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Type:
QRDA-I Standard
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Resolution: Answered
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Priority:
Moderate
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Component/s: None
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To summarize the comments in this ticket: The sample file in fact does not contain an IPP-disqualifying principal diagnosis. It is correctly assigned as a denominator exclusion because the length of inpatient encounter is less than two days.
We have a patient with three encounters in the reporting period. All the three encounters qualify for the ED measures IPP. Two of the encounters qualify for IPP of VTE-1 but the 3rd encounter has a diagnosis that disqualifies it from the IPP. On the CMS detail VTE-1 measure report, all the three encounters are listed and specifically the date of service for the encounter that does not pass IPP (3rd Encounter) is listed as a Denominator, Exclusion. Kindly clarify when the 3rd Encounter has a diagnosis which disqualifies the patient from IPP of VTE-1, why in the CMS report it has been considered to be Denominator, Exclusion?
Please find the attachment of the Sample QRDA-1 file for your perusal. Thanks.