MEASURE DESCRIPTION:
Percentage of patients, regardless of age, that undergo primary total knee arthroplasty for whom Percentage of patients, aged 18 years and older, undergoing a procedure using cardiopulmonary bypass who did not have a documented intraoperative pulmonary artery, oropharyngeal, or nasopharyngeal temperature ≥37.0 degrees Celsius during the period of cardiopulmonary bypass.
NQS DOMAIN/MEANINGFUL MEASURES AREA:
Patient Safety/Preventable Healthcare Harm
MEASURE TYPE:
Outcome
HIGH PRIORITY STATUS:
Yes
INVERSE MEASURE:
No
RISK ADJUSTED:
No
INSTRUCTIONS:
This measure is to be reported each time a patient undergoes a cardiac operation using cardiopulmonary bypass during the reporting period. It is anticipated that qualified anesthesia providers and eligible clinicians who provide denominator-eligible services will submit this measure.
Measure Reporting via the Qualified Clinical Data Registry
Patient demographics and CPT codes are used to identify patients who are included in the measure denominator. G-codes and Registry Codes are used to capture the numerator.
DENOMINATOR:
All patients aged 18 years or older, who undergo a procedure using cardiopulmonary bypass
- Denominator Criteria (Eligible Cases):
Patient aged 18 years and older
AND
Patient encounter during the reporting period (CPT):
00562, 00563, 00567, 00580
- Denominator Exclusions:
Procedure reduced or discontinued prior to initiation of CPB as indicated on the claim by Modifier 52 or Modifier 53
NUMERATOR:
Patients who did not have an intraoperative pulmonary artery, oropharyngeal, or nasopharyngeal temperature ≥37.0 degrees Celsius during cardiopulmonary bypass
-
Numerator Options:
Performance Met: All intraoperative pulmonary artery, oropharyngeal, or nasopharyngeal temperatures <37.0 degrees Celsius during cardiopulmonary bypass (11A11)
OR
Performance Not Met: At least one intraoperative pulmonary artery, oropharyngeal, or nasopharyngeal temperature ≥37.0 degrees Celsius (11A12)
OR
No documented pulmonary artery, oropharyngeal, or nasopharyngeal temperatures during cardiopulmonary bypass (11A13)
RELEVANT FIELDS:
-
Date of service
- Date of birth
- ASA CPT code
- CBP performed
- Hypothermia status
RATIONALE:
Appropriate temperature management in the setting of cardiopulmonary bypass (CPB) is important to avoid cerebral hyperthermia and associated cerebral injury. Studies have associated cerebral hyperthermia with complications such as cognitive dysfunction, mediastinitis, and acute kidney injury. Through careful monitoring, good communication with perfusionists, and the assurance of appropriate rewarming strategies, anesthesiologists can prevent cerebral hyperthermia.
REPORTING CODES: