Aspirin Prescribed at Discharge

Last updated: May 15, 2017

CMS Measure ID: CMS100v5
Version: 5
NQF Number: 0142
Measure Description:

Acute myocardial infarction (AMI) patients who are prescribed aspirin at hospital discharge

Initial Patient Population:

Patients age 18 and older at the time of hospital admission with a principal diagnosis of Acute Myocardial Infarction (AMI) and a length of stay less than or equal to 120 days, during the measurement period

Denominator Statement:

Equals Initial Population

Denominator Exclusions:

Patients with Comfort Measures documented

Patients discharged to another acute care facility

Patients who left against medical advice

Patients who expired

Patients discharged to home for hospice care

Patients discharged to a health care facility for hospice care

Numerator Statement:

Acute Myocardial Infarction patients prescribed aspirin at hospital discharge

Numerator Exclusions:

Not Applicable

Denominator Exceptions:

Patients with a documented reason for not prescribing aspirin at discharge. This includes patients with an aspirin allergy; discharged on warfarin or other specific anticoagulant medications; the administration of aspirin medications are on HOLD; or a medical or patient reason for not prescribing aspirin.

Measure Steward: Centers for Medicare & Medicaid Services (CMS)
Domain: Effective Clinical Care
Short Name: AMI2
Previous Version: Aspirin Prescribed at Discharge
Improvement Notation:

Improvement noted as an increase in rate

Guidance:

Initial population guidance:

Includes patients with a principal diagnosis of AMI during an emergency department visit less than or equal to one hour before the inpatient admission.

Exclusion element guidance:

Medical or patient reasons for not performing a test or giving a medication are categories for valid medical or patient reasons that are not specifically listed in the exclusion section of the measure. Each is expected to be captured and made available for measurement or clinical decision support within the EHR workflow but the exact method or location of capture is a local or vendor decision.

Addendum Notes: Removed from Hospital Quality Reporting

Specifications

Release Notes

Header

  • Updated Copyright.

    Section: Copyright

    Source: Annual Update

  • Incremented eMeasure Version number.

    Section: eMeasure Version number

    Source: Measure Lead

  • Added clarifying guidance for capturing the principal diagnosis to the Initial Population header.

    Section: Guidance

    Source: Measure Lead

Logic

  • Replaced 'Diagnosis, Active: XXX (ordinality: Principal)' datatype with 'Encounter, Performed: XXX (principal diagnosis: XXX)' datatype to conform with QDM 4.2 changes and provide more accurate logic.

    Section: Denominator

    Source: QDM Standards

  • Removed the ‘Union of’ operator from the Initial Population logic as it is no longer needed to meet the measure intent.

    Section: Initial Population

    Source: Measure Lead

  • Removed the Emergency Department (ED) section of logic from the Initial Population as it is not needed to capture the principal diagnosis.

    Section: Initial Population

    Source: Measure Lead

  • Replaced 'Diagnosis, Active: XXX (ordinality: Principal)' datatype with 'Encounter, Performed: XXX (principal diagnosis: XXX)' datatype to conform with QDM 4.2 changes and provide more accurate logic.

    Section: Initial Population

    Source: QDM Standards

  • Added new attribute 'principal diagnosis' to 'Encounter, performed' datatype to conform to QDM 4.2 changes and provide more accurate logic. Removed QDM data element Attribute: 'Ordinality: Principal' using 'Principal SNOMEDCT Value Set (2.16.840.1.113883.3.1.7.1.14.)’ to conform to QDM 4.2. changes and provide more accurate logic.

    Section: QDM Data Elements

    Source: QDM Standards

Value Set

  • Value set Acute Myocardial Infarction (AMI) (2.16.840.1.113883.3.666.5.3011): Added 9 SNOMEDCT codes (15712841000119100, 15712881000119105, 15712921000119103, 15712961000119108, 15713041000119103, 15713081000119108, 15713121000119105, 15713161000119100, 15713201000119105) and deleted 1 SNOMEDCT code (194798004).

    Section: None

    Source: None

  • Value set Aspirin (2.16.840.1.113883.3.666.5.626): Added 3 RXNORM codes (1593110, 1665356, 1722689) and deleted 24 RXNORM codes.

    Section: None

    Source: None

  • Value set Aspirin Allergen (2.16.840.1.113883.3.117.1.7.1.139): Added 2 RXNORM codes (1593109, 817958) and deleted 13 RXNORM codes.

    Section: None

    Source: None

  • Value set Medical Reason (2.16.840.1.113883.3.117.1.7.1.473): Deleted 1 SNOMEDCT code (161590003).

    Section: None

    Source: None

  • Value set Other Anticoagulants for Acute Myocardial Infarction (AMI) (2.16.840.1.113762.1.4.1045.31): Added 1 RXNORM code (1723476).

    Section: None

    Source: None

External Resources