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  1. QRDA Issue Tracker
  2. QRDA-1056

2021 eCQM Submission VTE-1 Case Numerator Met but had surgery which should have excluded

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    • Question/Guidance
    • Status: Resolved
    • Moderate
    • Resolution: Resolved
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    • CY 2021 QRDA file submission for VTE-1 with outcome as numerator but principal procedure should have caused the outcome to be denominator exclusion.

    Description

      One of our QRDA files submitted for CY2021 has an outcome from CMS as Numerator_met. However, the patient had a principal procedure with ICD10PCS code 0SPD0JZ which is in the "Knee Replacement Surgery" value set.  The procedure was done during the inpatient encounter. I am trying to understand why the case was not a denominator exclusion based on the principal procedure.  I have attached a file with screen shots of the encounter performed and the procedure performed portions of the QRDA file that was submitted.  

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            yanheras Yan Heras
            nancy.kreller Nancy Kreller
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