ICU admission with non-ICU level of care

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    • Type: Hosp Inpt eCQMs - Hospital Inpatient eCQMs
    • Resolution: Unresolved
    • Priority: Moderate
    • Component/s: None
    • None
    • CMS0190v14
    • CMS0190v13
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      We had a recent VTE-2 CMS 190 case fail CMS validation because the chart documents did not support an ICU admission. The patient was transferred to an ICU location but the order did not specify a need for ICU level of care. Subsequently, we have identified other cases where the patient was transferred to ICU location and in accordance with specifications the logic qualifies the case for VTE-2. However, the order does not specify ICU level of care and our EHR event log shows level of care as "non-ICU". Do these cases qualify for VTE-2 (CMS 190)?
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      We had a recent VTE-2 CMS 190 case fail CMS validation because the chart documents did not support an ICU admission. The patient was transferred to an ICU location but the order did not specify a need for ICU level of care. Subsequently, we have identified other cases where the patient was transferred to ICU location and in accordance with specifications the logic qualifies the case for VTE-2. However, the order does not specify ICU level of care and our EHR event log shows level of care as "non-ICU". Do these cases qualify for VTE-2 (CMS 190)?

      Based on the specifications, we believe the mapping is correct, however, should cases like these be selected for futurte validations by CMS, will we need documention to support that the patient required ICU level of care to pass validation?

            Assignee:
            Mathematica EH eCQM Team
            Reporter:
            Margaret Venditti
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              Created:
              Updated: