VTE-6

[Graham Moore]

Good afternoon,

I have a VTE core measure case where a psych patient admitted with bipolar d/o developed a DVT during their admission.  They received the appropriate tx for the DVT; however, is failing for the VTE-6 measure since they did not receive VTE prophylaxis between arrival and the dx of their DVT.  I thought in the past that mental d/o were excluded from the VTE prophylaxis component of the measure.  Can anyone provide clarification?  I just want to be sure that this patient is failing VTE-6 appropriately and it is not a problem with the SCIP logic with my core measure vendor.

Thanks,
Graham

[Peggy Schultes]

Was this billed as an acute care admission or as a psychiatric admission?

Inpatient acute care patients and inpatient psychiatric patients are billed under different CCNs. The acute care inpatient core measures (such as VTE) only apply to patients billed under the acute care inpatient CCN. Since the inpatient psychiatric patients are not billed as acute care, they are excluded from the VTE population. The inpatient psychiatric measures apply to the patients billed under the inpatient psychiatric CCN (these patients are in distinct psychiatric units in our hospital).

More information can be found here:
https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/InpatientPsychFacilPPS/index.html?redirect=/InpatientPsychFacilPPS/

I hoe this is helpful!