Yes, it seems if you use registry reporting you would use 4559F & 4255F, but I haven't had chance to review any articles describing how this revised measure is reported. It seems they did away with G9363 or G9362, lower the temperature threshold from 96.8 (36) to 95.9 (35.5), and removed the claims reporting option. I thought they felt this measure was topped out and were removing it.
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DENOMINATOR: All patients, regardless of age, who undergo surgical or therapeutic procedures under general or neuraxial anesthesia of 60 minutes duration or longer
AND Anesthesia of 60 minutes duration or longer: 4255F
AND NOT Monitored Anesthesia Care (MAC): G9654
Performance Met: At least 1 body temperature measurement equal to or greater than 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (4559F)
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Measure #424 (NQF 2671): Perioperative Temperature Management ? National Quality Strategy
Domain: Patient Safety
2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY
DESCRIPTION: Percentage of patients, regardless of age, who undergo surgical or therapeutic procedures under general or neuraxial anesthesia of 60 minutes duration or longer for whom at least one body temperature greater than or equal to 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) was recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time
INSTRUCTIONS: This measure is to be reported each time any procedure including surgical, therapeutic or diagnostic is performed under general or neuraxial anesthesia during the reporting period. There is no diagnosis associated with this measure. It is anticipated that clinicians who provide the listed anesthesia services as specified in the denominator coding will submit this measure.
Measure Reporting via Registry: CPT codes, HCPCS codes, quality-data codes and patient demographics are used to identify patients who are included in the measure?s denominator. The listed numerator options are used to report the numerator of 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.
DENOMINATOR: All patients, regardless of age, who undergo surgical or therapeutic procedures under general or neuraxial anesthesia of 60 minutes duration or longer
Denominator Instructions: The anesthesia time used for this measure should be the time recorded in the anesthesia record.
Denominator Criteria (Eligible Cases): All patients, regardless of age AND Patient encounter during the reporting period (CPT): 00100, 00102, 00103, 00104, 00120, 00124, 00126, 00140, 00142, 00144, 00145, 00147, 00148, 00160, 00162, 00164, 00170, 00172, 00174, 00176, 00190, 00192, 00210, 00211, 00212, 00214, 00215, 00216, 00218, 00220, 00222, 00300, 00320, 00322, 00326, 00350, 00352, 00400, 00402, 00404, 00406, 00410, 00450, 00454, 00470, 00472, 00474, 00500, 00520, 00522, 00524, 00528, 00529, 00530, 00532, 00534, 00537, 00539, 00540, 00541, 00542, 00546, 00548, 00550, 00560, 00600, 00604, 00620, 00625, 00626, 00630, 00632, 00635, 00640, 00670, 00700, 00702, 00730, 00740, 00750, 00752, 00754, 00756, 00770, 00790, 00792, 00794, 00796, 00797, 00800, 00802, 00810, 00820, 00830, 00832, 00834, 00836, 00840, 00842, 00844, 00846, 00848, 00851, 00860, 00862, 00864, 00865, 00866, 00868, 00870, 00872, 00873, 00880, 00882, 00902, 00904, 00906, 00908, 00910, 00912, 00914, 00916, 00918, 00920, 00921, 00922, 00924, 00926, 00928, 00930, 00932, 00934, 00936, 00938, 00940, 00942, 00944, 00948, 00950, 00952, 01112, 01120, 01130, 01140, 01150, 01160, 01170, 01173, 01180, 01190, 01200, 01202, 01210, 01212, 01214, 01215, 01220, 01230, 01232, 01234, 01250, 01260, 01270, 01272, 01274, 01320, 01340, 01360, 01380, 01382, 01390, 01392, 01400, 01402, 01404, 01420, 01430, 01432, 01440, 01442, 01444, 01462, 01464, 01470, 01472, 01474, 01480, 01482, 01484, 01486, 01490, 01500, 01502, 01520, 01522, 01610, 01620, 01622, 01630, 01634, 01636, 01638, 01650, 01652, 01654, 01656, 01670, 01680, 01682, 01710, 01712, 01714, 01716, 01730, 01732, 01740, 01742, 01744, 01756, 01758, 01760, 01770, 01772, 01780, 01782, 01810, 01820, 01829, 01830, 01832, 01840, 01842, 01844, 01850, 01852, 01860, 01924, 01925, 01926, 01930, 01931, 01932, 01933, 01935, 01936, 01951, 01952, 01961, 01962, 01963, 01965, 01966
AND Anesthesia of 60 minutes duration or longer: 4255F AND NOT Monitored Anesthesia Care (MAC): G9654
NUMERATOR: Patients for whom at least one body temperature greater than or equal to 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) was recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time
Numerator Options: Performance Met: At least 1 body temperature measurement equal to or greater than 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (4559F)
OR
Medical Performance Exclusion: Documentation of one of the following medical reason(s) for not achieving at least 1 body temperature measurement equal to or greater than 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (e.g., Emergency cases, Intentional hypothermia, etc.) (4559F with 1P)
OR
Performance Not Met: At least 1 body temperature measurement equal to or greater than 35.5 degrees Celsius (or 95.9 degrees Fahrenheit) recorded within the 30 minutes immediately before or the 15 minutes immediately after anesthesia end time (4559F with 8P)
RATIONALE: A drop in core temperature during surgery, known as p
perioperative hypothermia, can result in numerous adverse effects, which can include adverse myocardial outcomes, subcutaneous vasoconstriction, increased incidence of surgical site infection, and impaired healing of wounds. The desired outcome, reduction in adverse surgical effects due to perioperative hypothermia, is affected by maintenance of normothermia during surgery. Unintended perioperative hypothermia occurs in up to 20% of surgical patients. An observational cohort study in a pediatric setting found that more than 50% of children experienced intraoperative hypothermia. Pediatric patients undergoing major surgery were at greater risk of intraoperative hypothermia.
CLINICAL RECOMMENDATION STATEMENTS: Preadmission/Preoperative Recommendations
Assessment: Assess for risk factors for perioperative hypothermia (Class I, Level C); Measure patient temperature on admission (Class I, Level C); Determine patient?s thermal comfort level (Class I, Level C); Assess for signs and symptoms of hypothermia (Class I, Level C); Document and communicate all risk factor assessment findings to all members of the anesthesia/surgical team (Class I, Level A)
Version 10.0 CPT only copyright 2015 American Medical Association. All rights reserved. 11/17/2015 Page 3 of 7
Interventions: Implement passive thermal care measures (Class I, Level B); Maintain ambient room temperature at or above 24 degrees Celsius (Class I, Level C); Institute active warming for patients who are hypothermic (Class IIb, Level B); Consider preoperative warming to reduce the risk of intra/postoperative hypothermia (Class IIb, Level B)
Intraoperative Recommendations Assessment: Identify patient?s risk factors for unplanned preoperative hypothermia (Class I, Level C); Frequent intraoperative temperature monitoring should be considered in all cases (Class I, Level C); Assess for signs and symptoms of hypothermia (Class IIb, Level C); Determine patient?s thermal comfort level (Class IIb, Level C); Document and communicate all risk factor assessment findings to all members of the anesthesia/surgical team (Class I, Level A)
Interventions: Limit skin exposure to lower ambient environmental temperatures (Class I, Level C); Initiate passive warming measures (Class I, Level C); Maintain ambient room temperature from 20-25 degrees Celsius based on AORN and architectural recommendations (Class I, Level C); Patients undergoing a procedure with an anticipated anesthesia time greater than 30 minutes (Class I, Level C) and/or who are hypothermic preoperatively (Class I, Level A), and/or patients at risk for hypothermia (Class I, Level C) or at increased risk for suffering its complications (Class I, Level C) ? Forced air warming should be implemented (Class I, Level A); There is evidence to suggest that alternative active warming measures may maintain normothermia when used alone or in combination with forced air warming (Class IIb, Level B). These warming measures include: Warmed IV fluids (Class IIa, Level B), Warmed irrigation fluids (Class IIb, Level B), Circulating water garments (Class IIb, Level B), Circulating water mattresses (Class IIb, Level B), Radiant heat (Class IIb, Level B), Gel pad surface warming (Class IIa, Level B), Resistive heating (Class IIa, Level B) (ASPAN, 2010)
Maintenance of body temperature in a normothermic range is recommended for most procedures other than during periods in which mild hypothermia is intended to provide organ protection (e.g., during high aortic cross-clamping) (Class I Recommendation, Level of Evidence B) (ACC/AHA, 2007)
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The Measures, while copyrighted, can be reproduced and distributed, without modification, for noncommercial purposes, e.g., use by health care providers in connection with their practices. Commercial use is defined as the sale, license, or distribution of the Measures for commercial gain, or incorporation of the Measures into a product or service that is sold, licensed or distributed for commercial gain.
Commercial uses of the Measures require a license agreement between the user and the American Medical Association (AMA), [on behalf of the Physician Consortium for Performance Improvement? (PCPI?)] or American Society of Anesthesiologists (ASA). Neither the AMA, ASA, PCPI, nor its members shall be responsible for any use of the Measures.
The AMA?s, PCPI?s and National Committee for Quality Assurance?s significant past efforts and contributions to the development and updating of the Measures is acknowledged. ASA is solely responsible for the review and enhancement (?Maintenance?) of the Measures as of May 15, 2014. ASA encourages use of the Measures by other health care professionals, where appropriate.
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? 2014 American Medical Association and American Society of Anesthesiologists. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
Limited proprietary coding is contained in the Measure specifications for convenience. Users of the proprietary code sets should obtain all necessary licenses from the owners of these code sets. The AMA, ASA, the PCPI and its
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members disclaim all liability for use or accuracy of any Current Procedural Terminology (CPT?) or other coding contained in the specifications.
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