[CQM-2161] Questioning these three sets related to Amputees. ICD codes vs. removed aren't making sense as to why. Created: 08/30/16 Updated: 04/30/19 Resolved: 04/30/19 |
|
| Status: | Closed |
| Project: | eCQM Issue Tracker |
| Component/s: | ValueSet |
| Type: | EC eCQMs - Eligible Clinicians | Priority: | Minor |
| Reporter: | Sheila Danielson (Inactive) | Assignee: | Mathematica EC eCQM Team (Inactive) |
| Resolution: | Done | Votes: | 0 |
| Labels: | ValueSet | ||
| Contact Name: | Sheila Danielson |
| Contact Email: | sheila.danielson@confluencehealth.org |
| Contact Phone: | 509-664-4868 ext 5139 |
| Institution/Name: | Confluence Health |
| Guidance required: | Clarification |
| Solution: | Our expert panel agreed that only people with bilateral above and below the knee amputations should be excluded from the measure. Other amputations would need additional surveillance. Therefore, we could only use codes in the value set that were specific to above and below the knee amputations. ICD-9 and ICD-10 did not have many codes that were specific enough to include in the value set. To ensure the amputation is above or below the knee, the EHR should record the level of the amputation which could then be mapped to the appropriate codes for reporting. |
| Solution Posted On: | |
| 2017 Performance Period EC eCQMs: |
CMS123v5/NQF0056
|
| Impact: | 2017 VSA Specs CMS-123 Diabetic Foot Exam: 2.16.840.1.113883.3.67.1.101.1.140 (Bilateral Amputee) 2.16.840.1.113883.3.67.1.101.11.718 (Left Foot Amputee) 2.16.840.1.113883.3.67.1.101.11.719 (RIght Foot Amputee) |
| Description |
|
Amputee ICD-10 and ICD-9 groups for exclusion there are numerous codes removed for 2017 specs and additional added. Many of the codes removed don't make sense and seem they should be kept in. Some added codes essentially mean the same as ones no longer in there. Questioning these three sets related to Amputees. |
| Comments |
| Comment by Mathematica EC eCQM Team (Inactive) [ 08/22/17 ] |
|
Can you please tell us the source of the value sets you cited? The value set OIDs you cite are not valid for CMS123v5 for the EHR Incentive Program. The correct OIDs and value set names for this measure are: • Bilateral amputation of leg below or above knee, OID 2.16.840.1.113883.3.464.1003.113.12.1056 |
| Comment by Diana Strubler (Inactive) [ 07/20/17 ] |
|
Hello, We are having issues with the new code sets for this measure as well. In the past, this quality measure supported the SNOMED code of 73600009 which is described as "Bilateral traumatic amputation of legs at any level without complication (disorder)". All of our users selected this code. Now that this code is no longer supported, we need to somehow map the old code to a new code. The problem is there is not a 1:1 mapping that we can find. There is no longer a SNOMED code for bilateral. There are only ICD9 and ICD10 codes. The ICD9 codes only represent "traumatic" and ICD10 codes only represent "congenital". Do you have any suggestions on how we should handle this change? Will our users need to go in and select a unilateral code (along with a left and right attribute)? That seems like a lot of extra clicks for something they already answered in the past. Also, they may have answered this question a couple years back and may not remember the specific location at which the amputation took place (above knee, below knee, mid-thigh...etc). Thank you in advance! |
| Comment by Mathematica EC eCQM Team (Inactive) [ 12/15/16 ] |
|
We consulted our expert panel. They agreed that only people with bilateral amputations above and below the knee should be excluded. Other amputees would be at risk for additional complications and should continue to be evaluated. |
| Comment by Sheila Danielson (Inactive) [ 10/26/16 ] |
|
I am trying to "reply" to your email inquiry, but it is being bounced back. Here are my comments in response to your message today. Yes, the OID I referenced is an older one. I am just wondering why the below ICD-10 codes are not contained in the specifications for 2016 and 2017 reporting for this CMS-123 measure? The S78.xxxx and S88.xxxx ICD-10 encounter codes ARE included in the most recent specifications those are more so for encounters for amputations at the above the ankle, the below are all at the foot or ankle level. Perhaps they decided the leg should still be evaluated for this Diabetic Foot Exam measure even if they don't have a foot? I am just a bit puzzled. Bilateral Amputee Left Foot Amputee Right Foot Amputee |