CMS08 and CMS190- General or Neuraxial Anesthesia

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    • Type: Question/Guidance
    • Resolution: Resolved
    • Priority: Moderate
    • Component/s: None
    • None
    • CMS0108v12
    • Correct mapping of elements
    • Banner Health
    • Cari Jones
    • 4054738842
    • Hide
      Thank you for your inquiry for CMS108v12 Venous Thromboembolism Prophylaxis (VTE-1) and CMS190v12 Intensive Care Unit Venous Thromboembolism Prophylaxis (VTE-2).

      For VTE-1, the measure evaluates if the patient received VTE prophylaxis day of start of hospitalization to day after admission or procedure. When the General or Neuraxial Anesthesia datetime ends on the day of an inpatient (IP) admission, the VTE prophylaxis qualifying time frame will be the same as “day of or day after inpatient admission”. Only when the General or Neuraxial Anesthesia datetime ends a day after an IP admission, will the qualifying VTE prophylaxis time frame be based upon the General or Neuraxial Anesthesia end date. You provided the example below -

      IP start date/time: 08.13.24 at 1313 and Anesthesia stop date/time: 08.13.24 at 1802.

      Since the anesthesia stop date is the same day as the IP start date, the measure will examine VTE prophylaxis given on either 08.13.24 or 08.14.24. If the anesthesia stop date/time is 08.14.24 (a day after IP admission), and VTE prophylaxis was given on 08.13.24, 08.14.24, or 08.15.24, the encounter will meet the numerator.

      For VTE-2, the measure evaluates if the patient received VTE prophylaxis on the day of or day after first ICU Stay or Procedure. When the General or Neuraxial Anesthesia datetime ends on the day of first ICU admission, the VTE prophylaxis qualifying time frame will be same as “Day of or day after first ICU admission”. Only when the Anesthesia datetime ends a day after ICU, the qualifying VTE Prophylaxis time frame will be based upon Anesthesia end date. You provided the example below –

      ICU start date/time: 12.21.23 at 0416 and Anesthesia stop date/time: 12.21.23 at 0406.

      Since the anesthesia stop date is the same day as the ICU start date, the measure examines VTE prophylaxis given on either 12.21.23 or 12.22.23. If the anesthesia stop date/time is 12.22.23 (a day after ICU admission), and VTE prophylaxis was given on 12.22.23, 12.23.23, or 12.24.23, the encounter will meet the numerator.
      Show
      Thank you for your inquiry for CMS108v12 Venous Thromboembolism Prophylaxis (VTE-1) and CMS190v12 Intensive Care Unit Venous Thromboembolism Prophylaxis (VTE-2). For VTE-1, the measure evaluates if the patient received VTE prophylaxis day of start of hospitalization to day after admission or procedure. When the General or Neuraxial Anesthesia datetime ends on the day of an inpatient (IP) admission, the VTE prophylaxis qualifying time frame will be the same as “day of or day after inpatient admission”. Only when the General or Neuraxial Anesthesia datetime ends a day after an IP admission, will the qualifying VTE prophylaxis time frame be based upon the General or Neuraxial Anesthesia end date. You provided the example below - IP start date/time: 08.13.24 at 1313 and Anesthesia stop date/time: 08.13.24 at 1802. Since the anesthesia stop date is the same day as the IP start date, the measure will examine VTE prophylaxis given on either 08.13.24 or 08.14.24. If the anesthesia stop date/time is 08.14.24 (a day after IP admission), and VTE prophylaxis was given on 08.13.24, 08.14.24, or 08.15.24, the encounter will meet the numerator. For VTE-2, the measure evaluates if the patient received VTE prophylaxis on the day of or day after first ICU Stay or Procedure. When the General or Neuraxial Anesthesia datetime ends on the day of first ICU admission, the VTE prophylaxis qualifying time frame will be same as “Day of or day after first ICU admission”. Only when the Anesthesia datetime ends a day after ICU, the qualifying VTE Prophylaxis time frame will be based upon Anesthesia end date. You provided the example below – ICU start date/time: 12.21.23 at 0416 and Anesthesia stop date/time: 12.21.23 at 0406. Since the anesthesia stop date is the same day as the ICU start date, the measure examines VTE prophylaxis given on either 12.21.23 or 12.22.23. If the anesthesia stop date/time is 12.22.23 (a day after ICU admission), and VTE prophylaxis was given on 12.22.23, 12.23.23, or 12.24.23, the encounter will meet the numerator.

      I am hoping you can help with some clarification of the timing surround the element for General or Neuraxial Anesthesia for both VTE1 & 2.  

      Ex: 

      for VTE 1 I have the following incident- 

      IP start date/time: 08.13.24 at 1313

      Anesthesia stop date/time: 08.13.24 at 1802

      Is the window of time for VTE 1 General or Neuraxial Anesthesia to start from the day of the IP encounter and end the following day

      Since the Anesthesia stopped after the IP encounter start time, would I expect to see the General of Neuraxial Anesthesia date/time pulled into the QRDA file?  In other words, because of the timing of the end of the anesthesia (ends after IP encounter starts) the element counts towards the measure for this particular encounter?

       

      for VTE 2 I have the following incident-

      ICU start date/time-12.21.23 at 0416

      Anesthesia stop date/time- 12.21.23 at 0406

      Is the window of time for VTE 2 General or Neuraxial Anesthesia to start the day of or the day after ICU admission or transfer? 

      Since the Anesthesia stopped the day of the ICU start date, should I expect to see the General or Neuraxial Anesthesia date/time pulled into the QRDA file?  In other words, because of the timing (anesthesia ends the day of the ICU admit), the element counts toward the measure for this particular encounter? 

       

       

       

       

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            Assignee:
            Yan Heras
            Reporter:
            Cari Ann Jones
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              Created:
              Updated:
              Resolved: