STK 5 Denominator Exclusion for new Tenecteplase 25 mg vial

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
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      Thank you for your question regarding CMS72v13 (Antithrombotic Therapy by End of Hospital Day 2). The Value set "Thrombolytic (t-PA) Therapy" 2.16.840.1.113883.3.117.1.7.1.226 currently includes Tenecteplase 50 MG Injection - RxNorm 313212. At the time the measure was updated, this dose was not available to include in the value set. We will consider adding Tenecteplase 25 MG Injection during the current AU. Please note that this update will not be applied retrospectively, as all eCQM specifications are final upon publication. Semantic Clinical Drug (SCD) codes are generalizable drug concepts. Each RxNorm clinical drug name reflects the active ingredients, strengths, and dose form that comprises the drug.
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      Thank you for your question regarding CMS72v13 (Antithrombotic Therapy by End of Hospital Day 2). The Value set "Thrombolytic (t-PA) Therapy" 2.16.840.1.113883.3.117.1.7.1.226 currently includes Tenecteplase 50 MG Injection - RxNorm 313212. At the time the measure was updated, this dose was not available to include in the value set. We will consider adding Tenecteplase 25 MG Injection during the current AU. Please note that this update will not be applied retrospectively, as all eCQM specifications are final upon publication. Semantic Clinical Drug (SCD) codes are generalizable drug concepts. Each RxNorm clinical drug name reflects the active ingredients, strengths, and dose form that comprises the drug.
    • CMS0072v13
    • Patients not exclued from the denominator due to new RxNorm code for the 25 mg vial of Tenecteplase not being included as thrombolytic therapy given during hospitalization. Our organization is being penalized for providing safer care to the patient.

      Hello,

      I am requesting the inclusion of the RxNorm code for the newly available Tenecteplase 25 mg vial in the value set with OID 2.16.840.1.113883.3.117.1.7.1.226.

      • Clinical rationale:
      • Tenecteplase is now available in a 25 mg vial, which aligns with the maximum recommended dosage for ischemic stroke.
      • Previously, only 50–100 mg vials were available, which posed a risk of inadvertent overdosing if the entire vial was administered.
      • The 25 mg vial was introduced specifically to improve patient safety and reduce dosing errors.
      • Measure impact:
      • Because the RxNorm code for the 25 mg vial is not currently included in the value set, patients who received this safer vial are not being correctly excluded from the denominator.
      • This results in inaccurate measure reporting and penalizes organizations for adopting safer practices.

      Request:

      1. Please add the RxNorm code for the Tenecteplase 25 mg vial to the value set.
      2. Confirm whether this update will apply retrospectively so that patients treated with the 25 mg vial are correctly excluded from the denominator in past reporting periods.

      Thank you for your attention to this matter and for supporting accurate, safety‑aligned measure reporting.

      Sincerely,

      Becky Grigsby

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Rebecca Grigsby
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