Antithrombotic Therapy by End of Hospital Day 2

Measure Information	2024 Reporting Period	2025 Reporting Period	2026 Reporting Period	2027 Reporting Period
Title	Antithrombotic Therapy By End of Hospital Day 2	Antithrombotic Therapy by End of Hospital Day 2	Antithrombotic Therapy by End of Hospital Day 2	Antithrombotic Therapy by End of Hospital Day 2
CMS eCQM ID	CMS72v12	CMS72v13	CMS72v14	CMS72v15
Short Name	STK-5	STK-5	STK-5	STK-5
CBE ID*	Not Applicable	Not Applicable	Not Applicable	Not Applicable
Measure Steward	Joint Commission	Joint Commission	Joint Commission	Joint Commission
Description	Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2	Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2	Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2	Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2
Measure Scoring	Proportion	Proportion	Proportion	Proportion
Measure Type	Process	Process	Process	Process
Stratification	None	None	None	None
Risk Adjustment	None	None	None	None
Rationale	The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist. Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy. Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.	The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist. Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy. Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.	The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist. Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy. Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.	The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist. Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy. Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.
Clinical Recommendation Statement	Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist	Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist	Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist	Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist
Improvement Notation	Improvement noted as an increase in rate	Improvement noted as an increase in rate	Increased score indicates improvement	Increased score indicates improvement
Definition	None	None	None	None
Guidance	The "Nonelective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Inpatient Encounter" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective Inpatient Encounters include emergency, urgent, and unplanned admissions. NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous). In the denominator exclusions, the intent is to only exclude patients with a total length of stay of <2 days, including ED visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits. The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.	The "Nonelective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Inpatient Encounter" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective Inpatient Encounters include emergency, urgent, and unplanned admissions. NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous). In the denominator exclusions, the intent is to only exclude patients with a total length of stay of <2 days, including emergency department (ED) visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits. The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.	The "Nonelective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Inpatient Encounter" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective Inpatient Encounters include emergency, urgent, and unplanned admissions. NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous). In the denominator exclusions, the intent is to only exclude patients with a total length of stay of <2 days, including emergency department (ED) visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits. The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.	The "Nonelective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Encounter Inpatient " value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions. Nothing by mouth (NPO) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous). The denominator exclusion criteria "Encounter Less Than Two Days" is intended to exclude patients with an inpatient admission from either the emergency department (ED) (if there is one) and/or a direct admission to the hospital that does not have a length of stay greater than two days. The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home. This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period. This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.
Initial Population	Inpatient hospitalization for patients age 18 and older discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during measurement period	Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, ending during the measurement period	Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, ending during the measurement period	Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, ending during the measurement period
Denominator	Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke	Equals Initial Population	Equals Initial Population	Equals Initial Population
Denominator Exclusions	- Inpatient hospitalizations for patients who have a duration of stay less than 2 days - Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival - Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization	- Inpatient hospitalization for patients who have a duration of stay less than 2 days - Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival - Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization	- Inpatient hospitalizations for patients who have a duration of stay less than 2 days - Inpatient hospitalizations for patients with comfort measures documented day of or the day after arrival - Inpatient hospitalizations for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization	Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations. Inpatient hospitalizations for patients who have a duration of stay less than 2 days Inpatient hospitalizations for patients with comfort measures documented day of or the day after arrival Inpatient hospitalizations for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization
Numerator	Inpatient hospitalization for patients who had antithrombotic therapy administered the day of or day after hospital arrival	Inpatient hospitalization for patients who had antithrombotic therapy administered the day of or day after hospital arrival	Inpatient hospitalizations for patients who had antithrombotic therapy administered the day of or day after hospital arrival	Inpatient hospitalizations for patients who had antithrombotic therapy administered the day of or day after hospital arrival
Numerator Exclusions	Not Applicable	Not Applicable	None	None
Denominator Exceptions	- Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival - Inpatient hospitalization for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival - Inpatient hospitalization for patients with an INR greater than 3.5	- Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival. - Inpatient hospitalization for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival. - Inpatient hospitalization for patients with an international normalized ratio (INR) greater than 3.5.	- Inpatient hospitalizations for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival. - Inpatient hospitalizations for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival. - Inpatient hospitalizations for patients with an international normalized ratio (INR) greater than 3.5.	Inpatient hospitalizations for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival Inpatient hospitalizations for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival Inpatient hospitalizations for patients with an international normalized ratio (INR) greater than 3.5
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Previous Version	No Version Available	CMS72v12	CMS72v13	CMS72v14

Measure Information

2024 Reporting Period

2025 Reporting Period

2026 Reporting Period

2027 Reporting Period

Title

Antithrombotic Therapy By End of Hospital Day 2

Antithrombotic Therapy by End of Hospital Day 2

CMS eCQM ID

CMS72v12

CMS72v13

CMS72v14

CMS72v15

Short Name

STK-5

CBE ID*

Not Applicable

Measure Steward

Joint Commission

Description

Ischemic stroke patients administered antithrombotic therapy by the end of hospital day 2

Measure Scoring

Proportion

Measure Type

Process

Stratification

None

Risk Adjustment

None

Rationale

The effectiveness of antithrombotic agents in reducing stroke mortality, stroke-related morbidity and recurrence rates has been studied in several large clinical trials. While the use of these agents for patients with acute ischemic stroke and transient ischemic attacks (TIA) continues to be the subject of study, substantial evidence is available from completed studies. Data at this time suggest that antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist.

Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.

Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.

Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.

Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.

Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.

Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.

Aspirin is the recommended antithrombotic medication for early antithrombotic therapy and most frequently administered unless contraindicated. Anticoagulants at doses to prevent venous thromboembolism (VTE) are insufficient. Subcutaneous Lovenox (enoxaparin) and unfractionated heparin (UFH) SQ at lower dosages used for VTE prophylaxis (i.e., enoxaparin SQ 40 mg once daily; enoxaparin SQ 30 mg Q12 hours; UFH 5,000 units or less two or three times daily) are not sufficient for early antithrombotic therapy.

Anticoagulants at doses to prevent VTE are insufficient antithrombotic therapy to prevent recurrent ischemic stroke or TIA.

Clinical Recommendation Statement

Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity as long as no contraindications exist

Antithrombotic therapy should be administered within 2 days of symptom onset in acute ischemic stroke patients to reduce stroke mortality and morbidity if no contraindications exist

Improvement Notation

Improvement noted as an increase in rate

Increased score indicates improvement

Definition

None

Guidance

The "Nonelective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Inpatient Encounter" value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective Inpatient Encounters include emergency, urgent, and unplanned admissions.

NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).

In the denominator exclusions, the intent is to only exclude patients with a total length of stay of <2 days, including ED visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits.

The denominator population includes patients with inpatient hospitalizations and patients from Acute Hospital Care at Home programs, who are treated and billed as inpatients but receive care in their home.

This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).

In the denominator exclusions, the intent is to only exclude patients with a total length of stay of <2 days, including emergency department (ED) visit (if there is one). For the eCQM we model both of the scenarios of admission via the ED as well as direct admits. This statement addresses direct admits.

This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

NPO (Nothing by mouth) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).

This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

The "Nonelective Inpatient Encounter" value set intends to capture all non-scheduled hospitalizations. This value set is a subset of the "Encounter Inpatient " value set, excluding concepts that specifically refer to elective hospital admissions. Non-elective admissions include emergency, urgent and unplanned admissions.

Nothing by mouth (NPO) is not a valid reason for not administering antithrombotic therapy by end of hospital day 2 as another route of administration can be used (i.e., rectal or intravenous).

The denominator exclusion criteria "Encounter Less Than Two Days" is intended to exclude patients with an inpatient admission from either the emergency department (ED) (if there is one) and/or a direct admission to the hospital that does not have a length of stay greater than two days.

This eCQM is an episode-based measure. An episode is defined as each inpatient hospitalization or encounter that ends during the measurement period.

This version of the eCQM uses QDM version 5.6. Please refer to the QDM page for more information on the QDM.

Initial Population

Inpatient hospitalization for patients age 18 and older discharged from inpatient care (non-elective admissions) with a principal diagnosis of ischemic or hemorrhagic stroke and a length of stay less than or equal to 120 days that ends during measurement period

Inpatient hospitalizations (non-elective admissions) for patients age 18 and older, discharged from inpatient care with a principal diagnosis of ischemic stroke, ending during the measurement period

Denominator

Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke

Equals Initial Population

Denominator Exclusions

- Inpatient hospitalizations for patients who have a duration of stay less than 2 days

- Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival

- Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization

- Inpatient hospitalization for patients who have a duration of stay less than 2 days

- Inpatient hospitalization for patients with comfort measures documented day of or the day after arrival

- Inpatient hospitalization for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy

administered within 24 hours prior to arrival or anytime during hospitalization

- Inpatient hospitalizations for patients who have a duration of stay less than 2 days

- Inpatient hospitalizations for patients with comfort measures documented day of or the day after arrival

- Inpatient hospitalizations for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy

administered within 24 hours prior to arrival or anytime during hospitalization

Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.
Inpatient hospitalizations for patients who have a duration of stay less than 2 days
Inpatient hospitalizations for patients with comfort measures documented day of or the day after arrival
Inpatient hospitalizations for patients with intra-venous or intra-arterial Thrombolytic (t-PA) Therapy administered within 24 hours prior to arrival or anytime during hospitalization

Numerator

Inpatient hospitalization for patients who had antithrombotic therapy administered the day of or day after hospital arrival

Inpatient hospitalizations for patients who had antithrombotic therapy administered the day of or day after hospital arrival

Numerator Exclusions

Not Applicable

None

Denominator Exceptions

- Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival

- Inpatient hospitalization for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival

- Inpatient hospitalization for patients with an INR greater than 3.5

- Inpatient hospitalization for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival.

- Inpatient hospitalization for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival.

- Inpatient hospitalization for patients with an international normalized ratio (INR) greater than 3.5.

- Inpatient hospitalizations for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival.

- Inpatient hospitalizations for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival.

- Inpatient hospitalizations for patients with an international normalized ratio (INR) greater than 3.5.

Inpatient hospitalizations for patients with a documented reason for not administering antithrombotic therapy the day of or day after hospital arrival
Inpatient hospitalizations for patients who receive Prasugrel as an antithrombotic therapy the day of or day after hospital arrival
Inpatient hospitalizations for patients with an international normalized ratio (INR) greater than 3.5

Next Version

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No Version Available

Previous Version

No Version Available

CMS72v12

CMS72v13

CMS72v14

CMS72-v15.0.000-QDM-TRN.xlsx

TRN	Measure Section	Source of Change
Updated the eCQM version number.	eCQM Version Number	Annual Update
Updated measurement period to reflect exact dates of reporting.	Measurement Period	Standards/Technical Update
Updated the Measure Steward field from 'The Joint Commission' to 'Joint Commission' to reflect the organization's new name.	Measure Steward	Measure Lead
Updated the Measure Developer field from 'The Joint Commission' to 'Joint Commission' to reflect the organization's new name.	Measure Developer	Measure Lead
Updated copyright.	Copyright	Annual Update
Updated the names of the Encounter Inpatient and Nonelective Inpatient Encounter value sets as referenced in the Guidance section to align with the value set names recorded in the Value Set Authority Center.	Guidance	Annual Update
Updated the Guidance section to clarify the intent of the Denominator Exclusion criterion for inpatient hospitalizations for patients who have a duration of stay less than two days.	Guidance	Measure Lead
Updated the Denominator Exclusions narrative to describe how the exclusion of inpatient hospitalizations for patients admitted for elective carotid intervention is implicitly modeled by the inclusion of only non-elective hospitalizations in the measure's Initial Population and Denominator and to align with guidance provided across the stroke eCQM measure set.	Denominator Exclusions	Measure Lead
Updated references and measure header to reflect current evidence and new or updated literature.	Multiple Sections	Measure Lead
Updated grammar, wording, and/or formatting to improve readability and consistency.	Multiple Sections	Annual Update

TRN

Measure Section

Source of Change

Updated the eCQM version number.

eCQM Version Number

Annual Update

Updated measurement period to reflect exact dates of reporting.

Measurement Period

Standards/Technical Update

Updated the Measure Steward field from 'The Joint Commission' to 'Joint Commission' to reflect the organization's new name.

Measure Steward

Measure Lead

Updated the Measure Developer field from 'The Joint Commission' to 'Joint Commission' to reflect the organization's new name.

Measure Developer

Measure Lead

Updated copyright.

Annual Update

Updated the names of the Encounter Inpatient and Nonelective Inpatient Encounter value sets as referenced in the Guidance section to align with the value set names recorded in the Value Set Authority Center.

Guidance

Annual Update

Updated the Guidance section to clarify the intent of the Denominator Exclusion criterion for inpatient hospitalizations for patients who have a duration of stay less than two days.

Guidance

Measure Lead

Updated the Denominator Exclusions narrative to describe how the exclusion of inpatient hospitalizations for patients admitted for elective carotid intervention is implicitly modeled by the inclusion of only non-elective hospitalizations in the measure's Initial Population and Denominator and to align with guidance provided across the stroke eCQM measure set.

Denominator Exclusions

Measure Lead

Updated references and measure header to reflect current evidence and new or updated literature.

Multiple Sections

Measure Lead

Updated grammar, wording, and/or formatting to improve readability and consistency.

Multiple Sections

Annual Update

TRN	Measure Section	Source of Change
Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.	Definitions	Standards/Technical Update
Updated the version number of the Joint Commission Overall Library to v10.0.000 and the library name from 'TJCOverallQDM' to 'JCCommonQDM'.	Definitions	Annual Update
Updated the version number of the Joint Commission Overall Library to v10.0.000 and the library name from 'TJCOverallQDM' to 'JCCommonQDM'.	Functions	Annual Update

TRN

Measure Section

Source of Change

Updated the names of CQL definitions, functions, and/or aliases for clarification and to align with the CQL Style Guide.

Definitions

Standards/Technical Update

Updated the version number of the Joint Commission Overall Library to v10.0.000 and the library name from 'TJCOverallQDM' to 'JCCommonQDM'.

Definitions

Annual Update

Updated the version number of the Joint Commission Overall Library to v10.0.000 and the library name from 'TJCOverallQDM' to 'JCCommonQDM'.

Functions

Annual Update

TRN	Measure Section	Source of Change
Value set Antithrombotic Therapy for Ischemic Stroke (2.16.840.1.113762.1.4.1110.62): Added 1 RxNorm code (2664074) based on terminology update. Deleted 1 RxNorm code (827318) based on terminology update.	Terminology	Annual Update
Value set Ischemic Stroke (2.16.840.1.113883.3.117.1.7.1.247): Added 84 SNOMED CT codes based on terminology update.	Terminology	Annual Update
Value set Patient Refusal (2.16.840.1.113883.3.117.1.7.1.93): Added 1 SNOMED CT code (1303950002) based on terminology update. Deleted 1 SNOMED CT code (182890002) based on terminology update.	Terminology	Annual Update
Value set Payer Type (2.16.840.1.114222.4.11.3591): Deleted 42 SOPT codes based on new or changed coding guidelines.	Terminology	Measure Lead
Value set Thrombolytic tPA Therapy (2.16.840.1.113883.3.117.1.7.1.226): Added 1 RxNorm code (2711697) based on terminology update.	Terminology	Annual Update
Replaced value set Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival (2.16.840.1.113762.1.4.1110.21) with direct reference code ICD-10-CM code (Z92.82) based on applicability of a single code to represent clinical data.	Terminology	Annual Update

TRN

Measure Section

Source of Change

Value set Antithrombotic Therapy for Ischemic Stroke (2.16.840.1.113762.1.4.1110.62): Added 1 RxNorm code (2664074) based on terminology update. Deleted 1 RxNorm code (827318) based on terminology update.

Terminology

Annual Update

Value set Ischemic Stroke (2.16.840.1.113883.3.117.1.7.1.247): Added 84 SNOMED CT codes based on terminology update.

Terminology

Annual Update

Value set Patient Refusal (2.16.840.1.113883.3.117.1.7.1.93): Added 1 SNOMED CT code (1303950002) based on terminology update. Deleted 1 SNOMED CT code (182890002) based on terminology update.

Terminology

Annual Update

Value set Payer Type (2.16.840.1.114222.4.11.3591): Deleted 42 SOPT codes based on new or changed coding guidelines.

Terminology

Measure Lead

Value set Thrombolytic tPA Therapy (2.16.840.1.113883.3.117.1.7.1.226): Added 1 RxNorm code (2711697) based on terminology update.

Terminology

Annual Update

Replaced value set Intravenous or Intraarterial Thrombolytic tPA Therapy Prior to Arrival (2.16.840.1.113762.1.4.1110.21) with direct reference code ICD-10-CM code (Z92.82) based on applicability of a single code to represent clinical data.

Terminology

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Antithrombotic Therapy by End of Hospital Day 2

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