. The measure developer will consider refinements to capture STEMI onset time to intervention time in a future annual update. For your second question, your understanding is correct. If the patient is discharged to acute care within 45 minutes of ED arrival, the patient would meet the third numerator criteria in this scenario.
    • CMS0996v5
    • CMS0996v4
    • It appears we are not appropriately treating patients regarding prompt door to balloon time.

      Follow Up Questions to recent Case # CQM 7743

      1. What ICD10 or SNOMEDCT code represents a late presentation for STEMI?
      2. If patient goes to CATH and it is decided that no intervention is indicated, then is transferred to Acute Care, According to what was referenced in Case #CQM 7743, this scenario would fall into the 3rd numerator- 'Transfer to Acute Care'. Is this correct?

      CQM-7743 STEMI timing and possible exclusion - Office of the National Coordinator for Health Information Technology (healthit.gov)

            Assignee:
            Augustine Weber
            Reporter:
            Susan Maillis (Inactive)
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