CMS506v7 Safe Use of Opioids Question about "Opioid Use Disorder"

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Unresolved
    • Priority: Moderate
    • Component/s: None
    • None
    • Jessica
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      The measure should state:
      diagnosis of "OPIOID USE DISORDER"
               WITH (... not OR...)
      "Treatment for Opioid Use Disorders" (Medication active or Medication, Order)
      OR
      "Intervention, performed": "OPIOID MED ASSISTED TREATMENT"

      This would be more logical.
      Show
      The measure should state: diagnosis of "OPIOID USE DISORDER"          WITH (... not OR...) "Treatment for Opioid Use Disorders" (Medication active or Medication, Order) OR "Intervention, performed": "OPIOID MED ASSISTED TREATMENT" This would be more logical.
    • CMS0506v7
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      Patients are being excluded due to diagnosis of "OPIOID USE DISORDER" OR exists "Treatment for Opioid Use Disorders" (Medication active or Medication, Order) WITH "Intervention, performed": "OPIOID MED ASSISTED TREATMENT" The OR part is the issue. Patients may have an "OPIOID USE DISORDER" diagnosis, and that indicates that they are on chronic pain medications. They may not be on any treatment for this diagnosed disorder, rather they are continually being prescribed multiple opioids and/or benzos. The intent of the measure is to prevent an opioid disorder from occurring. How it is worded, will not accurately INCLUDE patient populations.
      Show
      Patients are being excluded due to diagnosis of "OPIOID USE DISORDER" OR exists "Treatment for Opioid Use Disorders" (Medication active or Medication, Order) WITH "Intervention, performed": "OPIOID MED ASSISTED TREATMENT" The OR part is the issue. Patients may have an "OPIOID USE DISORDER" diagnosis, and that indicates that they are on chronic pain medications. They may not be on any treatment for this diagnosed disorder, rather they are continually being prescribed multiple opioids and/or benzos. The intent of the measure is to prevent an opioid disorder from occurring. How it is worded, will not accurately INCLUDE patient populations.

      Patients are being excluded due to diagnosis of "OPIOID USE DISORDER" OR exists "Treatment for Opioid Use Disorders" (Medication active or Medication, Order) WITH "Intervention, performed": "OPIOID MED ASSISTED TREATMENT"

      A patient has a diagnosis of (SNOWMEDCT 19819002) Continuous opioid dependence disorder (OID 2.16.840.1.113762.1.4.1111.171). 

      This 75yr patient admitted with SBO and is discharged on:

      Norco 7.5-325mg, 1 tablet oral Q8 hrs PRN

      Norco 10-325mg, 1 tablet Q4 hrs PRN

      Tramadol 100mg Q8hrs PRN

      Trazodone HCl 150mg Nightly 

      No Medication, Active or Medication, Order for "Treatments for Opioid Use Disorders" were present, WITH no Intervention, Performed for "Opioid Medication Assisted Treatment." 

      Why would the OUD diagnosis be included IF there is no treatment ordered? 

        1. SUO Onc Jira Question Oct 3 2025 ie OUD diagnosis OR treatment when it should be WITH.docx
          130 kB

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Jessica A. Gage
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              Created:
              Updated: