Conflicting Discharge Disposition value sets between HH-Hyper and SUO- Which to use in QRDA?

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    • Type: Value Sets
    • Resolution: Answered
    • Priority: Moderate
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      Thank you for your question on reporting guidance for eCQMs for the 2025 and 2026 reporting periods. As you noted in your question, hospital eCQMs do not all use the same value set when identifying discharge dispositions to hospice care. Specifically, CMS506, Safe Use of Opioids - Concurrent Prescribing and CMS986, Malnutrition Care Score use the discharge disposition attribute with the "Hospice Care Referral Or Admission" value set (2.16.840.1.113762.1.4.1116.365). And CMS104, Discharged on Antithrombotic Therapy; CMS71, Anticoagulation Therapy for Atrial Fibrillation/Flutter; and CMS871, Hospital Harm - Severe Hyperglycemia use the discharge disposition attribute with the "Discharged To Health Care Facility For Hospice Care" (2.16.840.1.113883.3.117.1.7.1.207) and "Discharged To Home For Hospice Care" (2.16.840.1.113883.3.117.1.7.1.209) value sets. However, please note that the "Discharged To Health Care Facility For Hospice Care" and "Discharged To Home For Hospice Care" value sets each have one code in common with the "Hospice Care Referral Or Admission" value set, including one of the codes referenced in your question (428361000124107). The overlap between the value sets is shown in the green shaded cells in the attached Excel file.

      The measure developers of these eCQMs will consider opportunities for greater alignment in codes used in hospital eCQMs to identify discharge dispositions to hospice care in a future annual update cycle.
      Show
      Thank you for your question on reporting guidance for eCQMs for the 2025 and 2026 reporting periods. As you noted in your question, hospital eCQMs do not all use the same value set when identifying discharge dispositions to hospice care. Specifically, CMS506, Safe Use of Opioids - Concurrent Prescribing and CMS986, Malnutrition Care Score use the discharge disposition attribute with the "Hospice Care Referral Or Admission" value set (2.16.840.1.113762.1.4.1116.365). And CMS104, Discharged on Antithrombotic Therapy; CMS71, Anticoagulation Therapy for Atrial Fibrillation/Flutter; and CMS871, Hospital Harm - Severe Hyperglycemia use the discharge disposition attribute with the "Discharged To Health Care Facility For Hospice Care" (2.16.840.1.113883.3.117.1.7.1.207) and "Discharged To Home For Hospice Care" (2.16.840.1.113883.3.117.1.7.1.209) value sets. However, please note that the "Discharged To Health Care Facility For Hospice Care" and "Discharged To Home For Hospice Care" value sets each have one code in common with the "Hospice Care Referral Or Admission" value set, including one of the codes referenced in your question (428361000124107). The overlap between the value sets is shown in the green shaded cells in the attached Excel file. The measure developers of these eCQMs will consider opportunities for greater alignment in codes used in hospital eCQMs to identify discharge dispositions to hospice care in a future annual update cycle.
    • CMS0506v8, CMS0871v5
    • CMS0506v7, CMS0871v4
    • CMS0506v6, CMS0871v3
    • QRDA files get rejected for having multiple discharge dispositions, but different measures use different value sets for the same discharge disposition concepts that contain different values.

      QRDA files get rejected for having multiple discharge dispositions, but different measures use different value sets for the same discharge disposition concepts that contain different values. 

      Some times different value sets have similar concepts represented by different values.  For example - the c oncept of  Discharge Disposition =  Home Hospice Care exists on Safe Use of Opioids eCQM Denominator exclusion uses valueset "Hospice Care Referral or Admission" (2.16.840.1.113762.1.4.1116.365)  =  code 444933003.   It also exists  Hospital Harm Harm - Severe Hyperglycemia  eCQM uses value set Discharged to Home for Hospice Care (2.16.840.1.113883.3.117.1.7.1.209) = code 428361000124107

       

      Both of these codes are valid mappings.  Since you cannot submit both the 444933003 and 428361000124107 code for the discharge disposition, which should be included in the QRDA file?  

       

        1. ValueSetCodeComparisonReport_Hospice Value Sets Used in Hospital eCQMs.xlsx
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            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Elizabeth Butler
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