High Priority MeasureNo
Percentage of Rh-negative pregnant women aged 14-50 years at risk of fetal blood exposure who receive RhImmunoglobulin (Rhogam) in the emergency department (ED)
This measure is to be submitted each time a pregnant patient presents to the emergency department with complaints including blunt abdominal trauma, vaginal bleeding, ectopic pregnancy, and threatened or spontaneous abortion. Registries may utilize claims data to determine the emergency department discharge. Patients who present to the emergency department with these complaints should have documentation in the medical record of receiving an order for Rh-Immunoglobulin (Rhogam). It is anticipated that eligible clinicians who provide care in the emergency department will submit this measure. For registries using claims data, the Part B claim form place of service field must indicate that the encounter has taken place in the emergency department.
The listed denominator criteria is used to identify the intended patient population. The numerator options included in this specification are used to submit the quality actions allowed by the measure. The quality-data codes listed do not need to be submitted for registry-based submissions; however, these codes may be submitted for those registries that utilize claims data.
All pregnant female patients aged 14 to 50 years who are Rh-negative and at significant risk of fetal blood exposure
Denominator Criteria (Eligible Cases):
Female patients aged 14 to 50 years on date of encounter
Diagnosis for Rh-Negative (ICD-10-CM): O36.0110, O36.0111, O36.0190, O36.0191, O36.0910, O36.0911, O36.0990, O36.0991
Diagnosis of High Risk Pregnancy Complications (ICD-10-CM): O00.80, O00.81, O00.90, O00.91, O02.1, O03.1, O03.6, O04.6, O07.1, O08.1, O20.0, O20.8, O20.9, O26.891, O43.011, O43.019, O44.30, O44.50, O44.31, O44.51, O45.001, O45.009, O45.011, O45.019, O45.021, O45.029, O45.091, O45.099, O45.8X1, O45.8X9, O45.90, O45.91, O46.001, O46.011, O46.021, O46.8X1, O46.8X9, O46.90, O46.91
Patient encounter during the performance period (CPT): 99281, 99282, 99283, 99284, 99285, 99291
Place of Service Indicator: 23
(The Part B claim form Place of Service field must indicate emergency department)
Patients who receive an order for Rh-Immunoglobulin (Rhogam) in the ED
Numerator Instructions: This measure is to be submitted each time a patient meets the requirements as indicated in the denominator. In the clinical event a patient has documented receipt of Rhogam submit qualitydata code G8810.
Performance Met: Rh-immunoglobulin (Rhogam) ordered (G8809)
Denominator Exception: Rh-immunoglobulin (Rhogam) not ordered for reasons documented by clinician (e.g., patient had prior documented receipt of Rhogam within 12 weeks, patient refusal) (G8810)
Performance Not Met: Documentation Rh-immunoglobulin (Rhogam) was not ordered, reason not given (G8811)