STEMI - door to balloon late vs late prsentation

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    • Type: Hosp Outpt eCQMs - Hospital Outpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Julie-Marie Lebbie
    • 206.251.7172
    • VMFH
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      Thank you for your inquiry regarding CMS0996v5 and CMS0996v6, Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The issue of capturing the time to intervention starting with STEMI onset as opposed to ED arrival has previously been brought to the measure developer. EHR limitations make it challenging to account for this situation. The measure developer will continue to evaluate feedback and recommendations during the annual update cycle and update the measure as needed to align with clinical guidelines and workflow.
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      Thank you for your inquiry regarding CMS0996v5 and CMS0996v6, Appropriate Treatment for ST-Segment Elevation Myocardial Infarction (STEMI) Patients in the Emergency Department (ED). The issue of capturing the time to intervention starting with STEMI onset as opposed to ED arrival has previously been brought to the measure developer. EHR limitations make it challenging to account for this situation. The measure developer will continue to evaluate feedback and recommendations during the annual update cycle and update the measure as needed to align with clinical guidelines and workflow.
    • CMS0996v6
    • CMS0996v5
    • financial

      For OP40/CMS996 - STEMI- We ask for clarification on coding for situations that are  impacting our Door-to-Balloon (D2B) metric:

      Late-Presenting STEMI: Patients initially present to the ED for unrelated reasons, with a STEMI diagnosis made later in the visit. While our PCI may be within 90 mins of diagnosis, the D2B clock starts at initial door time, often pushing us beyond 90 mins.

      • Question: How do we accurately code these cases to reflect the true "diagnosis-to-balloon" time without being penalized by the initial door time? Is there a modifier or alternative coding?

      Accurate coding is crucial for our D2B metrics, quality improvement, and data integrity. Your guidance is highly appreciated.

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Julie-Marie Lebbie
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