acceptable antithrombotics

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Molly Misuraca
    • 7472103467
    • Olive View - UCLA Medical Center
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      Thank you for your inquiry regarding CMS72/STK-5, Antithrombotic Therapy by End of Hospital Day 2. In order to meet the measure numerator, hospitals must administer medications referenced in the value set "Antithrombotic Therapy for Ischemic Stroke 2.16.840.1.113762.1.4.1110.62" day of or day after hospital arrival.

      This value set represents concepts of antithrombotic medications used to reduce stroke mortality and morbidity and excludes concepts that represent enoxaparin and heparin generally given for VTE prophylaxis. The doses mentioned are prophylactic rather than therapeutic, and not acceptable for stroke long-term anticoagulation therapy. As stated in the measure rationale, “Anticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.” The 5000 UNT dose would not be appropriate for stroke anticoagulation therapy and would not meet the numerator criteria.

      You can reference the applicable codes found within this value set on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/. Click on the “Search Value Sets” tab and enter the value set ID to review codes included in the respective value set.
      Show
      Thank you for your inquiry regarding CMS72/STK-5, Antithrombotic Therapy by End of Hospital Day 2. In order to meet the measure numerator, hospitals must administer medications referenced in the value set "Antithrombotic Therapy for Ischemic Stroke 2.16.840.1.113762.1.4.1110.62" day of or day after hospital arrival. This value set represents concepts of antithrombotic medications used to reduce stroke mortality and morbidity and excludes concepts that represent enoxaparin and heparin generally given for VTE prophylaxis. The doses mentioned are prophylactic rather than therapeutic, and not acceptable for stroke long-term anticoagulation therapy. As stated in the measure rationale, “Anticoagulants at doses to prevent venous thromboembolism are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.” The 5000 UNT dose would not be appropriate for stroke anticoagulation therapy and would not meet the numerator criteria. You can reference the applicable codes found within this value set on the Value Set Authority Center (VSAC) at https://vsac.nlm.nih.gov/ . Click on the “Search Value Sets” tab and enter the value set ID to review codes included in the respective value set.
    • CMS1017v2
    • CMS0072v13
    • STK - 5 and UF Heparin 5000 units SQ

      Hi there,

       

      My understanding from reading the rationale for acceptable antithrombotics by day two for STK - 5 is that UF Heparin 5000 units SQ two to three times a day does not meet this metric as an antithrombotic.  This is also confirmed when I look at the TJC list for antithrombotics; IV Heparin is the only acceptable version on Heparin listed to meet this metric.  My fellow coworkers state that CMS considers UF Heparin 5000 units SQ as acceptable to meet this STK - 5 requirement and so my hospital is counting this as a numerator met.  I disagree; I understand this as patients who only get 5000 Units of unfractionated Heparin SQ by day two with a stroke admission are fallouts.  Could you please settle this for us?

       

      Kind regards,

      Molly Misuraca

       

            Assignee:
            Augustine Weber
            Reporter:
            Molly Misuraca (Inactive)
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