Performance Measurement Network

Question: CSTK 4 Denominator Population

As the performance measurement name and rationale reference Intracerebral Hemorrhage (ICH, and the included population for the denominator references table 8.2 (as does the algorithm and not table 8.2b, I am in need of clarification as to whether or not SAH patients are to be included in this measure. In other words, might the references to 8.2 be a typo that should read 8.2b?

Answer:

The reference to Table 8.2 is not a typo. The initial patient population for CSTK-04 is CSTK-02 Sub-Population 2 Hemorrhagic Stroke Patients. (Please refer to the CSTK initial patient population and measure algorithms. Patients with a principal diagnosis of both 430 and 431 are included in the denominator population (Table 8.2.)

The key decision in this algorithm is "Admitting Diagnosis" because it is the admitting rather than principal diagnosis that continues the case to flow down. Patients on Table 8.2c will continue to be included in the measure population. Patients not on Table 8.2c are excluded at this point. Table 8.2c does not include 430 SAH but does include other hemorrhagic codes in addition to 431 ICH. At the end of the day, it's the admitting diagnosis that determines the final patient population for this measure and not the principal diagnosis.

Admitting Diagnosis is a new data element for CSTK and not used in STK core.))

Question Details
Focus area(s): Chart Abstracted Measure Specifications – Clinical
Related documents: CSTK-04, ICD-9-CM Principal Diagnosis Code, Appendix: Code tables
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