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 ID NQF # Measure Type High Priority Measure? NQS Domain Data Submission Method(s)
254 0000 Process No Effective Clinical Care Registry

Measure Description

Percentage of pregnant female patients aged 14 to 50 who present to the emergency department (ED) with a chief complaint of abdominal pain or vaginal bleeding who receive a trans-abdominal or trans-vaginal ultrasound to determine pregnancy location

Instructions

This measure is to be submitted each time a patient who presents in the emergency department with a chief complaint of abdominal pain and/or vaginal bleeding who receive a trans-abdominal or trans-vaginal ultrasound during the performance period. It is anticipated that clinicians who provide care in the emergency department will submit this measure. The Part B claim form place of service field must indicate that the encounter has taken place in the emergency department.

NOTE: No notes related

Measure Submission

The listed denominator criteria is used to identify the intended patient population. The numerator quality-data codes included in this specification are used to submit the quality actions allowed by the measure. All measure-specific coding should be submitted on the claim(s) representing the eligible encounter.

NUMERATOR

Patients who receive a trans-abdominal or trans-vaginal ultrasound with documentation of pregnancy location in medical record

Definition

Numerator Instructions: This measure is to be submitted each time a patient meets the requirements as indicated in the denominator. If the clinician documents that the clinical event surrounding the patient, with or without performance of trans-abdominal or trans-vaginal ultrasound, does not meet the intent of the measure, submit quality-data code G8807.

Numerator Quality-Data Coding Options

NUMERATOR 

Denominator Exception: G8807:
Trans-Abdominal or Trans-Vaginal Ultrasound not Performed for Documented Reasons

Trans-abdominal or trans-vaginal ultrasound not performed for reasons documented by clinician (e.g., patient has visited the ED multiple times within 72 hours, patient has a documented Intrauterine Pregnancy [IUP])

NUMERATOR 

Performance Met: G8806:
Trans-Abdominal or Trans-Vaginal Ultrasound Performed and Pregnancy Location Documented During ED Visit

Performance of trans-abdominal or trans-vaginal ultrasound

NUMERATOR:

Performance Not Met: G8808:
Trans-Abdominal or Trans-Vaginal Ultrasound not Performed, Reason not Given:

Trans-abdominal or trans-vaginal ultrasound not performed, reason not given

Numerator Note: No data

Denominator

All pregnant female patients aged 14 to 50 who present to the ED with a chief complaint of abdominal pain or vaginal bleeding

Eligible cases are determined and must be reported, if either of the following conditions

Option 1 – Denominator Criteria (Eligible Cases):

AND

Pregnant females aged 14 to 50

AND

Diagnosis of Other Current Condition in the Mother Classifiable Elsewhere but Complicating
Pregnancy, Childbirth, or the Puerperium (ICD-10-CM): O26.891, O26.899, O26.90, O26.91

AND

Diagnosis for Abdominal Pain (ICD-10-CM): R10.0, R10.10, R10.13, R10.2, R10.30, R10.31, R10.32,
R10.33, R10.813, R10.814, R10.815, R10.816, R10.817, R10.819, R10.823, R10.824, R10.825, R10.826,
R10.827, R10.829, R10.84, R10.9
OR
Diagnosis for Vaginal Bleeding (ICD-10-CM): O20.0, O20.8, O20.9, O44.30, O44.50, O44.31, O44.51
O45.001, O45.009, O45.011, O45.019, O45.021, O45.029, O45.091, O45.099, O45.8X1, O45.8X9, O45.90,
O45.91, O46.001, O46.009, O46.011, O46.019, O46.021, O46.029, O46.091, O46.8X1, O46.8X9, O46.90,
O46.91, O46.099

AND

Patient encounter during the performance period (CPT): 99281, 99282, 99283, 99284, 99285, 99291

AND

Place of Service Indicator: 23
(The Part B claim form Place of Service field must indicate emergency department)

 

 

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