CMS1028v2 and subsequent versions of the eCQM

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    • Type: EH/CAH
    • Resolution: Unresolved
    • Priority: Moderate
    • None
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      Implementers should consistently report POA indicators for each coded diagnosis in a patient’s record when reporting CMS1028v3 for the 2025 reporting period, CMS1028v4 for the 2026 reporting period, and subsequent versions of this eCQM. More information on POA indicators can be found on the “Coding” page of the CMS website (https://www.cms.gov/medicare/payment/fee-for-service-providers/hospital-aquired-conditions-hac/coding) and more information on how POA indicators are used in CMS1028/PC-07 can be found in question #8 of the PC-07 eCQM frequently asked questions (FAQ) document (https://qualitynet.cms.gov/files/688908b72844d4a92b853c16?filename=PC-07_SOCeCQM_FAQ.pdf).
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      Implementers should consistently report POA indicators for each coded diagnosis in a patient’s record when reporting CMS1028v3 for the 2025 reporting period, CMS1028v4 for the 2026 reporting period, and subsequent versions of this eCQM. More information on POA indicators can be found on the “Coding” page of the CMS website ( https://www.cms.gov/medicare/payment/fee-for-service-providers/hospital-aquired-conditions-hac/coding ) and more information on how POA indicators are used in CMS1028/PC-07 can be found in question #8 of the PC-07 eCQM frequently asked questions (FAQ) document ( https://qualitynet.cms.gov/files/688908b72844d4a92b853c16?filename=PC-07_SOCeCQM_FAQ.pdf ).
    • 2024, 2025, 2026

      eCQMs Impacted – CMS1028/PC-07, Severe Obstetric Complications

      Issue – Data from the 2024 reporting period for CMS1028v2 suggest that hospitals are not consistently reporting Present on Admission (POA) indicators for patients’ coded diagnoses when reporting this measure.

      The omission of POA indicators may result in (1) the measure undercounting inpatient delivery hospitalizations that meet the numerator criteria and (2) the measure’s risk-adjustment model not appropriately accounting for inpatient delivery hospitalizations for patients with pre-existing conditions considered as risk-adjustment variables.

            Assignee:
            Unassigned
            Reporter:
            Joelencia Leflore
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              Created:
              Updated: