HEDIS

HEDIS

 

Are you collecting the HEDIS incentive with the Health Plans your Participate  with ?

 The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service. Altogether, HEDIS consists of 81 measures across 5 domains of care. Because so many plans collect HEDIS data, and because the measures are so specifically defined, HEDIS makes it possible to compare the performance of health plans on an "apples-to-apples" basis

 

Sample below shows the requirements to meet the measure for  Comprehensive Adult Diabetes Care ( CDC ):

 The use of the following CPT CATII Codes will identify that a service was performed for the measure:

 

For HbA1c:

3044F: Most recent hemoglobin A1c (HbA1c) level less than 7.0% (DM)

3045F: Most recent hemoglobin A1c (HbA1c) level 7.0-9.0% (DM)

3046F: Most recent hemoglobin A1c level greater than 9.0% (DM)

 

For LDL-C:

3048F: Most recent LDL-C less than 100 mg/dL (CAD) (DM)

3049F: Most recent LDL-C 100-129 mg/dL (CAD) (DM)

3050F: Most recent LDL-C greater than or equal to 130 mg/dL (CAD) (DM

 

For Eye:

2022F: Dilated retinal eye exam with interpretation by an ophthalmologist or optometrist documented and reviewed (DM)

For Foot:

 

2028F: Foot examination

performed (includes examination through visual inspection; sensory exam with monofilament; and pulse exam - report when any of the 3 components are completed) (DM)

 

Understanding what is required for each HEDIS measure is key to the practice and your continued  participation with the various Health Plans. When the  Health Plans Score successfully  you the provider receive the incentive.

 

AccuChecker provides a HEDIS Module to assist you  in understanding each HEDIS measure and shows how to correctly code to qualify for the Measure.

 

www.accuchecker.com

For more details, a Free Trial or Webinar call : 305-227-2383  or 1-877-938-9311

 

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