OP 40 and patient refusal of care

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    • Type: Hosp Outpt eCQMs - Hospital Outpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Melisa Olson
    • 7152366264
    • Hide
      Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). Updated Version 6 STEMI measure specifications for the 2026 reporting period have recently been posted to the eCQI Resource Center: https://ecqi.healthit.gov/ecqm/hosp-outpt/2026/cms0996v6?qt-tabs_measure=measure-information. These updated measure specifications exclude patients from the measure denominator who have documentation of hospice services in the six months within the start of the ED encounter, or who have active hospice status at the start of the ED encounter. The measure also has denominator exceptions for ED encounters with a documented reason (such as patient refusal) for (i) not administering fibrinolytic therapy within 30 minutes of ED arrival or (ii) not performing a PCI within 90 minutes of ED arrival.
      Show
      Thank you for your inquiry regarding CMS996: Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). Updated Version 6 STEMI measure specifications for the 2026 reporting period have recently been posted to the eCQI Resource Center: https://ecqi.healthit.gov/ecqm/hosp-outpt/2026/cms0996v6?qt-tabs_measure=measure-information . These updated measure specifications exclude patients from the measure denominator who have documentation of hospice services in the six months within the start of the ED encounter, or who have active hospice status at the start of the ED encounter. The measure also has denominator exceptions for ED encounters with a documented reason (such as patient refusal) for (i) not administering fibrinolytic therapy within 30 minutes of ED arrival or (ii) not performing a PCI within 90 minutes of ED arrival.
    • CMS0996v6
    • CMS0996v5
    • CMS0996v4
    • A case continues to be in the denominator despite a patient's refusal of care and request for comfort measures

      Regarding OP 40, is there any denominator exclusions for a patient that refuses treatment or transfer and/or requests comfort measures? We had a patient that did not pass the OP 40 measure because they refused fibrinolytic treatment & transfer - the patient requested to start comfort measures. 

      thank you

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Melisa Olson
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