VTE 1 (108) & VTE 2 (190) - reasons for no VTE prophylaxis

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Cari Jones
    • 4054738842
    • INTEGRIS Healthcare
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      Thank you for your question regarding Venous Thromboembolism Prophylaxis (CMS0108v13) and Intensive Care Unit Venous Thromboembolism Prophylaxis (CMS190v13).

      The measure developer updated the guidance in AU2025 (for the 2026 implementation), to indicate that CMS108v14 does not require the use of a special risk assessment model or tool to determine VTE risk (e.g., Caprini, Padua, and IMPROVE). While this guidance text is not included in the 2025 measure specification (CMS108v13), this version also does not require a special risk assessment model or tool. If a physician assesses and documents that the patient is “low risk for VTE” within the qualifying timeline, then the case will satisfy the numerator condition.
      Show
      Thank you for your question regarding Venous Thromboembolism Prophylaxis (CMS0108v13) and Intensive Care Unit Venous Thromboembolism Prophylaxis (CMS190v13). The measure developer updated the guidance in AU2025 (for the 2026 implementation), to indicate that CMS108v14 does not require the use of a special risk assessment model or tool to determine VTE risk (e.g., Caprini, Padua, and IMPROVE). While this guidance text is not included in the 2025 measure specification (CMS108v13), this version also does not require a special risk assessment model or tool. If a physician assesses and documents that the patient is “low risk for VTE” within the qualifying timeline, then the case will satisfy the numerator condition.
    • CMS0108v13
    • Seeking clarification of reasons for no VTE prophylaxis, specifically "Low Risk" reason

      If a particular facility did not have an official VTE Risk Assessment, but did have a place to document, "No VTE Prophylaxis, pt is at low risk for VTE" would that be an acceptable Reason for no VTE prophylaxis, thus putting the patient into the NUM population? 
      OR
      Would Low Risk have to be determined by either a low risk score from a VTE Risk Assessment OR an INR > 3.0, and ONLY these two ways?

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Cari Ann Jones
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              Created:
              Updated:
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