2026 MIPS Measure #392: Cardiac Tamponade and/or Pericardiocentesis Following Atrial Fibrillation Ablation

Rate of cardiac tamponade and/or pericardiocentesis following atrial fibrillation ablation. This measure is submitted as four rates stratified by age and gender: Submission Age Criteria 1: Females 18-64 years of age Submission Age Criteria 2: Males 18-64 years of age Submission Age Criteria 3: Females 65 years of age and older Submission Age Criteria 4: Males 65 years of age and older

This measure is to be submitted a minimum of once per performance period for patients with atrial fibrillation ablation performed during the performance period. This measure may be submitted by Merit-based Incentive Payment System (MIPS) eligible clinicians who perform the quality actions described in the measure based on the services provided and the measure-specific denominator coding.

NOTE: Include only patients that have had atrial fibrillation ablation performed by November 30, 2024 for evaluation of cardiac tamponade and/or pericardiocentesis occurring within 30 days within the performance period. This will allow the evaluation of cardiac tamponade and/or pericardiocentesis complications within the performance period. A minimum of 30 cases is recommended by the measure owner to ensure a volume of data that accurately reflects provider performance; however, this minimum number is not required for purposes of QPP submission.

This measure will be calculated with 5 performance rates:

Females 18-64 years of age
Males 18-64 years of age
Females 65 years of age and older
Males 65 years of age and older
Overall percentage of patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days
MIPS eligible clinicians should continue to submit the measure as specified, with no additional steps needed to account for multiple performance rates. For accountability reporting in the CMS MIPS program, the rate for Submission Criteria 5 is used for performance.

All patients aged 18 years and older with atrial fibrillation ablation performed during the reporting period

SUBMISSION CRITERIA 1: Females 18-64 years old

SUBMISSION CRITERIA 2: Males 18-64 years old

SUBMISSION CRITERIA 3: Females 65 years of age and older

SUBMISSION CRITERIA 4: Males 65 years of age and older

AND

Diagnosis code for atrial fibrillation during the reporting period (ICD-10-CM): I48.0, I48.11, I48.19, I48.20, I48.21, I48.91

AND

Procedure code for atrial fibrillation ablation during the reporting period (ICD-10-PCS): 02583ZZ, 02584ZZ

WITHOUT

Telehealth Modifier (including but not limited to): GQ, GT, POS 02, POS 10

AND/OR

Ablation procedures that have been performed by November 30 of current performance period (CPT): 93656

The number of patients from the denominator with cardiac tamponade and/or pericardiocentesis occurring within 30 days following atrial fibrillation ablation

Numerator Instructions:
INVERSE MEASURE – A lower calculated performance rate for this measure indicates better clinical care or control. The “Performance Not Met” numerator option for this measure is the representation of the better clinical quality or control. Submitting that numerator option will produce a performance rate that trends closer to 0%, as quality increases. For inverse measures a rate of 100% means all of the denominator eligible patients did not receive the appropriate care or were not in proper control.

Performance Met: Patients with cardiac tamponade and/or pericardiocentesis occurring within 30 days (G9408)

OR

Performance Not Met: Patients without cardiac tamponade and/or pericardiocentesis occurring within 30 days (G9409)

Cardiac tamponade is one of the most serious complications of atrial fibrillation ablation that can lead to substantial morbidity due to a significant drop in the cardiac output and blood pressure leading to hypo-perfusion of important organs such as the brain, heart, and kidneys. In many cases, cardiac tamponade has to be treated surgically, and it invariably prolongs hospital stay. If not treated promptly, cardiac tamponade can lead to death. The risk of this dreaded complication has been reported to range from 2 to 6%; however, these rates were observed in tertiary referral centers where the procedure was performed by experienced and skillful operators. Given that the occurrence of cardiac tamponade is largely dependent on the operator’s level of experience and, therefore, is in most cases preventable, higher rates are expected to occur when less experienced operators perform the procedure. These issues prove the need to measure performance in this area.