["Procedure, Performed": "Knee Replacement Surgery"]

Performance/Reporting Period

2022

Value Set Description from VSAC

Clinical Focus: The purpose of this value set is to represent concepts for the procedure of a total knee replacement.
Data Element Scope: This value set may use a model element related to Procedure.
Inclusion Criteria: Includes concepts that represent a procedure for total knee replacement.
Exclusion Criteria: No exclusions.

Constrained to codes in the Procedure, Performed: Knee Replacement Surgery value set (2.16.840.1.113883.3.117.1.7.1.261)

QDM Datatype and Definition (QDM Version 5.5 Guidance Update)

"Procedure, Performed"

Data elements that meet criteria using this datatype should document the completion of the procedure indicated by the QDM category and its corresponding value set.

Timing:

relevant dateTime references the time the procedure is performed when the procedure occurs at a single point in time.
relevantPeriod references a start and stop time for a procedure that occurs over a time interval. relevantPeriod addresses:
- startTime - The time the procedure begins.
- stopTime - The time the procedure ends.
author dateTime references the time the action was recorded.
Refer to the eCQM expression to determine allowable timings to meet measure criterion.

Notes:

Timing refers to a single instance of a procedure. If a measure seeks to evaluate multiple procedures over a period of time, the measure developer should use CQL logic to represent the query request.
The incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.
negation rationale indicates a one-time documentation of a reason an activity is not performed. Negation of QDM datatype-related actions for a reason always use the author dateTime attribute to reference timing and must not use relevantPeriod.
For clarification, see Appendix 6.6 with 2020 guidance about differentiating between successful and unsuccessful procedures.

eCQMs using this data element:

CMS108v10 - Venous Thromboembolism Prophylaxis

CMS190v10 - Intensive Care Unit Venous Thromboembolism Prophylaxis

QDM Attributes

rank

Rank defines a position in a hierarchy for diagnoses or procedures. It replaces ordinality previously assigned to "Procedure, Performed", "Procedure, Order", and "Procedure, Recommended". ordinality does not align with any FHIR resources; it does align with definitions for FHIR encounter.diagnosis. Thus, the concept fits best consistently across QDM for the concept of principal for encounter diagnosis and for procedure.

The thought process or justification for the datatype. In some measures, specific treatments are acceptable inclusion criteria only if a justified reason is present. Each of these measures uses a value set (often, but not exclusively, using SNOMED CT) to express acceptable justification reasons. Other measures specify reasons as justification for exclusions. Examples include patient, system, or medical-related reasons for declining to perform specific actions. Each of these measures also uses a value set to express acceptable justification reasons for declining to perform expected actions.

relevantDateTime

Relevant dateTime addresses the time an activity occurs as a single point in time. If the activity occurs over a period of time, use Relevant Period.

relevantPeriod

Relevant Period addresses the time between the start of an action to the end of an action. Each datatype using relevant period defines specific definitions for the start and stop time for the action listed.

Note: negation rationale indicates a one-time documentation of a reason an activity is not performed. Negation of QDM datatyperelated actions for a reason always use the author dateTime attribute to reference timing and must not use relevantPeriod