TJC2026A Note for "Postoperative Functional/Health Status Assessment"

• Topic Version for Release TJC2026A: 31
• Topic has changed since last release: Compare versions

Rationale

Updated Denominator Excluded Populations and added Pre-Collection Mortality data element to exclude patients who expire after the principal procedure and prior to the end of the data collection period. Updated Table 14.10 name to be more inclusive of additional fracture codes added.

Description

Denominator:

Excluded Populations

Change from:

Table 14.10 (Femur, hip, pelvic fracture)

To:

Table 14.10 (Fractures)

(last bullet)

Add:

• Documentation that the patient expired after the principal procedure and prior to the end of the data collection period

Data Elements (last bullet)

Add: Pre-Collection Mortality

Algorithm:

Add:
New check box for Pre-Collection Mortality after 2nd check box for ICD-10-CM Principal or Other Diagnosis Codes.

If Pre-Collection Mortality is missing, the branch will go to Measure Category Assignment of X.
If Pre-Collection Mortality equals Y, the branch will go to Measure Category Assignment of B.
If Pre-Collection Mortality equals N, the branch will go to Check CPT Code Procedure Date.

Narrative:

Change:
Step 2a, 2b from:

a. If ICD-10-CM Principal or Other Diagnosis Codes is At least one on Table 14.10, the case will proceed to a Measure Category Assignment of B and will be Not In Measure Population. For Overall Rate (THKR-OP-5a). Proceed to Step 8.
b. If ICD-10-CM Principal or Other Diagnosis Codes is None on Table 14.10, the case will continue processing and proceed to Check CPT Code Procedure Date.

To:
a. If ICD-10-CM Principal or Other Diagnosis Codes is At least one on Table 14.10, the case will proceed to a Measure Category Assignment of B and will be Not In Measure Population. For Overall Rate (THKR-OP-5a). Proceed to Step 9.
b. If ICD-10-CM Principal or Other Diagnosis Codes is None on Table 14.10, the case will continue processing and proceed to Check Pre-Collection Mortality.

Add: Step 3:
3. Check Pre-Collection Mortality
a. If Pre-Collection Mortality is missing, the case will proceed to a Measure Category Assignment of X and Case Will Be Rejected. For Overall Rate (THKR-OP-5a). Proceed to Step 9.
b. If Pre-Collection Mortality equals Y, the case will proceed to a Measure Category Assignment of B and will be Not In Measure Population. For Overall Rate (THKR-OP-5a). Proceed to Step 9.
c. If Pre-Collection Mortality equals N, the case will continue processing and proceed to Check CPT Code Procedure Date.

Change all step number after step 3.