ePC02 Cesarean Birth CMS 334: Cesarean Delivery with prior uterine surgery

XMLWordPrintable

    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • L. Kenny
    • JHH
    • Hide
      Thank you for your question about CMS334v6 Cesarean Birth. While extensive or complicated myomectomy can be an indication for a cesarean section, these cases are rare in nulliparous patients. The code to identify prior myomectomy is too broad to only exclude extensive or complicated cases, which is why it is not listed for the exclusions for this measure. In addition, neurosurgery, spine, and IBD complications and severe fetal anomalies are less common and should not significantly increase a hospital’s rate. We will continue to monitor feedback and consult with the TAP for potential updates. As always, we recommend that the appropriate care should be provided based upon the provider’s assessment of patient’s needs, regardless on the impact to the performance calculation.
      Show
      Thank you for your question about CMS334v6 Cesarean Birth. While extensive or complicated myomectomy can be an indication for a cesarean section, these cases are rare in nulliparous patients. The code to identify prior myomectomy is too broad to only exclude extensive or complicated cases, which is why it is not listed for the exclusions for this measure. In addition, neurosurgery, spine, and IBD complications and severe fetal anomalies are less common and should not significantly increase a hospital’s rate. We will continue to monitor feedback and consult with the TAP for potential updates. As always, we recommend that the appropriate care should be provided based upon the provider’s assessment of patient’s needs, regardless on the impact to the performance calculation.
    • CMS0334v7
    • CMS0334v6
    • high: impacts our rates

      At our hospital we care for high-risk pregnancies which include patients with known prior uterine surgeries such as a myomectomy. Vaginal delivery is contraindicated sometimes in patients who have had specific known previous uterine surgery. These patients fall into the measure due to having a cesarean birth (when nulliparous) due to the limited denominator exclusions. According to ACOG and SMFM guidelines, the recommendation for delivery is cesarean birth. Is there consideration for further review of the limited denominator exclusion for this population and adding them to the denominator exclusion list? 

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Laura Kenny
            Votes:
            0 Vote for this issue
            Watchers:
            6 Start watching this issue

              Created:
              Updated:
              Resolved:
              Solution Posted On: