VTE Value set for History of VTE

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • Elizabeth Ballard
    • 1-667895-5398
    • MedStar Health
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      Thank you for your question regarding Venous Thromboembolism Prophylaxis (CMS108v13). The Venous Thromboembolism (OID: 2.16.840.1.113883.3.117.1.7.1.279) value set excludes a diagnosis of venous thromboembolism (VTE) that is chronic or history of, located in the upper extremities, and veins. Therefore, we will not consider adding these codes to the value set.

      Please reference the value set inclusion and exclusion criteria for details via https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.279/definition
      Show
      Thank you for your question regarding Venous Thromboembolism Prophylaxis (CMS108v13). The Venous Thromboembolism (OID: 2.16.840.1.113883.3.117.1.7.1.279) value set excludes a diagnosis of venous thromboembolism (VTE) that is chronic or history of, located in the upper extremities, and veins. Therefore, we will not consider adding these codes to the value set. Please reference the value set inclusion and exclusion criteria for details via https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.117.1.7.1.279/definition
    • CMS0108v13
    • Report outcomes are found as being Not Met when in fact the patient did receive the correct medication during their inpatient hospitalization.

      Hospital providers treat patients with a prior history of having a DVT with Apixaban. Why are History of DVT (SNOMED CT 2986938011) or On DVT prophylaxis (SNOMED CT 452673015) codes not found included in the VTE value set (2.16.840.1.113883.3.117.1.7.1.279)? Are additional considerations being given to expand the value set in order to capture the most appropriate ICD10 or SNOMED CT codes? In 2025, hospitals continue to have patient outcomes be reflected as being a measure outlier when in fact proper care was provided on day of or day after the start of the encounter. 

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Elizabeth D Ballard
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