ePC02 Cesarean Birth CMS 334

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Laura Kenny
    • Johns Hopkins Hospital
    • Hide
      Thank you for your inquiry regarding CMS334v6 (Cesarean Birth). Conditions for which cesarean delivery is indicated, which are excluded from the measure, have corresponding diagnosis codes that were added to the following value sets: 'Abnormal Presentation' (2.16.840.1.113762.1.4.1045.105), 'Genital Herpes' (2.16.840.1.113883.3.464.1003.110.12.1049), and 'Placenta Accreta Spectrum, Previa, or Vasa Previa' (2.16.840.1.113762.1.4.1110.37).

      The measure developer does not currently have plans to add risk-adjustment to the measure. The Cesarean Birth measure (ePC-02) is designed to measure the rates of cesarean births among a subset of the general obstetric population of women while also keeping the burden of data collection to a minimum. The measure focuses on mothers having their first birth who are at the highest risk of primary cesarean birth when compared to mothers who have experienced a previous vaginal birth. Extensive testing has shown that it is not necessary to exclude all known indications for performing cesareans, since these types of medical conditions are less common and would not significantly increase a hospital's adjusted cesarean rate. In summary, including a comprehensive set of maternal medical exclusions would add burden to data collection without commensurate benefit.
      Show
      Thank you for your inquiry regarding CMS334v6 (Cesarean Birth). Conditions for which cesarean delivery is indicated, which are excluded from the measure, have corresponding diagnosis codes that were added to the following value sets: 'Abnormal Presentation' (2.16.840.1.113762.1.4.1045.105), 'Genital Herpes' (2.16.840.1.113883.3.464.1003.110.12.1049), and 'Placenta Accreta Spectrum, Previa, or Vasa Previa' (2.16.840.1.113762.1.4.1110.37). The measure developer does not currently have plans to add risk-adjustment to the measure. The Cesarean Birth measure (ePC-02) is designed to measure the rates of cesarean births among a subset of the general obstetric population of women while also keeping the burden of data collection to a minimum. The measure focuses on mothers having their first birth who are at the highest risk of primary cesarean birth when compared to mothers who have experienced a previous vaginal birth. Extensive testing has shown that it is not necessary to exclude all known indications for performing cesareans, since these types of medical conditions are less common and would not significantly increase a hospital's adjusted cesarean rate. In summary, including a comprehensive set of maternal medical exclusions would add burden to data collection without commensurate benefit.
    • CMS0334v7
    • CMS0334v6
    • CMS0334v5
    • rates for ePC02

      We are a large academic hospital and were wondering if the PC 02 rates will be risk stratified? We deliver a large number of high risk pregnancies with multiple comorbidities such as 

      • Chronic Hypertension
      • Pre-gestational Diabetes
      • Type 1 DM
      • Type 2 DM
      • Gestational Hypertensive
      • Preeclampsia
      • Preeclampsia with Severe Features
      • Eclampsia
      • HELLP syndrome
      • Lupus
      • Transplant
      • Fetal Growth Restriction
      • Oligohydramnios
      • Chronic Kidney Disease
      • Congestive Heart Failure
      • Adult Congenital Heart Disease

      Cardiac Disease in Pregnancy  and transfers for delivery due to the need for the NICU

      These diagnosis increase the need for a cesarean  vs a vaginal delivery. Are there any discussion for the future or present to include the POA diagnosis similar to PC-07 for risk stratification for the PC02 measure?

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Laura Kenny
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