[CQM-5897] Is 1 Opioid + Naloxone a fallout for CMS506? Created: 01/24/23 Updated: 02/09/23 Resolved: 02/09/23 |
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| Status: | Closed |
| Project: | eCQM Issue Tracker |
| Component/s: | None |
| Type: | EC eCQMs - Eligible Clinicians | Priority: | Moderate |
| Reporter: | Ira Bader (Inactive) | Assignee: | Joelencia Leflore |
| Resolution: | Answered | Votes: | 0 |
| Labels: | None | ||
| Contact Name: | Ira Bader |
| Contact Email: | baderi@nychhc.org |
| Contact Phone: | 2125628483 |
| Institution/Name: | NYC H+H/Bellevue |
| Solution: | Thank you for your question on CMS506. The opioid medication list for the measure, Schedule II & III Opioid Medications (2.16.840.1.113762.1.4.1111.165) does not contain naloxone as a stand-alone medication. In version 5 of Safe Use of Opioids (2023), we removed all buprenorphine/naloxone combination medications from Schedule II & III Opioid Medications (2.16.840.1.113762.1.4.1111.165) as well. This value set, along with Schedule IV Benzodiazepines (2.16.840.1.113762.1.4.1125.1), is used to determine both the measure denominator and numerator.
This means that naloxone and buprenorphine/naloxone combination medications do not count towards either the denominator, which requires patient discharge with at least one opioid or benzodiazepine, or towards the numerator. For example: 1) A patient discharged from an inpatient stay with naloxone and no other Schedule II or III opioids or benzodiazepines would not be in the initial patient population/denominator. 2) A patient discharged from an inpatient stay with naloxone and a benzodiazepine would be in the initial patient population/denominator. This is because the patient is discharged with a benzodiazepine. 3) A patient discharged from an inpatient stay with naloxone, methadone, and a benzodiazepine would be in the denominator and numerator because both methadone and the benzodiazepine count towards the numerator. Please see Schedule II & III Opioid Medications (2.16.840.1.113762.1.4.1111.165) and Schedule IV Benzodiazepines (2.16.840.1.113762.1.4.1125.1) to see which medications would qualify a patient encounter for the measure denominator and numerator and let us know if you have additional questions. |
| Solution Posted On: | |
| 2023 Reporting Period Hosp Inpt eCQMs: |
CMS0506v5
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| Impact: | I can't answer this question posed by a hospital service chief. |
| Description |
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In March 1, 2022 webinar slide Q+A 19, the answer says Naloxone would not be in the numerator unless they were also prescribed another Opioid. Does that mean that 1 Opioid + Naloxone is a CMS506 fallout? |
| Comments |
| Comment by Joelencia Leflore [ 02/09/23 ] |
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We apologize for the delay in providing a response for your question. We continue to investigate the issue noted in your ticket and will provide a response as soon as we are able. Thank you for your continued patience. |
| Comment by Joelencia Leflore [ 02/02/23 ] |
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We continue to investigate the issue noted in your ticket and will provide a response as soon as we are able. Thank you for your patience. |
| Comment by Joelencia Leflore [ 01/26/23 ] |
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Thank you for submitting your question. We will review your ticket and provide a response as soon as possible. |