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We are trying to find some guidance regarding this measure. The providers' numbers seem low when we run the CQR report and are trying to figure out why. I hope there is someone who has some insight into how GE reports this. We have reviewed the CQR manual but still have questions. 1) Where is the adverse effect, allergy, or intolerance info pulled from? I thought it would be from the patient's allergy list. Does it come from the medication list - if a statin is added to the medication list and then removed, most of the time the 'Reason for Removal' is left as Other. Should it be changed to 'Side effects or to 'Adverse reaction'? If we see a new patient and they say they have a allergy to statins, do we have to enter the statin(s) into their med list first and then remove it? Normally, we would just add it to the allergy list. 2) Our providers also are fuming about not being able to include patients who refuse to take a statin - they have no allergy, they just don't want to be on it. I contacted CMS about this because for other measures there is a Patient Reason value set. CMS responded "In regard to Quality ID #438 (why does GE call it CMS-347?) Statin Theray for the Prevention and Treatment of Cadiovascular Disease...., the measure is specified as the owner intended. In this case, the owner chose not to include an option for 'Patient Reason'...In the instance a patient refuses for any reason, you would report 'Performance Not Met'.". One of our doctors found Z53.20 "Procedure and treatment not carried out because of patient's decision for unspecified reasons" and is hoping that will count as an exception but I don't see it in the Value Sets (and I will ask CMS but I think I know the answer). Part of the problem is that the CMS measures don't always match what has become the standard of practice. Any help would be greatly appreciated.
Posted : May 22, 2018 4:09 am
