Update 2/9/2015: A variation on the diagnostic test criterion solution is proposed, per feedback received from the community thus far: Variation #2: Instead of requiring a reason for the VTE diagnostic test, link the test to the diagnosis of venous thromboembolism through timing. The diagnosis would be sourced from EHR clinical documentation, such as the problem list or a list of encounter diagnoses, and would a few general SNOMED-CT concepts for venous thromboembolism (no specific locations). Additionally, the timing relationship would require the start time for the diagnosis to occur within 2 days after the VTE diagnostic test was performed. We welcome and encourage feedback from the community regarding the proposed variation, as well as the remaining components of the solution outlined below. Update 1/29/2015: We are considering the following preliminary solution for this issue: * Eliminate the VTE confirmed value set from the measure logic; * Replace the intended use of the VTE confirmed value set by identifying VTE diagnoses from the administratively assigned ICD-9-CM/ICD-10-CM codes for the specific VTE locations which are the target of the VTE treatment measures (pulmonary embolism and deep thrombosis of proximal lower limb veins). This would be achieved by refining the existing Venous Thromboembolism ICD-9-CM/ICD-10-CM value sets, which are used in the Initial Patient Population under the Diagnosis, Active QDM datatype. In addition, the Venous Thromboembolism SNOMED-CT value set would be eliminated since the expected source for the granular VTE codes would be the coder-assigned diagnoses. * Maintain the VTE diagnostic study criterion, adding a reason for the test. The diagnostic test reason value set would include a few general SNOMED-CT concepts for venous thromboembolism and would provide an implicit tie between the administratively assigned VTE diagnosis and the VTE diagnostic test. This requirement would also provide a proxy for when a VTE was suspected, which is a critical component of the VTE-6 measure. We welcome and encourage feedback from the community regarding the proposed approach. The version of these eCQMs recently posted for reporting for the 2017 Reporting Period include the following guidance statement: “CMS recognizes the difficulty in capturing the VTE confirmed concept required in this measure and suggests eligible hospitals participating in the Medicare & Medicaid EHR Incentive Programs consider selecting alternative electronic clinical quality measures (eCQMs) to meet program requirements for meaningful use. If suitable alternatives are unavailable, CMS will accept a 0 denominator submission for the eCQM version only for this measure.” To view these specifications, please visit https://www.cms.gov/regulations-and-guidance/legislation/ehrincentiveprograms/ecqm_library.html