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Cesarean Birth

Compare Versions of: "Cesarean Birth"

The Compare function compares two years of the measure specifications found in the header of the measure's HTML. It does not include a comparison of any information in the body of the HTML, e.g., population criteria, Clinical Quality Language, or value sets.

Strikethrough text highlighted in red indicates information changed from the previous version. Text highlighted in green indicates information updated in the new eCQM version.

Compare 2024 version to

Table Options
Measure Information 2024 Reporting Period
Title Cesarean Birth
CMS eCQM ID CMS334v5
Short Name

PC-02

CBE ID* 0471e
Measure Steward The Joint Commission
Description

Nulliparous women with a term, singleton baby in a vertex position delivered by cesarean birth

Measure Scoring Proportion measure
Measure Type Outcome
Stratification

None

Risk Adjustment

None

Rationale

The removal of any pressure to not perform a cesarean birth has led to a skyrocketing of hospital, state and national cesarean birth (CB) rates. Some hospitals’ CB rates were over 50%. Hospitals with CB rates at 15-20% have infant outcomes that are just as good and better maternal...

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Clinical Recommendation Statement

The American College of Obstetrics and Gynecology (ACOG) report, Evaluation of Cesarean Delivery, recognizes the importance of the Nulliparous, Term Singleton Vertex (NTSV) population as the optimal focus for measurement and quality improvement action. A reduction in the number of...

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Improvement Notation

Within Optimal Range. The Joint Commission does not want to encourage inappropriately low Cesarean rates that may be unsafe to patients. Acceptable PC-02 rates are 30% or lower, however there is not an established threshold for what rate may be too low. PC-06 serves as a balancing...

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Definition

Parity: The number of pregnancies reaching 20 weeks gestation regardless of the number of fetuses or outcomes

Gravidity: The number of pregnancies, current and past, regardless of the pregnancy outcome

Preterm Birth: The number of births >= 20 weeks and < 37 weeks gestation, regardless of...

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Guidance

Vertex position is modeled implicitly, as the measure excludes deliveries with abnormal presentations.

Patients who do not receive prenatal care and have no documented gestational age or estimated due date are implicitly excluded from the measure, as gestational age is required to meet de...

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Initial Population

Inpatient hospitalizations for patients age >= 8 years and < 65 admitted to the hospital for inpatient acute care who undergo a delivery procedure with a discharge date that ends during the measurement period

Denominator

Inpatient hospitalizations for nulliparous patients who delivered a live term singleton newborn >= 37 weeks' gestation

See Guidance and Definition Sections for more details.

Denominator Exclusions

Inpatient hospitalizations for patients with abnormal presentation, placenta previa, placenta accreta or vasa previa during the encounter

Numerator

Inpatient hospitalizations for patients who deliver by cesarean section

Numerator Exclusions

None

Denominator Exceptions

None

Next Version
Previous Version

Header

  • Updated the NQF Number and Endorsed By fields to reflect NQF endorsement.

    Measure Section: NQF Number

    Source of Change: Measure Lead

  • Updated the NQF Number and Endorsed By fields to reflect NQF endorsement.

    Measure Section: Endorsed By

    Source of Change: Measure Lead

  • 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

  • Added guidance to clarify patients may now be qualified for the denominator based on gestational age diagnosis codes when neither calculated or reported gestational age is available.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Added guidance to note Gravida, Preterm Birth, Term Birth and Parity results are expected to be submitted via QRDA I as integers (and not quantities or numbers) to meet measure criteria.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Removed redundant language from the Guidance section relating to Parity, Gravidity and Preterm/Term births.

    Measure Section: Guidance

    Source of Change: Measure Lead

  • Updated Initial Population language to 'who undergo a delivery procedure with a discharge date that ends during the measurement period' to better align metadata and logic.

    Measure Section: Initial Population

    Source of Change: Measure Lead

  • Removed redundant language from the Denominator section relating to Parity, Gravidity and Preterm/Term births.

    Measure Section: Denominator

    Source of Change: Measure Lead

  • Expanded placenta previa denominator exclusion to include placenta accreta and vasa previa, per technical/clinical expert recommendation and applicability to the measure.

    Measure Section: Denominator Exclusions

    Source of Change: Measure Lead

  • Moved metadata language that referred to the chart abstracted measure from the Denominator and Denominator Exclusions sections to the Guidance section to reduce potential confusion.

    Measure Section: Multiple Sections

    Source of Change: Measure Lead

Logic

  • Added logic to denominator criteria to capture patients with specified weeks gestation based on diagnosis codes when neither calculated or reported gestational age is available.

    Measure Section: Denominator

    Source of Change: Measure Lead

  • Revised definition names to align with the expanded denominator exclusion of placenta accreta and vasa previa per technical/clinical expert recommendation and applicability to the measure.

    Measure Section: Definitions

    Source of Change: Measure Lead

  • Updated the version number of the PC Maternal Library to v3.0.000.

    Measure Section: Definitions

    Source of Change: Annual Update

  • Added 'EarliestOf' and 'relevantPeriod' to the Gravida, Parity, Preterm/Term Birth functions' 'where' and 'sort by' logic which will cause the 'NormalizeInterval' to be invoked, allowing for the consistent application of relevant datetime and relevant period when using 'Assessment, Performed' datatype.

    Measure Section: Functions

    Source of Change: ONC Project Tracking System (JIRA): CQM-5620

  • Removed 'Truncate.Time' function and added 'as DateTime' to Estimated Delivery Date result to simplify logic and allow hospitals to submit data as date only or as date/time.

    Measure Section: Functions

    Source of Change: Measure Lead

  • Updated the version number of the PC Maternal Library to v3.0.000.

    Measure Section: Functions

    Source of Change: Annual Update

Value Set

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

  • Added value set 37 to 42 Plus Weeks Gestation (2.16.840.1.113762.1.4.1110.68) based on change in measure requirements/measure specification.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set Abnormal Presentation (2.16.840.1.113762.1.4.1045.105): Added 13 SNOMED CT codes based on applicability of value set and/or OID. Added 7 ICD-10-CM codes (O64.8XX0, O64.8XX1, O64.8XX2, O64.8XX3, O64.8XX4, O64.8XX5, O64.8XX9) based on applicability of value set and/or OID.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value set (2.16.840.1.113762.1.4.1110.37): Renamed to Placenta Previa or Accreta or Vasa Previa based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • Value Set Placenta Previa or Accreta or Vasa Previa (2.16.840.1.113762.1.4.1110.37): Added 5 SNOMED CT codes (199895009, 199896005, 33058001, 70129008, 79668009) based on review by technical experts, SMEs, and/or public feedback. Deleted 1 SNOMED CT code (48888007) based on terminology update. Added 9 ICD-10-CM codes (O43.213, O43.219, O69.4XX0, O69.4XX1, O69.4XX2, O69.4XX3, O69.4XX4, O69.4XX5, O69.4XX9) based on review by technical experts, SMEs, and/or public feedback.

    Measure Section: Terminology

    Source of Change: Measure Lead

  • 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: Jun 03, 2024