HEDIS® measurement year 2023 documentation for Childhood Immunization Status (CIS)

 

Measure description: The percentage of children who turn 2 years of age in the measurement year who had the following vaccines on or before their second birthday:

  • Four DTaP (diphtheria, tetanus, and acellular pertussis)
  • Three IPV (polio)
  • One MMR (measles, mumps, and rubella)
  • Three HiB (haemophilus influenza type B)
  • Three hep B (hepatitis B)
  • One VZV (chicken pox)
  • Four PCV (pneumococcal conjugate)
  • One hep A (hepatitis A)
  • Two or three RV (rotavirus)
  • Two flu (influenza)

 

The measure calculates a rate for each vaccine and three combination rates.

 

HEDIS measurement year 2023 documentation for Lead Screening in Children (LSC)

 

Measure description: The percentage of children 2 years of age who had one or more capillary or venous lead blood test for lead poisoning by their second birthday.

 

In provider medical records, we look for the following:

  • Immunization records from birth (Department of Health immunization records are acceptable).
  • If available, newborn inpatient records documenting hepatitis B.
  • For immunizations not recorded on the immunization record, provide progress notes for:
    • Immunizations administered.
    • Patient’s history of disease (chickenpox, hep A, hep B, measles, mumps, rubella).
  • Lead testing results and date (capillary or venous) on or before the second birthday.
  • Evidence of hospice services in 2023.
  • Evidence patient expired in 2023.

 

Helpful hints:

  • Childhood immunizations and lead blood tests must be completed by child’s second birthday.
  • Assess immunization needs at every clinical encounter and, when indicated, immunize.
  • Ensure immunization records include all vaccines that were ever given including hospitals, health departments, and all former providers, including refusals and contraindications.
  • FluMist (LAIV) vaccination (only approved for ages 2 to 49) may be used for the second vaccination; however, it must be given on the child’s second birthday to be compliant.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).


Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Maine, Inc. Independent licensee of the Blue Cross and Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.


MEBCBS-CM-012255-22-CPN11878



Featured In:
January 2023 Provider Newsletter - Maine