ecqm.unions

Historyof Ascvd Diagnosisor Procedure Union

Description:

Based On: Union50

Used By:

• CMS347v2

QDM Attributes

MyocardialInfarctionDiagnosis

Clinical Focus: Under Development

Data Element Scope: Under Development

Inclusion Criteria: Under Development

Exclusion Criteria: Under Development

ResultValue constrained to codes in the Myocardial Infarction valueset (2.16.840.1.113883.3.526.3.403)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

MyocardialInfarctionDiagnosis

0..*

CerebrovascularDiseaseStrokeTiaDiagnosis

Clinical Focus: This value set includes stroke and high risk diagnoses associated with stroke, including TIA and generalized ischemic cerebrovascular disease, which would indicate a patient has Atherosclerotic Cardiovascular Disease (ASCVD) in relation to a cerebrovascular event.

Data Element Scope: Appropriate for use with data elements in QDM Categories or Attributes represented by diagnosis codes.

Inclusion Criteria: Includes ASCVD diagnoses of cerebrovascular origin.

Exclusion Criteria: Excludes any other ASCVD diagnoses not related to cerebrovascular disease, stroke, or TIA.

ResultValue constrained to codes in the Cerebrovascular disease, Stroke, TIA valueset (2.16.840.1.113762.1.4.1047.44)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

CerebrovascularDiseaseStrokeTiaDiagnosis

0..*

AtherosclerosisAndPeripheralArterialDiseaseDiagnosis

Clinical Focus: This set of values is intended to capture that a patient has a diagnosis, condition, or disorder of Atherosclerosis or Peripheral Arterial Disease (PAD).

Data Element Scope: Appropriate for use with data elements in QDM Categories or Attributes represented by diagnosis codes.

Inclusion Criteria: Conditions that indicate arterial blood flow is restricted putting patients at higher risk for heart disease are included.

Exclusion Criteria: Other vascular conditions that are not diagnosed as part of Atherosclerosis and Peripheral Artery Disease are excluded.

ResultValue constrained to codes in the Atherosclerosis and Peripheral Arterial Disease valueset (2.16.840.1.113762.1.4.1047.21)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

AtherosclerosisAndPeripheralArterialDiseaseDiagnosis

0..*

IschemicHeartDiseaseOrCoronaryOcclusionRuptureOrThrombosisDiagnosis

Clinical Focus: The intent of this set of values is to capture ischemic heart disease and associated diagnoses as related to Atherosclerotic Cardiovascular Disease (ASCVD).

Data Element Scope: Appropriate for use with data elements in QDM Categories or Attributes represented by diagnosis codes.

Inclusion Criteria: Included are acute and chronic forms of ischemic heart disease as well as coronary occlusion, thrombosis, or rupture that can be related to ASCVD.

Exclusion Criteria: Excluded are acute coronary occlusion related directly to myocardial infarction and myocardial ischemia.

ResultValue constrained to codes in the Ischemic heart disease or coronary occlusion, rupture, or thrombosis valueset (2.16.840.1.113762.1.4.1047.46)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

IschemicHeartDiseaseOrCoronaryOcclusionRuptureOrThrombosisDiagnosis

0..*

StableAndUnstableAnginaDiagnosis

Clinical Focus: The intent of this set of values is to capture the diagnosis of angina.

Data Element Scope: Appropriate for use with data elements in QDM Categories or Attributes represented by diagnosis codes.

Inclusion Criteria: Included are stable and unstable angina, pre and post infarction angina, angina decubitus, intermediate coronary syndrome, other unspecified angina or sequelae of myocardial infarction, and other forms of angina pectoris.

Exclusion Criteria: Excluded is any form of angina that does not define Atherosclerotic Cardiovascular Disease (ASCVD

ResultValue constrained to codes in the Stable and Unstable Angina valueset (2.16.840.1.113762.1.4.1047.47)

Diagnosis: Condition/Diagnosis/Problem represents a practitioner’s identification of a patient’s disease, illness, injury, or condition. This category contains a single datatype to represent all of these concepts: Diagnosis. A practitioner determines the diagnosis by means of examination, diagnostic test results, patient history, and/or family history. Diagnoses are usually considered unfavorable, but may also represent neutral or favorable conditions that affect a patient’s plan of care (e.g., pregnancy). The QDM does not prescribe the source of diagnosis data in the EHR. Diagnoses may be found in a patient’s problem list, encounter diagnosis list, claims data, or other sources within the EHR. The preferred terminology for diagnoses is SNOMED-CT, but diagnoses may also be encoded using ICD-9/10. The Diagnosis datatype should not be used for differential diagnoses or rule-out diagnoses (neither of which are currently supported by the QDM).

DataType

Cardinality

StableAndUnstableAnginaDiagnosis

0..*

PciPerformed

Clinical Focus: This grouping value set contains procedures used to define percutaneous coronary intervention (PCI).

Data Element Scope: The intent of this data element is to identify patients who had percutaneous coronary intervention (PCI) during an episode of acute myocardial infarction. Using the Quality Data Model, this particular element would map to the Procedure, Performed datatype.

Inclusion Criteria: Include codes that identify patients receiving percutaneous coronary intervention (PCI). This is a grouping of ICD10PCS and SNOMEDCT codes.

Exclusion Criteria: None

Subject constrained to the PCI

ProcedurePerformed: 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: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) 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. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

PciPerformed

0..*

CabgSurgeriesPerformed

Clinical Focus: This grouping of value sets identifies patients who have a CABG surgical procedure.

Data Element Scope: The intent of this data element is to identify patients who have a CABG surgical procedure. Using the Quality Data Model, this particular element will map to the Procedure category.

Inclusion Criteria: Only use codes which represent CABG surgical procedures. Codes used are to be ICD10PCS, ICD9 or SNOMED-CT codes only.

Exclusion Criteria: Exclude codes that represent a CABG performed using a scope.

Subject constrained to the CABG Surgeries

ProcedurePerformed: 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: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) 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. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

CabgSurgeriesPerformed

0..*

CarotidInterventionPerformed

Clinical Focus: This set of values identifies patients who have undergone a carotid artery surgical procedure.

Data Element Scope: Appropriate for use with data elements in QDM Categories or Attributes represented by procedure codes.

Inclusion Criteria: Included are codes that represent carotid intervention surgical procedures.

Exclusion Criteria: Excluded are codes that would not indicate a carotid intervention has been surgically performed.

Subject constrained to the Carotid Intervention

ProcedurePerformed: 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: The Relevant Period addresses: StartTime = the time the procedure begins; StopTime = the time the procedure is completed NOTE: 1) 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. 2) The Incision dateTime is a single point in time available from the Operating Room and/or Anesthesia Record.

DataType

Cardinality

CarotidInterventionPerformed

0..*