eCQM Impacted – CMS996v4 (STEMI)

Issue –The ‘Major Surgical Procedure’ value set, used to define the denominator exclusion “Major Surgical Procedure 21 Days or Less Before End of ED Encounter” includes two SNOMED CT codes that overlap the ‘Percutaneous Coronary Intervention’ value set, used to evaluate the numerator: SNOMED CT 29843007 (Coronary atherectomy by laser (procedure)) and SNOMED CT 609154002 (Percutaneous transluminal insertion of metal stent into coronary artery using fluoroscopic guidance with contrast (procedure)). This leads to patients being excluded from the denominator and numerator if they had one or more of the overlapping procedures performed within 21 days or less before the end of ED encounter, even if they meet the numerator criterion.