Venous Thromboembolism (VTE)

Venous Thromboembolism (VTE) Initial Patient Population

The VTE measure set is unique in that there is only one sub-population within the measure set.

Initial Patient Population Definitions Table

Measures	Initial Patient Population definition
VTE-6	The count of all patients in sub-population 3

The VTE sub-population utilizes four data elements:

• Admission Date
• Birthdate
• Discharge Date
• ICD-10-CM Other Diagnosis Code

Patients admitted to the hospital for inpatient acute care are included in the VTE ICD sub-populations if they have:
1 – No VTE sub-population – is retired.
2 – Principal VTE sub-population – is retired.
3 - Other VTE Only sub-population – Patients with an ICD-10-CM Other Diagnosis Code as defined in Appendix A, Tables 7.03 and 7.04, a Patient Age (Admission Date minus Birthdate) greater than or equal to 18 years, and a Length of Stay (Discharge Date minus Admission Date) less than or equal to 120 days. The patients cannot have an ICD-10-CM Principal Diagnosis Code as defined in Appendix A, Tables 7.03 and 7.04.

Initial Patient Population Algorithm

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Venous Thromboembolism (VTE) Initial Patient Population Algorithm Narrative

Variable Key: Patient Age, Initial Patient Population Reject Case Flag and Length of Stay

1. Start VTE Initial Patient Population logic sub-routine. Process all cases that have successfully reached the point in the Data Processing Flow which calls this Initial Patient Population Algorithm. Do not process cases that have been rejected before this point in the Data Processing Flow.
   
2. Calculate Patient Age. Patient Age, in years, is equal to the Admission Date minus the Birthdate. Use the month and day portion of admission date and birthdate to yield the most accurate age.
   
3. Check Patient Age:
   
   1. If the Patient Age is less than 18 years, the patient is not in any VTE subpopulation and is not eligible to be sampled for any VTE sub-population. Set the Initial Patient Population Reject Case Flag to equal Yes. Return to Data Processing Flow section.
      
   2. If the Patient Age is greater or equal to 18 years, continue processing and proceed to Length of Stay Calculation.
      
4. Calculate the Length of Stay. Length of Stay, in days, is equal to the Discharge Date minus the Admission Date.
   
5. Check Length of Stay:
   
   1. If the Length of Stay is greater than 120 days, the patient is not in any VTE sub-population and is not eligible to be sampled for any VTE subpopulation. Set the Initial Patient Population Reject Case Flag to equal Yes. Return to Data Processing Flow section.
      
   2. If the Length of Stay is less than or equal to 120 days, continue processing and proceed to ICD-10-CM Principal Diagnosis Code.
      
6. Check ICD-10-CM Principal Diagnosis Code
   
   1. If the ICD-10-CM Principal Diagnosis Code is on Table 7.03 or 7.04, the patient is not in any VTE sub-population. Set the Initial Patient Population Reject Case Flag to equal Yes. Return to Data Processing Flow section.
      
   2. If the ICD-10-CM Principal Diagnosis Code is not on Table 7.03 or 7.04, continue processing and proceed to ICD-10-CM Other Diagnosis Code.
      
7. Check ICD-10-CM Other Diagnosis Code
   1. If at least one of the ICD-10-CM Other Diagnosis Codes is on Table 7.03 or 7.04, the patient is in the 3rd or Other VTE Only sub-population. Note: Other VTE Only is not sampled. Set the Initial Patient Population Reject Case Flag to equal No. Include the patient in the Initial Patient Population of the appropriate measures. Return to Transmission Data Flow section.
      
   2. If none of the ICD-10-CM Other Diagnosis Code is on Table 7.03 or 7.04, the patient is not in any of the VTE sub-populations and is not eligible to be sampled for any VTE sub-population. Set Initial Patient Population Reject Case Flag to equal Yes. Return to Data Processing Flow section.
      

Sample Size Requirements

Hospitals that choose to sample have the option of sampling quarterly or sampling monthly. A hospital may choose to use a larger sample size than is required. Hospitals whose Initial Patient Population size is less than the minimum number of cases per quarter/month for the sub-population cannot sample that sub-population. Regardless of the option used, hospital samples must be monitored to ensure that sampling procedures consistently produce statistically valid and useful data. Due to exclusions and contraindications, hospitals selecting sample cases MUST submit AT LEAST the minimum required sample size.

For information concerning how to perform sampling, refer to the Population and Sampling Specifications section in this manual.

Quarterly Sampling
Sampling for VTE Sub-population 3 – The Other VTE Only sub-population is not eligible for sampling and will use the entire Initial Patient Population for reporting.

Monthly Sampling
Sampling for VTE Sub-population 3 – The Other VTE Only sub-population is not eligible for sampling and will use the entire Initial Patient Sub-Population for reporting.