Performance Measurement Network

Question: Procedure codes for HF outpatients

This is follow up to a prior question: "Procedures Performed During Hospitalization";.

I am entering the HF outpatient data. When I am entering the procedure codes, am I looking for procedures that were done the day of the outpatient visit such as an ECHO or stress test? Or am I looking for any procedures that were done in the hospital at any time within this past year….OR do I need to enter both (all procedure codes done in the last year as well as any procedures done during the outpatient visit?

Thank you, Michele

Answer:

Thanks for the question. When you are looking at procedures for the OP, if they do not have one done during that visit, that is ok, most patients may not have a procedure done during the OP visit.

With regard to the LVF and the ejection fractions which are needed to determine if the patient will be part of the population for certain measures (e.g.,ACHF-01a, b, c,) this determination can me made anytime prior to the OP visit. Most likely the pt will already have had a echo (etc) to determine thier EF.

If the pt has had the procedure done prior to the OP visit, you do not need to enter a procedure and the date the test was done, so you do not have to go back to the medical record and enter all procedures that were done. If the pt should have a procedure done during the OP visit, then you would enter that one, or leave the field blank.

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: ACHF,
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