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What is the normothermia quality measure?
Free CE credit on CMS Quality Measure Reporting Requirements. Watch now.
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ASC-13: Normothermia Outcome
On Jan. 1, 2018, data collection began for the Ambulatory Surgical Center Quality Reporting (ASCQR) program’s new normothermia outcomes measure, ASC-13. Data collected from Jan. 1 through Dec. 31, 2018 will be reported in 2019 and may impact the 2020 payment determination.1
- ASC-13: Normothermia Outcome
- ASC-14: Unplanned Anterior Vitrectomy
- ASC–15a: OAS CAHPS – About Facilities and Staff
- ASC–15b: OAS CAHPS – Communication About Procedure
- ASC–15c: OAS CAHPS – Preparation for Discharge and Recovery
- ASC–15d: OAS CAHPS – Overall Rating of Facility
- ASC–15e: OAS CAHPS – Recommendation of Facility.
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ASC-13: Normothermia Outcome is used to assess the percentage of patients having surgical procedures under general or neuraxial anesthesia of 60 minutes or more in duration who are normothermic within 15 minutes of arrival in the Post Anesthesia Care Unit (PACU).2 Time under anesthesia is defined as the difference, in minutes, between the time associated with the start of anesthesia and the time associated with the end of anesthesia.2
What the normothermia quality measure means for your ambulatory surgery center.
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Ambulatory surgery centers that do not meet program requirements, which include reporting of quality measure data for the ASCQR Program, may receive a reduction in their ASC payment update. Data for ASC-13 are to be submitted using a web-based tool located on the QualityNet Secure Portal at www.QualityNet.org.
While payment determination does not begin until 2020, the data collection period is already underway and continues throughout 2018.3 Having protocols in place to maintain normothermia throughout the perioperative process, including monitoring and documenting temperatures, is essential.
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Ambulatory surgery center checklist for the normothermia quality measure.
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- Defined process to manage the data collection
- Staff education including the prevention of inadvertent perioperative hypothermia
- Defined perioperative temperature management protocol
Frequently Asked Questions about the normothermia quality measure.²-³
ASCQR General Information
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Are the ASCs with less than 240 Medicare cases per year still exempt from reporting?
Yes, ASCs with less than 240 Medicare cases per year are still exempt.
ASCs that have fewer than 240 Medicare claims (primary plus secondary payer) per year during a reporting period for a payment determination year would not be required to participate in the ASCQR Program for the subsequent reporting period for that subsequent payment determination year. This includes all program requirements, both claims-based and measures entered via a web-based tool.
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We are a small ASC receiving our certification in August 2016. What are the reporting expectations?
The Centers for Medicare & Medicaid Services (CMS) has designated HSAG as the Ambulatory Surgical Center Quality Reporting (ASCQR) Program Support Contractor. HSAG provides technical support and feedback to assist ASCs with quality data reporting.
Submit all questions about the ASCQR Program to HSAG at Outpatient and ASC Quality Reporting—Questions/Answers or by calling, toll-free, (866) 800-8756 weekdays from 7 a.m. to 6 p.m. Eastern Time.
Documents that must be submitted to the ASCQR Support Contractor by conventional mail should be sent to:
HSAG
Attn: ASCQR Support Contractor
3000 Bayport Dr., Suite 300
Tampa, FL 33607 -
Where do I go for more information on the normothermia quality measure?
www.qualityreportingcenter.com for general ASC quality reporting program information
www.ascquality.org (PDF, 737 KB) for information specific to the normothermia measure
www.qualitynet.org for information about how to report data to CMS
Measure Definitions
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What is the definition of normothermia that CMS is using?
Patients who are under general or neuraxial anesthesia of 60 minutes or more in duration who are normothermic within 15 minutes of arrival to the PACU.
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What is the temperature range for the normothermia measure?
The numerator states a temperature equal to or greater than 96.8 degrees Fahrenheit/36 degrees Celsius.
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Concerning the normothermia measure, if the patient's temperature is taken upon arrival to PACU and the temperature is below 96.8, can the temperature be taken more than once in the 15 minute period to allow for warming of the patient?
Yes, patients who were normothermic within 15 minutes of arrival in the PACU are included in the numerator, so any temperature within the 15 minute time frame can be used to meet the measure specifications. If the patient's temperature was greater than or equal to 96.8°F (36°C) within 15 minutes of the time into PACU, the requirements of the measure have been met.
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Our surgery center does not do general or neuraxial anesthesia. How does the ASC-13 affect us? What information are we to submit?
It is not necessary to track patients who do not undergo general or neuraxial anesthesia. The measure excludes: patients who did not have general or neuraxial anesthesia, patients whose length of anesthesia is less than 60 minutes, and patients with physician/advanced practice nurse/physician assistant documentation of intentional hypothermia for the procedure performed.
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Deep sedation with propofol is not being considered as general anesthesia...correct?
Per the measure specifications, general anesthesia is defined as a drug-induced loss of consciousness during which the patient is not arousable, even by painful stimulation. Depending on the dose administered, propofol may in-fact be used for moderate sedation, monitored anesthesia care, and the induction/maintenance of general anesthesia. The ASC-13 measure only includes procedures performed under general or neuraxial anesthesia of 60 minutes or more in duration and, as a result, only procedures in which propofol is used as a general anesthetic for 60 minutes or more would be included in this measure.
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What if the temperature is not recorded within the initial 15 minutes?
If the temperature is not recorded within 15 minutes, then the measure's numerator criteria would not be met.
Implementation Process
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When will detailed specifications, including the algorithms, for ASC-13 be available?
The Specifications Manual will become public 6 months prior to when the data collection period is to begin. The January 2018 Specifications Manual will be posted on QualityNet in July 2017.
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To clarify: ASC-13 measure begins with 1/1/18 discharges for the 2020 payment year?
For ASC-13, the data collection period would be the calendar year 2 years prior to the applicable payment determination year. For example, for the calendar year 2020 payment determination, the data collection period would be calendar year 2018. ASCs will submit this data to CMS during the time period of January 1 to May 15 in the year prior to the affected payment determination year. For example, for the calendar year 2020 payment determination, the submission period would be January 1, 2019 to May 15, 2019.
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Your ASC can Own the Zone
With the introduction of proactive normothermia management, made possible with the 3M™ Bair Hugger™ normothermia system, we are helping clinicians Own the Zone and maintain normothermia for every surgical patient, from the second your patient enters pre-op until the moment that patient is discharged.
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Request a Normothermia Assessment
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