Patient(s) with a recent emergency room encounter for a transient cerebral ischemic event that had any physician visit within 14 days of the acute event.
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1.5 Measure Type1.7 Electronic Clinical Quality Measure (eCQM)1.8 Level Of Analysis1.9 Care Setting1.20 Testing Data Sources
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1.14 Numerator
Create a POST period from the day after the initiating Facility Event (i.e., the ER encounter for the transient cerebral ischemic event) through 14 days after the initiating Facility Event
AND
During the POST period, did the patient have any professional encounter (code set PR0107, RV0107) with any diagnosis
(Note: Will allow non-physician encounters (e.g., nurse practitioner and physician assistance encounters) to count toward numerator compliance as long as the provider(s) has submitted one of the face-to-face encounter codes (e.g., 99213) listed in our code set.)
Time Window: 30 days after the initiating encounter (i.e., ER encounter for transient cerebral ischemia)
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1.15 Denominator
For condition confirmation, patients must meet the following criteria:
1. All males or females that are 18 years or older at the end of the report period
2. Patient must have been continuously enrolled:
Medical benefits throughout the 12 months prior to the end of the report period
AND
Pharmacy benefit plan for 6 months prior to the end of the report period
Note: The standard enrollment break logic allows unlimited breaks of no more than 45 days and no breaks greater than 45 days.
3. Either one of the following (A or B):
A. The patient is listed on the Disease Registry Input File for this condition, if a Disease Registry Input File is available. Note: Disease Registry is NOT a required input file.
B. During the 24 months prior to the end of the report period, patient has 2 or more that are at least 14 days apart of the following services, where the diagnosis is Occlusive Vascular Disease OR Stroke, non-hemorrhagic OR Transient cerebral ischemia (code set DX0110, DX0146, DX0149):
• Professional Encounter (code set PR0107, RV0107)
• Professional Supervision (code set PR0108)
• Facility Event – Confinement/Admi-ssion
• Facility Event – Emergency Room
• Facility Event – Outpatient Surgery
In addition, for this measure, the patient must meet the following criteria:
Create multiple temporary events for transient cerebral ischemic event.
Set Episode Start Date to the date of service of any claim (i.e. initiating event) for the service and diagnosis stated below during the following window of time: 365 days prior to the end of the report period through 30 days prior to the end of the report period
Facility Event – Emergency Room AND
The primary diagnosis on the claim was: Transient cerebral ischemia (code set DX0149)
Time Window: 365 days prior to the end of the report period through 30 days prior to the end of the report period
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Exclusions
None
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Most Recent Endorsement ActivityMeasure Retired and Endorsement Removed Neurology Endorsement Maintenance ProjectInitial EndorsementLast UpdatedRemoval Date
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StewardOptumSteward Organization POC Email
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Risk Adjustment
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6.1.2 Current or Planned Use(s)
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