Thank you for your question regarding Venous Thromboembolism Prophylaxis (CMS0108v13). In the CMS108v13 eCQM specification, the measure description declares the timing as "between the day of arrival to the day after hospital admission...". The numerator population also specifies as "Inpatient hospitalizations for patients who received VTE prophylaxis between the day of arrival and the day after hospital admission". In the measure logic, the function HospitalizationWithObservation() defines the time frame of "between the day of arrival to the day after hospital admission" as below: "The day of arrival" includes Emergency department visit, Observation Service as the start of hospitalization if patient was admitted to inpatient through ED and/or Observation when the transition between discharge from these encounters and admission to the inpatient encounter is one hour or less. "the day after hospital admission" is the day after inpatient admission date.

Require further understanding of the verbiage in the spec manual referring to inpatient admission status in the context of the VTE-1 eCQM measure. The spec manual indicates patient must receive VTE prophylaxis the day of or day after inpatient admission. Does this mean that even if the patient is in Observation status and VTE prophylaxis is implemented during Observation status, the metric is met satisfactorily as long as the patient is admitted that same day or by the day after the implementation of VTE prophylaxis? Am I correct on the logic of the metric in that the admission status does not matter (admit to observation vs admit to inpatient) as long as the patient has documented VTE prophylaxis on the day of inpatient admission or the day following inpatient admission?