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Anticoagulation Therapy for Atrial Fibrillation or Flutter

Compare Versions of: "Anticoagulation Therapy for Atrial Fibrillation or Flutter"

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Measure Information 2022 Reporting Period 2023 Reporting Period 2024 Reporting Period
Title Anticoagulation Therapy for Atrial Fibrillation or Flutter Anticoagulation Therapy for Atrial Fibrillation or Flutter Anticoagulation Therapy for Atrial Fibrillation or Flutter
CMS eCQM ID CMS71v11 CMS71v12 CMS71v13
Short Name

STK-3

STK-3

STK-3

NQF Number Not Applicable Not Applicable Not Applicable
Description

Ischemic stroke patients with atrial fibrillation/flutter who are prescribed or continuing to take anticoagulation therapy at hospital discharge

Ischemic stroke patients with atrial fibrillation/flutter who are prescribed or continuing to take anticoagulation therapy at hospital discharge

Ischemic stroke patients with atrial fibrillation/flutter who are prescribed or continuing to take anticoagulation therapy at hospital discharge

Initial Population

Inpatient hospitalizations 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 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 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

Denominator

Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke, and a history of atrial ablation, or current or history of atrial fibrillation/flutter

Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke, and a history of atrial ablation, or current or history of atrial fibrillation/flutter

Inpatient hospitalizations for patients with a principal diagnosis of ischemic stroke, and a history of atrial ablation, or current or history of atrial fibrillation/flutter

Denominator Exclusions Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizationsInpatient hospitalizations for patients discharged to another hospitalInpatient hospitalizations for patients who left against medical adviceInpatient hospitalizations for patients who expiredInpatient hospitalizations for patients discharged to home for hospice careInpatient hospitalizations for patients discharged to a health care facility for hospice careInpatient hospitalizations for patients with comfort measures documented * Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.* Inpatient hospitalizations for patients discharged to another hospital* Inpatient hospitalizations for patients who left against medical advice* Inpatient hospitalizations for patients who expired* Inpatient hospitalizations for patients discharged to home for hospice care* Inpatient hospitalizations for patients discharged to a health care facility for hospice care* Inpatient hospitalizations for patients with comfort measures documented - Inpatient hospitalizations for patients admitted for elective carotid intervention. This exclusion is implicitly modeled by only including non-elective hospitalizations.- Inpatient hospitalizations for patients discharged to another hospital- Inpatient hospitalizations for patients who left against medical advice- Inpatient hospitalizations for patients who expired- Inpatient hospitalizations for patients discharged to home for hospice care- Inpatient hospitalizations for patients discharged to a health care facility for hospice care- Inpatient hospitalizations for patients with comfort measures documented
Numerator

Inpatient hospitalizations for patients prescribed or continuing to take anticoagulation therapy at hospital discharge

Inpatient hospitalizations for patients prescribed or continuing to take anticoagulation therapy at hospital discharge

Inpatient hospitalizations for patients prescribed or continuing to take anticoagulation therapy at hospital discharge

Numerator Exclusions

Not Applicable

Not Applicable

Not Applicable

Denominator Exceptions

Inpatient hospitalizations for patients with a documented reason for not prescribing anticoagulation therapy at discharge

Inpatient hospitalizations for patients with a documented reason for not prescribing anticoagulation therapy at discharge

Inpatient hospitalizations for patients with a documented reason for not prescribing anticoagulation therapy at discharge

Measure Steward The Joint Commission The Joint Commission The Joint Commission
Measure Scoring Proportion measure Proportion measure Proportion measure
Measure Type Process measure Process measure Process measure
Improvement Notation

Improvement noted as an increase in rate

Improvement noted as an increase in rate

Improvement noted as an increase in rate

Guidance

The "Non-elective 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.

The "Medication, Discharge" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.

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 5.5. Please refer to the eCQI resource center  for more information on the QDM.

The "Non-elective 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.

The "Medication, Discharge" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.

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.

The "Medication, Discharge" datatype refers to the discharge medication list and is intended to express medications ordered for post-discharge use.

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.

Next Version No Version Available
Previous Version No Version Available

Header

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

    Measure Section: Description

    Source of Change: Annual Update

  • Updated copyright.

    Measure Section: Copyright

    Source of Change: Annual Update

  • Replaced asterisks with bullets to align with style guide.

    Measure Section: Denominator Exclusions

    Source of Change: Standards/Technical Update

Logic

  • Added value set 'History of Atrial Ablation' to provide additional approaches for identifying history of atrial ablation.

    Measure Section: Denominator

    Source of Change: Measure Lead

  • Removed definition 'Anticoagulant Therapy at Discharge' and replaced it with inline reference to QDM datatype 'Medication, Discharge' to improve readability.

    Measure Section: Numerator

    Source of Change: Measure Lead

  • Renamed definition from 'Reason for Not Giving Anticoagulant at Discharge' to 'Documented Reason for Not Giving Anticoagulant at Discharge' based on recommendation from clinical experts.

    Measure Section: Denominator Exceptions

    Source of Change: Measure Lead

  • Updated the version number of the TJC Overall Library to v7.1.000.

    Measure Section: Definitions

    Source of Change: Annual Update

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

    Measure Section: Definitions

    Source of Change: Standards/Technical Update

  • Combined two definitions, 'Encounter with a history of Atrial Fibrillation or Flutter' and 'Encounter with Current Diagnosis Code of Atrial Fibrillation or Flutter', and renamed to 'Encounter with Prior or Present Diagnosis of Atrial Fibrillation or Flutter' align with logic intent.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Added Global functions EarliestOf, Earliest and HasStart in new history of atrial ablation logic.

    Measure Section: Functions

    Source of Change: Measure Lead

  • Updated the version number of the TJC Overall Library to v7.1.000.

    Measure Section: Functions

    Source of Change: Annual Update

  • Added QDM datatypes 'Assessment, Performed' and 'Diagnosis' for new value set 'History of Atrial Ablation' to provide additional approaches for identifying patients with a history of atrial ablation to reduce burden.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Value Set

The VSAC is the source of truth for the value set content, please visit the VSAC for downloads of current value sets.

  • Value set Anticoagulant Therapy (2.16.840.1.113883.3.117.1.7.1.200): Added 7 RxNorm codes (2590616, 2590620, 2590623, 2590627, 2590631, 2590635, 2618839) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Atrial Fibrillation or Flutter (2.16.840.1.113883.3.117.1.7.1.202): Added 2 SNOMED CT codes (312442005, 428076002) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Added value set History of Atrial Ablation (2.16.840.1.113762.1.4.1110.76) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set (2.16.840.1.113883.3.117.1.7.1.473): Renamed to Medical Reason For Not Providing Treatment based on recommended value set naming conventions.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Patient Refusal (2.16.840.1.113883.3.117.1.7.1.93): Added 2 SNOMED CT codes (1162745003, 895451009) based on terminology update. Deleted 5 SNOMED CT codes (183944003, 413312003, 183947005, 371138003, 609589008) based on terminology update.

    Measure Section: Terminology

    Source of Change: Annual Update

  • Value set Payer (2.16.840.1.114222.4.11.3591): Added 5 SOP codes (1111, 1112, 142, 344, 141) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

Last Updated: Jan 26, 2024