{"id":161,"date":"2009-08-20T09:42:56","date_gmt":"2009-08-20T13:42:56","guid":{"rendered":"http:\/\/www.hnetalk.com\/Provider\/?p=161"},"modified":"2009-08-20T09:42:56","modified_gmt":"2009-08-20T13:42:56","slug":"hedis-2010","status":"publish","type":"post","link":"http:\/\/hnetalk.com\/provider\/hedis-2010\/","title":{"rendered":"Hedis 2010"},"content":{"rendered":"

<\/a><\/span><\/p>\n

HEDIS\u00ae 2010 Measures<\/span><\/span><\/strong><\/p>\n

\u00a0<\/p>\n

*Measures that may be<\/span><\/em> collected with medical record review. <\/span><\/span><\/p>\n

We are committed to helping you find ways to save time, positively affect staff efficiencies, and increase patient satisfaction. To that end, we encourage you to use Category II CPT and Category I CPT\/HCPC codes when coding certain services and test results used for HEDIS measures. For your convenience, we have posted a list of Category II CPT codes that affect HEDIS measures. <\/span><\/span><\/p>\n

<\/span><\/p>\n

CPT Catagory II Codes.doc<\/a><\/span><\/span><\/span><\/span><\/p>\n

<\/p>\n

<\/span><\/p>\n

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Prevention and Screening<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure<\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

* Adult BMI Assessment<\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Members 18-75 years of age who had an outpatient visit in the measurement year and had their body mass index documented<\/span>.<\/span> <\/span><\/p>\n<\/td>\n

\n

Documentation in the medical record must include:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Date of the BMI<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>BMI value<\/span><\/p>\n

Members younger than 19 years, documentation of BMI percentile will meet criteria:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>BMI percentile documented as a value (75th<\/sup> percentile)<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>BMI percentile plotted on an age- growth chart. <\/span><\/span><\/p>\n

Documentation of height and weight only does not meet HEDIS criteria.<\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n

\n

*Weight Assessment and Counseling for Nutrition and Physical Activity for Children\/Adolescents <\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Members 2-17 years of age, who had an outpatient visit with a PCP or OB\/GYN and had evidence of the following documented:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>BMI percentile<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Counseling for Nutrition<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Counseling for Physical Activity<\/span><\/strong><\/p>\n<\/td>\n

\n

BMI Percentile documentation must includes:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Date of the BMI and evidence of either<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>BMI percentile<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>BMI percentile plotted on age-growth chart<\/span><\/p>\n

Counseling for Nutrition documentation must includes:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>A note indicating the date and evidence of at least one of the following: <\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Engagement in discussion of current nutrition behaviors<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Checklist indicating nutrition was addressed<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Counseling or referral for nutrition education<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Anticipatory guidance for nutrition<\/span><\/p>\n

Counseling for Physical Activity documentation includes:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>A note indicating the date and evidence of at least one of the following: <\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Engagement in discussion of current physical activity behaviors<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Checklist indicating physical activity was addressed<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Counseling or referral for physical activity education<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Member received educational materials on physical activity<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Anticipatory guidance for physical activity <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

*Childhood Immunization <\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Vaccines must be completed by the 2nd<\/sup> birthday<\/span><\/p>\n<\/td>\n

\n

\u00a7 <\/span><\/span><\/span>4 DTaP\/DT (do not count any before 42 days of age)<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>3 IPV (do not count any before 42 days of age)<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>1 MMR <\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>2 HiB (do not count any before 42 days of age) <\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>3 Hepatitis B<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>1 VZV, positive serology, or documented chicken pox disease before 2nd<\/sup> birthday<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>4 pnemococcal conjugate<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>2 Hepatitis A<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>2 or 3 doses (depending on which vaccine is administered of Rotavius<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>2 influenza (do not count any before 6 months of age)<\/span><\/p>\n

NOTE<\/span><\/strong>: Medical record documentation of \u201cimmunizations are up-to-date\u201d is not<\/strong> acceptable.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

*Adolescent Immunizations<\/span><\/strong><\/p>\n

Vaccines must be completed by the 13th birthday<\/strong><\/span><\/p>\n<\/td>\n

\n

\u00a7 <\/span><\/span><\/span>1 meningococcal conjugate or meningococcal polysaccharide between 11th<\/sup> and 13th<\/sup> birthday<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>1 Tdap or Td between 10th<\/sup> and 13th<\/sup> birthday<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

*Lead Screening in <\/span><\/strong><\/p>\n

Children <\/span>(Medicaid only)<\/span><\/strong><\/p>\n

<\/strong>Children Age 2<\/span><\/p>\n<\/td>\n

\n

Children who received at least one capillary or venous lead test on or before the child\u2019s 2nd birthday.<\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\n

Breast Cancer Screening<\/span><\/strong><\/p>\n

<\/strong>Ages 40-69<\/span> <\/span><\/strong><\/p>\n<\/td>\n

\n

Women who have received a mammogram in the measurement year or one year prior.<\/span> <\/span><\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

*Cervical Cancer Screening<\/span><\/strong><\/p>\n

<\/strong>Ages 21-64<\/span><\/p>\n<\/td>\n

\n

Women who have received a PAP test within the measurement year or prior two years.<\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\n

*Colorectal Cancer <\/span><\/span><\/strong><\/p>\n

Screening<\/span><\/strong><\/p>\n

<\/strong>Ages 50-75<\/span><\/p>\n<\/td>\n

\n

Adults who received one or more of the following screenings:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Colonoscopy in past<\/strong> 10 years<\/strong><\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Double contrast enema <\/strong>(DCBE) in past 5 years<\/strong><\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Fecal occult blood test (FOBT) annually<\/strong><\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Flexible sigmoidoscopy in past 5 years<\/strong><\/span> <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Chlamydia Screening<\/span><\/strong><\/p>\n

<\/strong>Ages 16-24 and presumed sexually active<\/span> <\/span><\/strong><\/p>\n<\/td>\n

\n

Women identified by claims or pharmacy data indicating potential sexual activity<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Annual test for chlamydia <\/span><\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\n

Glaucoma Screening on Older Adults(Medicare only)<\/span><\/strong><\/p>\n

<\/strong>Age 65 and older<\/span> <\/span><\/strong><\/p>\n<\/td>\n

\n

Older adults without a prior diagnosis of glaucoma or glaucoma suspect who received a glaucoma eye exam by an optometrist or ophthalmologist <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Respiratory Conditions<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure <\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Appropriate Testing of Children with Pharyngitis <\/span><\/strong>Ages 2-18 years<\/span><\/p>\n<\/td>\n

\n

Children diagnosed with pharyngitis that were prescribed an antibiotic and received a Group A streptococcus test 3 days before or after the prescription. <\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\n

Appropriate Treatment of Children with Upper Respiratory Infections<\/span><\/strong><\/p>\n

Ages 3 months- 18 years<\/span><\/p>\n<\/td>\n

\n

Children diagnosed with URI and were not dispensed an antibiotic prescription within 3 days of URI diagnosis.<\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\n

Avoidance of Antibiotic Treatment in Adults with Acute Bronchitis<\/span><\/strong><\/p>\n

Ages 18-64<\/span><\/p>\n<\/td>\n

\n

Adults diagnosed with acute bronchitis who were not<\/strong> dispensed an antibiotic prescription. <\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\n

Use of Spirometry Testing in the Assessment and Diagnosis of COPD<\/span><\/strong><\/p>\n

<\/strong>Age 40 and older<\/span><\/p>\n<\/td>\n

\n

Adults with a new (within the measurement year) diagnosis or newly<\/strong> active COPD<\/span><\/p>\n

who received spirometry testing to confirm diagnosis.<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Spirometry testing must occur 730 days prior to or 180 days after the diagnosing event.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Pharmacotherapy Management of COPD Exacerbation<\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Age 40 and older<\/span><\/p>\n<\/td>\n

\n

Adults who had an acute inpatient discharge or an ED encounter with a primary diagnosis of COPD who were dispensed both:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>A systemic corticosteroid within 14 days of discharge<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>A bronchodilator within 30 days of discharge <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Use of Appropriate Medications for People with Asthma<\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Ages 5-50 <\/span><\/p>\n<\/td>\n

\n

Children and adults identified with asthma that received prescription for long-term control of asthma.<\/span><\/p>\n

NOTE<\/strong>: Long acting beta-2 agonists do not count by themselves. They are considered add-on therapy.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Cardiovascular<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure<\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

*Cholesterol Management<\/span><\/strong><\/p>\n

for Patients with <\/span><\/strong><\/p>\n

Cardiovascular Condition<\/span><\/strong><\/p>\n

<\/strong>Ages 18-75<\/span><\/p>\n<\/td>\n

\n

Adults who were discharged alive for any of the following:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Acute myocardial infarction (AMI)<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Coronary artery bypass graft (CABG)<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Percutaneous transluminal coronary angioplasty (OTCA)<\/span><\/p>\n

or <\/strong><\/span>who had:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Diagnosis of ischemic vascular disease for 2 years with each of the following tests in the measurement year: LDL-C screening and LDL-C control <\/span>and had a LDL-C performed.<\/span><\/p>\n

Documentation must include data and results of a LDL-C <\/strong><\/span><\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

*Controlling High Blood <\/span><\/strong><\/p>\n

Pressure<\/span><\/strong><\/p>\n

<\/strong>Ages 18-85<\/span><\/p>\n<\/td>\n

\n

Adults who had a diagnosis of hypertension with blood pressure control (<140\/90) in the most recent blood pressure reading in medical chart in the measurement year:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>The lowest systolic and lowest diastolic reading will be used if there are several BP recorded on the same date the.<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Home BP readings will be used if documented in the medical chart.<\/span> <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Persistence of Beta-<\/span><\/strong><\/p>\n

Blocker Treatment After <\/span><\/strong><\/p>\n

Heart Attack<\/span><\/strong><\/p>\n

<\/strong>Age 18 and older<\/span><\/p>\n<\/td>\n

\n

Adults who were hospitalized and discharged alive after an acute myocardial infarction who received persistent treatment with beta-blockers for six months after discharge.<\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\u00a0<\/td>\n\u00a0<\/td>\n\u00a0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n


<\/span><\/p>\n

\u00a0<\/p>\n

\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Diabetes<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure<\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

*Comprehensive Diabetes<\/span><\/strong><\/p>\n

Care<\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Ages 18-75<\/span><\/p>\n<\/td>\n

\n

Adults with annual screening of the following:<\/span><\/p>\n

    \n
  • HbA1c testing<\/span><\/li>\n
  • HbA1c > 9.0 % = poor control<\/span><\/li>\n
  • HbA1c <8.0%<\/span><\/li>\n
  • HbA1c < 7.0 %= good control<\/span><\/li>\n
  • LDL-C testing<\/span><\/li>\n
  • LDL-C <100mg\/dL<\/span><\/li>\n
  • Retinal eye exam<\/span><\/li>\n
  • Nephropathy screening test or evidence of nephropathy<\/span><\/li>\n
  • Blood pressure < 140\/90<\/span><\/li>\n
  • Blood pressure < 130\/80<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n

Musculoskeletal<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure<\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Disease Modifying Anti-Rheumatic Drug Therapy for Rheumatoid Arthritis<\/span><\/strong><\/p>\n

<\/strong>Age 18 and older<\/span><\/p>\n<\/td>\n

\n

Adults who were diagnosed with rheumatoid arthritis that received at least one prescription for a disease modifying anti-rheumatic drug.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Osteoporosis Management in Women who had a Fracture<\/span><\/strong><\/p>\n

<\/strong>Age 67 and older<\/span><\/p>\n<\/td>\n

\n

Women who received the following within 6 months of suffering a fracture:<\/span><\/p>\n

    \n
  • Bone mineral density (BMD) test<\/span><\/li>\n
  • Rx for a drug to treat or prevent osteoporosis<\/span><\/li>\n<\/ul>\n

    <\/strong><\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Use of Imaging Studies for Low Back Pain<\/span><\/strong><\/p>\n

<\/strong>Age 18 and older<\/span><\/p>\n<\/td>\n

\n

Adults with a primary diagnosis of low back pain who did not <\/strong>have an imaging study within 28 days of diagnosis. <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Behavioral Health<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure<\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Antidepressant Medication Management<\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Age 18 and older<\/span><\/p>\n<\/td>\n

\n

Adults newly<\/strong> diagnosed with depression and treated with an antidepressant who remain on medication. The rates reported are:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Effective acute phase: remained on antidepressant for 84 days of the acute treatment phase<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Effective continuation phase: remained on antidepressant for 180 days<\/span><\/p>\n

To qualify as a new<\/strong> diagnosis, 2 criteria must be met:<\/span><\/p>\n

1.<\/span> <\/span>A 120-day negative depression diagnosis history on or before the start date<\/span><\/p>\n

2. <\/span>A 90-day negative medication history on or before the start date<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Follow-up Care for Children Prescribed ADHD Medication<\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Ages 6-12 years<\/span><\/p>\n<\/td>\n

\n

Children who received an initial prescription for ADHD medication and:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>At least one follow-up visit with a prescribing practitioner within 30 days of medication initiation<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Remained on the medication for at least 210 days and who, in addition to the visit in the initiation phase, had at least two visits within four weeks and nine months.<\/span> <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Follow-up After Hospitalization for Mental Illness<\/span><\/strong><\/p>\n

<\/strong><\/p>\n

Ages 6 and over<\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n

\n

Patient discharged from an inpatient mental health admission and receive at least one ne follow-up outpatient visit, intensive outpatient encounter or partial hospitalization with a mental health practitioner:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>within 7 days of discharge; <\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>within 30 days after discharge.<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n


<\/span><\/p>\n

\u00a0<\/p>\n

\n\n\n\n\n\n
\n

Medication Management<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure<\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Annual Monitoring for Patients on Persistent Medications <\/span><\/strong><\/p>\n

<\/strong>Age 18 and older<\/span><\/p>\n

\u00a0<\/p>\n

\u00a0<\/p>\n

\u00a0<\/p>\n

\u00a0<\/p>\n

\u00a0<\/p>\n

\u00a0<\/p>\n

\u00a0<\/p>\n

<\/strong><\/p>\n<\/td>\n

\n

Adults on persistent medications (at least 180 days) who received the following annual lab test monitoring:<\/span><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Medications <\/strong><\/span><\/p>\n<\/td>\n

\n

Annual monitoring lab test(s)<\/span><\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

ACE inhibitors\/ ARBs<\/span><\/p>\n

Digoxin<\/span><\/p>\n

Diuretics<\/span><\/p>\n<\/td>\n

\n

Serum potassium (K+) and either <\/strong>serum creatinine (SCr), or<\/strong> blood urea nitrogen (BUN)<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Anticonvulsants:<\/span><\/p>\n

Carbamazepine<\/span><\/p>\n

Phenobarbital<\/span><\/p>\n

Phenytoin<\/span><\/p>\n

Valproic Acid<\/span><\/p>\n<\/td>\n

\n

Anticonvulsants drug serum concentration<\/span><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\n

Potentially Harmful Drug-Disease Interactions in the Elderly<\/span><\/strong><\/p>\n

(Medicare only) Age 65 and older<\/span><\/p>\n<\/td>\n

\n

Older adults who have an underlying disease, condition or health concern and who received an ambulatory prescription for a contraindicated <\/span><\/p>\n

medication, at the same time or after the diagnosis.<\/span> <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Use of High-Risk Medications in the Elderly <\/span><\/strong>(Medicare only)Age 65 and older<\/span><\/p>\n<\/td>\n

\n

Older adults who have received at least one high-risk medication and older adults who have received at least two different high-risk medications.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measures Collected through CAHPS Health Plan Survey<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure<\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Flu Shots for Adults <\/span><\/strong><\/p>\n

<\/strong>Ages 50-64<\/span><\/p>\n<\/td>\n

\n

Adults who received an annual flu shot.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Flu Shots for Older Adults<\/span><\/strong><\/p>\n

(Medicare only) Age 65 and older<\/span><\/p>\n<\/td>\n

\n

Older adults who received an annual flu shot.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Medical Assistance with Smoking Cessation <\/span><\/strong><\/p>\n

Tobacco users 18 and older<\/span><\/p>\n<\/td>\n

\n

Current smokers who were seen by a practitioner and:<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Advised to quit smoking<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Cessation medications were recommended or discussed<\/span><\/p>\n

\u00a7 <\/span><\/span><\/span>Cessation strategies were recommended or discussed<\/span><\/p>\n

\u00a0<\/p>\n<\/td>\n<\/tr>\n

\n

Pneumonia Vaccination Status for Older Adults <\/span><\/strong>(Medicare only)<\/span><\/p>\n

Age 65 and older<\/span><\/p>\n<\/td>\n

\n

Older adults who received a pneumococcal vaccine<\/span>.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Access\/Availability of Care<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure<\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Adult Access to Preventive\/Ambulatory Care<\/span><\/strong><\/p>\n

<\/strong>Age 20 and over<\/span><\/p>\n<\/td>\n

\n

Adults with annual ambulatory or preventive care visit.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Children and Adolescents\u2019 Access to PCPs<\/span><\/p>\n

Age 12 months to 19 years<\/span><\/p>\n<\/td>\n

\n

Children and adolescents with a visit with their primary care physician.<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Initiation and Engagement of Alcohol and Other Drug Dependence (AOD) Treatment<\/span><\/strong><\/p>\n

Age 13 and older<\/span><\/p>\n<\/td>\n

\n

Adolescents and adults diagnosed with alcohol and other drug dependence who:<\/span><\/p>\n

    \n
  • Initiate treatment within 14 days<\/span><\/li>\n
  • Receive at least 2 AOD services within 30 days of treatment initiation<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n

Prenatal\/ Postpartum Care<\/span><\/strong><\/p>\n

<\/strong>Pregnant Women<\/span> <\/span><\/strong><\/strong><\/p>\n<\/td>\n

\n

Women who have received:<\/span><\/p>\n

    \n
  • Prenatal visit within first trimester (or within 42 days of enrollment)<\/span><\/li>\n
  • Postpartum visit between 21 and 56 days after delivery<\/span><\/li>\n<\/ul>\n

    \u00a0<\/p>\n<\/td>\n<\/tr>\n

\u00a0<\/td>\n\u00a0<\/td>\n\u00a0<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n


<\/span><\/p>\n

\u00a0<\/p>\n

\n\n\n\n\n\n\n\n
\n

Use of Services<\/span><\/p>\n<\/td>\n<\/tr>\n

\n

Measure <\/span><\/p>\n<\/td>\n

\n

Screening, test or care needed <\/span><\/p>\n<\/td>\n<\/tr>\n

\n

*Well-child Exams<\/span><\/strong><\/p>\n

Ages 0-15 months<\/span><\/p>\n<\/td>\n

\n

6 well-care visits (at least 2 weeks apart) with a PCP. Must show evidence of all of the following:<\/span><\/p>\n

    \n
  • Health and development history (physical and mental)<\/span><\/li>\n
  • Physical exam<\/span><\/li>\n
  • Health education\/anticipatory guidance<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n

*Well-child Exams<\/span><\/strong><\/p>\n

Ages 3-6 years<\/span><\/p>\n<\/td>\n

\n

At least one well-care visit with a PCP or OB\/GYN. Must show evidence of all the following:<\/span><\/p>\n

    \n
  • Health and development history (physical and mental)<\/span><\/li>\n
  • Physical exam<\/span><\/li>\n
  • Health education\/anticipatory guidance<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n
\n

*Adolescent Well-Care Visit<\/span><\/strong><\/p>\n

Ages 12-21 years<\/span><\/p>\n<\/td>\n

\n

At least one well-care visit with a PCP or OB\/GYN. Must show evidence of all the following:<\/span><\/p>\n

    \n
  • Health and development history (physical and mental)<\/span><\/li>\n
  • Physical exam<\/span><\/li>\n
  • Health education\/anticipatory guidance<\/span><\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    \u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"

    HEDIS\u00ae 2010 Measures<\/p>\n

    *Measures that may be collected with medical record review.<\/p>\n

    We are committed to helping you find ways to save time, positively affect staff efficiencies, and increase patient satisfaction. To that end, we encourage you to use Category II CPT and Category I CPT\/HCPC codes when coding certain services and test results used for HEDIS measures. For your convenience, we have posted a list of Category II CPT codes that affect HEDIS measures. <\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[4],"tags":[],"class_list":["post-161","post","type-post","status-publish","format-standard","hentry","category-informational-purposes-only"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p6ZZHB-2B","_links":{"self":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/161","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/comments?post=161"}],"version-history":[{"count":0,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/posts\/161\/revisions"}],"wp:attachment":[{"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/media?parent=161"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/categories?post=161"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/hnetalk.com\/provider\/wp-json\/wp\/v2\/tags?post=161"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}