Measure ID: MIPS 351|Orthopedics|2026 Performance Year

Total Knee or Hip Replacement: Venous Thromboembolic and Cardiovascular Risk

Percentage of patients regardless of age undergoing a total knee or total hip replacement who are evaluated for the presence or absence of venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., History of Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), Myocardial Infarction (MI), Arrhythmia and Stroke).

Process – High PriorityOrthopedicsPatient Safety

Last updated: January 15, 2026

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Measure Specification

Denominator (Eligible Population)

All patients, regardless of age
ANDPatient procedure during the performance period
ORPerformance Not Met: Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of DVT, PE, MI, arrhythmia and stroke, reason not given) (G9299)

Denominator Exclusions

None

Numerator

Patients who are evaluated for the presence or absence of venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of DVT, PE, MI, arrhythmia and stroke).

Submission Codes (QDCs)

✓ Performance Met
G9298Patients who are evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of DVT, PE, MI, arrhythmia and stroke)
✗ Performance Not Met
G9299Patients who are not evaluated for venous thromboembolic and cardiovascular risk factors within 30 days prior to the procedure (e.g., history of DVT, PE, MI, arrhythmia and stroke, reason not given)

Denominator Exceptions

None — this measure has no denominator exceptions.

🧮MIPS Score Simulator

Estimate only — actual CMS scoring may vary based on reporting method, data completeness, and annual rule updates.

%Benchmarks vary by collection type
💡 Tip: Enter your performance rate to compare MIPS points across all collection types. The same rate can score differently depending on how you submit.
VBCA Insights

💡Why This Measure Matters

Knee and hip replacement patients face real risks: blood clots (DVT/PE) and heart problems in the postoperative period, especially if they have prior cardiac events or clot history. This measure ensures you're documenting a risk assessment within 30 days before surgery, checking for prior MI, arrhythmia, stroke, or thromboembolism. That assessment guides whether you need prophylactic blood thinners, extra monitoring, or modified surgical plans. Knowing the risk prevents catastrophe.

📖Clinical Rationale

Prior to a total knee or total hip replacement, the patient’s venous thromboembolic and cardiovascular risk should be evaluated. A population-based study of all Olmstead County, Minnesota, patients undergoing a total hip or knee arthroplasty from 1994 - 2008, reported that patients undergoing a total hip or total knee arthroplasty with a previous history of a cardiac event or a thromboembolic event were associated with an increased risk of a 90-day cardiac or thromboembolic event following surgery.

A study using the Danish national resident registries compared all patients undergoing a primary total hip replacement and total knee replacement from 1998 – 2007 to control groups not undergoing one of the procedures and found that the MI rate 2 weeks after total knee replacement was increased 31-fold compared to the control group. The MI rate 2 weeks after total hip replacement was increased 25-fold compared to the control group.

Any preoperative disease state should be identified and managed prior to surgery to minimize the risk of the surgical procedure. This measure is designed for use by physicians and eligible health care professionals managing ongoing care for all patients undergoing a total knee or hip replacement. This measure addresses the preoperative period.

📝Clinical Recommendations

Perioperative mortality and morbidity due to coronary artery disease (CAD) are untoward complications of noncardiac surgery. Major adverse cardiac events (MACE) after noncardiac surgery is often associated with prior CAD events. The stability and timing of a recent MI impact the incidence of perioperative morbidity and mortality. A validated risk-prediction tool can be useful in predicting the risk of perioperative MACE in patients undergoing noncardiac surgery. (Class IIa Level of Evidence: B)

📋Implementation Notes

This measure contains one strata defined by a single submission criteria. This measure produces a single performance rate. For the purposes of MIPS implementation, this procedure measure is submitted each time a procedure is performed during the performance period.

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