I am reaching out to request clarification regarding a PC-07 Severe Obstetric Complications case and whether any exclusion may apply based on the clinical circumstances.

We have an inpatient delivery case that is currently triggering the PC-07 measure due to a hysterectomy. However, the patient has a history of uterine transplant. At the time of delivery, the patient underwent a scheduled (planned) hysterectomy following childbirth, which was anticipated as part of the post-pregnancy management related to the uterine transplant.

There were no unexpected emergent indications for the hysterectomy during the delivery admission. The hysterectomy was planned prior to admission and performed as scheduled.

Based on our review of the PC-07 specification, we understand that exclusions related to hysterectomy are limited, primarily to cases involving placenta increta or percreta without other severe obstetric complications. Given this unique clinical scenario, we are seeking guidance on the following:

• Is there any allowable exclusion or interpretation within the PC-07 measure logic for a planned hysterectomy performed following delivery in the setting of a prior uterine transplant?
• If not, can you confirm that this case would appropriately remain included in the PC-07 numerator despite the hysterectomy being planned and expected?

We appreciate your guidance to ensure accurate and consistent reporting in alignment with the measure specifications.

Thank you for your time and support.

Respectfully,

Chelsea