Appendix H
Miscellaneous Tables
Last Updated: Version 3.3
Index
Number
Tables 1.1-2.0
Table 2.1
Table 2.2
Table 2.3
Table 2.5
Table 2.6
Table 2.7
Name
Reserved for Future Use
VTE Prophylaxis Inclusion Table
Reserved for Future Use
VTE Parenteral Therapy Table
Retired
Qualifiers and Modifiers Table
Allowable Measure Set Combinations
Page
N/A
Appendix H-2
N/A
Appendix H-4
N/A
Appendix H-5
Appendix H-6
Specifications Manual for National Hospital Inpatient Quality Measures
Discharges 01-01-13 (1Q13) through 06-30-13 (2Q13)
Appendix H-1
Tables 1.1-2.0 – Reserved for Future Use
Last Updated: Version 4.0a
Table 2.1 VTE Prophylaxis Inclusion Table
VTE Prophylaxis
Inclusion/Synonyms
Coumadin/ Warfarin
Coumadin
Jantoven
Warfarin
Warfarin Sodium
Graduated Compression
Anti-Embolism stockings
Stockings (GCS)
Anti-thrombosis stockings
- Knee or
Elastic support hose
thigh high
Graduated compression elastic stockings
Jobst stockings
Surgical hose
TED hose (TEDs)
White hose
Thrombosis stockings
Factor Xa Inhibitor
Arixtra
Fondaparinux sodium
1
Oral Factor Xa Inhibitor
Rivaroxaban
Xarelto
Low Dose Unfractionated
HEP
Heparin (LDUH)
Heparin
- Include only Heparin given Heparin Na
by the subcutaneous (SQ,
Heparin Sod
Subcu, SC, SubQ) route
Heparin Sodium
Heparin Sodium Inj.
Heparin Sodium Inj. Pork
Heparin Subcu/SQ/SC/SubQ
Low Molecular Weight
Dalteparin
Heparin (LMWH)
Enoxaparin
Fragmin
Innohep
Lovenox
Tinzaparin
Intermittent Pneumatic
AE pumps (anti-embolic pumps)-calf/thigh
Compression Device (IPC) Alternating Leg Pressure (ALP)
Athrombic pumps-calf/thigh
Continuous Enhanced Circulation Therapy (CECT)
DVT boots-calf/thigh
EPC cuffs/ stockings-External pneumatic compressioncalf/thigh
Flotron/Flotron DVT system-thigh
Impulse pump-thigh
Intermittent pneumatic compression stockings
Intermittent compression device (ICD)
Specifications Manual for National Hospital Inpatient Quality Measures
Discharges 01-01-13 (1Q13) through 06-30-13 (2Q13)
Appendix H-2
Table 2.1 VTE Prophylaxis Inclusion Table
VTE Prophylaxis
Inclusion/Synonyms
KCI stockings
Leg pumpers
PAS (Pulsatile anti-embolic stockings)
Plexipulse-calf/thigh
Pneumatic intermittent impulse compression device
Rapid inflation asymmetrical compression (RIAC)
devices
Sequential compression device
Sequential pneumatic hose
Thromboguard
Thrombus pumps-calf/thigh
Vascutherm
VasoPress DVT System
Venodyne boots-calf/thigh
Venous Foot Pump (VFP)
AE pumps-foot only
A-V impulse system
Foot pump
Kendall AV impulse (foot)
Kendall boots
Plantar venous plexus pump-foot only
Plexiboots-foot only
Pneumoboots-foot only
SC boots-foot only
SCD boots-foot only
Venous foot pump
Note: This table is not meant to be an inclusive list of all available prophylaxis;
rather it represents current information available at the time of publication.
1
The U.S. Food and Drug Administration has approved Xarelto (rivaroxaban) to reduce
the risk of blood clots, deep vein thrombosis (DVT) and pulmonary embolism (PE)
following knee or hip replacement surgery ONLY.
Specifications Manual for National Hospital Inpatient Quality Measures
Discharges 01-01-13 (1Q13) through 06-30-13 (2Q13)
Appendix H-3
Table 2.2 – Reserved for Future Use
Last Updated: Version 4.0
Table 2.3 VTE Parenteral Therapy Table
VTE Prophylaxis
Inclusion/Synonyms
Direct Thrombin Inhibitors Argatroban (Acova)
- argatroban
Bivalirudin (Angiomax)
- bivalirudin
Lepirudin (recombinant hirudin)(Refludan)
- lepirudin
Factor Xa Inhibitor
Unfractionated Heparin
(UFH)
- intravenous (IV)
- subcutaneous (fixed dose
or monitored)
Low Molecular Weight
Heparin (LMWH)
Arixtra
Fondaparinux sodium
HEP
Heparin
Heparin Na
Heparin Sod
Heparin Sodium
Heparin Sodium Inj.
Heparin Sodium Inj. Pork
Heparin Subcu/SQ/SC
Dalteparin
Enoxaparin
Fragmin
Innohep
Lovenox
Tinzaparin
Specifications Manual for National Hospital Inpatient Quality Measures
Discharges 01-01-13 (1Q13) through 06-30-13 (2Q13)
Appendix H-4
Table 2.5 – Retired
Last Updated: Version 4.2
Table 2.6 Qualifiers and Modifiers Table
Qualifiers
Modifiers
 Qualifiers are words used as adjectives to indicate some
 Quantitative
uncertainty about whether or not a condition really exists.
modifiers are
adjectives that
 The following qualifiers should be abstracted as negative
quantitatively
findings, unless otherwise specified in a data element’s
describe a condition.
guidelines – Consider this list all-inclusive:
 The following
 And/or (+/-; e.g., “ST abnormalities consistent with
quantitative
ischemia and/or injury”), except when comparing only
modifiers should be
Inclusions (e.g., “ST segment elevation and/or STEMI”)
abstracted as
 Cannot exclude
negative findings,
 Cannot rule out
unless otherwise
 Could/may/might be
specified in a data
 Could/may/might have
element’s guidelines Could/may/might have been
Consider this list
 Could/may/might have had
all-inclusive:
 Could/may/might indicate
 Borderline
 Or, except when comparing only Inclusions
 Insignificant/not
 Possible
significant/no
 Questionable (?)
significant
 Risk of
 Minor
 Ruled out (r’d/o, r/o’d)
 Scant
 Suggestive of
 Slight
 Suspect
 Sub-clinical
 Suspicious
 Subtle
 Vs., except when comparing only Inclusions
 Trace
Example:
 Trivial
If the in-hospital echocardiogram report documents
“questionable LVSD,” this should be abstracted as a
negative finding.
Note: These guidelines apply only to those data elements that refer to them in
their Guidelines for Abstraction Exclusion list(s).
Specifications Manual for National Hospital Inpatient Quality Measures
Discharges 01-01-13 (1Q13) through 06-30-13 (2Q13)
Appendix H-5
Last Updated: Version 4.2
Table 2.7 Allowable Measure Set Combinations
Can combine
Cannot combine
AMI
HF
PN
STK
≥ 18 ≥ 18 ≥ 18 ≥ 18
years years years years
Principal Procedure or Principal/Other
Diagnosis
P Dx
AMI
≥ 18 yrs
P Dx
HF
≥ 18 yrs
P Dx
No
PN
≥ 18 yrs
P Dx
No
STK
≥ 18 yrs
P Dx
No
1
CAC
2 to < 18 yrs P Dx
No
VTE - No VTE
≥ 18 yrs
P/O Dx ≥ 18
VTE – O Dx
≥ 18 yrs
O Dx
≥ 18
VTE
VTE – P Dx VTE ≥ 18 yrs
P Dx
No
SCIP
No age
P/O Px ≥ 18
limitation
ED
No age
All Dx
≥ 18
limitation
IMM
No age
All Dx
≥ 18
limitation
1
TOB
No age
All Dx
≥ 18
limitation
1
SUB
No age
All Dx
≥ 18
limitation
P Dx
No
P Dx
No
No
P Dx
No
No
No
No
No
No
≥ 18
≥ 18
No
No
≥ 18
≥ 18
No
≥ 18
≥ 18
No
≥ 18
No
≥ 18
No
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
1
CAC
2 to
< 18
years
P Dx
No
No
No
No
VTE No
VTE
≥ 18
years
VTE –
O Dx
VTE
≥ 18
years
VTEP Dx
1
VTE
SCIP
ED
IMM
TOB
≥ 18 No age No age No age
No age
years limitation limitation limitation limitation
SUB
No age
limitation
P/O Dx
≥ 18
≥ 18
≥ 18
≥ 18
No
O Dx
≥ 18
≥ 18
≥ 18
≥ 18
No
P Dx
P Px
All Dx
All Dx
No
≥ 18
≥ 18
≥ 18
No
≥ 18
≥ 18
≥ 18
No
≥ 18
≥ 18
≥ 18
No
≥ 18
≥ 18
≥ 18
No 2 to < 18 2 to < 18 2 to < 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
All Dx
≥ 18
≥ 18
≥ 18
≥ 18
2 to < 18
≥ 18
≥ 18
All Dx
≥ 18
≥ 18
≥ 18
≥ 18
2 to < 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
≥ 18
Yes
≥ 18
Yes
≥ 18
Yes
≥ 18
≥ 18
≥ 18
Yes
Yes
Yes
Yes
≥ 18
≥ 18
≥ 18
Yes
Yes
Yes
Yes
≥ 18
≥ 18
≥ 18
Yes
Yes
Yes
≥ 18
≥ 18
≥ 18
Yes
Yes
Yes
No
No
No
2 to <
18
2 to <
18
2 to <
18
2 to <
18
2 to <
18
≥ 18
≥ 18
Yes
1
Yes
Yes
1
These measure sets are Joint Commission Only. The measure set combinations containing these sets are only applicable for the
transmission of data to The Joint Commission.
Specifications Manual for National Hospital Inpatient Quality Measures
Discharges 01-01-13 (1Q13) through 06-30-13 (2Q13)
Appendix H-6